CPAPtalk.com

Thanks for all suggestions:

1-mask setting is very comfortable. it is the best I ever invented for my own level of comfort

2- Congestion yes, but I take Afrin every night to resolve it for now till I take more aggressive measure

3- wieght: actually in last 2 months I lost 15 pounds intentionally (2 pound/week) and that should improve the apnea (my weight now is 205 )

4- Medications: well all what I am taking is Simvastatin for cholesterol and Lexapro for depression. neither are known to cause more apnea. actually Lexapro should improve apnea.

5- Alcohol intake: No, only once a week (weekend) so it is not part of the equation at all- the rest of the week I am totally dry

6- Back sleep yes. around 50% of the night. Now I thought when I am on APAP, that this will be my share of discomfort in my sleep, I don't have to put a ball in my back and force side sleeping !!!


to answer ozij: every time I raise the pressure I wait 3-4 days to make sure of the results. I plan to use fixed CPAP on 16 as a trial

williamco wrote:Thanks for all suggestions:

1-mask setting is very comfortable. it is the best I ever invented for my own level of comfort

2- Congestion yes, but I take Afrin every night to resolve it for now till I take more aggressive measure

3- wieght: actually in last 2 months I lost 15 pounds intentionally (2 pound/week) and that should improve the apnea

4- Medications: well all what I am taking is Simvastatin for cholesterol and Lexapro for depression. neither are known to cause more apnea. actually Lexapro should improve apnea.

5- Alcohol intake: No, only once a week (weekend) so it is not part of the equation at all- the rest of the week I am totally dry

6- Back sleep yes. around 50% of the night. Now I thought when I am on APAP, that this will be my share of discomfort in my sleep, I don't have to put a ball in my back and force side sleeping !!!


to answer ozij: every time I raise the pressure I wait 3-4 days to make sure of the results. I plan to use fixed CPAP on 16 as a trial

Serious problem there! Go up to the search line and put in "Afrin" and start reading. The rebound effect makes your problem worse.

Back-sleeping (supine position) is the worst for apneas and probably why you're needing such a high pressure. Try to teach yourself to sleep on your side.


Den

Den: so far I haven't experienced rebound issue from Afrin, so for the sake of exclusion this is not a factor for now

back sleeping: do you think people with high pressure should all be side sleepers? what I mean, is this a big issue for all high pressure- is it common issue among people with high pressure?

I just saw my Dr. last Friday, and asked what is the max. pressure. He said 40.

Hope that helps!

Thanks lovecollies.
I am going to change my username to " Balloon "

williamco wrote:Den: so far I haven't experienced rebound issue from Afrin, so for the sake of exclusion this is not a factor for now

back sleeping: do you think people with high pressure should all be side sleepers? what I mean, is this a big issue for all high pressure- is it common issue among people with high pressure?

The use of Afrin should be limited to ONLY three nights. Find something else! Do nasal rinses before bedtime.

Positional sleep apnea has been an issue for quite a few on the forum.

Rooster was able to cut his pressure needs in half by switching to side-sleeping.

viewtopic/t40307/viewtopic.php?f=1&t=40 ... 94#p352594


Den

William, just a word of caution, Afrin is a big no,no except for maybe a night or two when absolutely necessary. Besides the rebound affect causing more congestion, it can sometimes be addicting. I've had asthma, mild COPD and chronic sinusitis for many years so I'm aware of all the pitfalls. For my particular situation I've used prescription nasal sprays for years, which does not cause any problem when used as directed. Another word to the wise, you'll never go wrong taking suggestions from the experts giving you advice here. They're the best! Dori

Another word to the wise, you'll never go wrong taking suggestions from the experts giving you advice here. They're the best!

absolutely I am very open to all suggestion and I will work on it. that why I ask and read your posts.
as I always say: thanks for all suggestions

The use of Afrin should be limited to ONLY three nights.

Hmmm, maybe that's it !! I'm sleeping longer & deeper, but feel worse !! I stopped using Afrin a week ago. My AHI has increased, such as today it was 7.3

I still wake up 1-2 times a night from severe nasal congestion, the past few nights. When I slept 6 hours, no sleep disturbance with Afrin.

williamco wrote:millich , the reason I am scared is not that I am at pressure 16, but it is the speed I am going at
3 months ago when I started, the machine was topping at 10-11 cmH20
then gradually the machine started to creep up till 15 in a matter of 2 months
last week my AHI started to creep up from 2.5 to 3 to 4.5 and the machine started to creep up on the pressure to 17

Why do you have your machine set to such a wide range of pressures? You should only have a 4cm or so gap. Why don't you set your upper limit to say 14cm for a few nights and see how that goes?

A move from 2.5 AHI to 4.5 is not much. Did you have any centrals on your sleep study? Higher pressures can increase your AHI if your having centrals.

An please consider getting off the afrin, it will only cause you problems. Maybe you need more pressure because your getting rebound during the night and don't realize it? Use a neti pot, take nasal steroids, and/or have turbinate reduction surgery... just don't keep taking Afrin!

williamco wrote

back sleeping: do you think people with high pressure should all be side sleepers? what I mean, is this a big issue for all high pressure- is it common issue among people with high pressure?

I have Positional Sleep Apnea. Sleeping on my left side all night results in a very restful sleep and an AHI of less than 0.3. If I sleep on my right side, my AHI approaches 3 (10X increase) and I feel tired the next day. Sleeping on my back results in a much Higher AHI. For example, I did an experiment in August to support a study that I was conducting where I needed to create a high AHI. I slept on my back at a pressure of 10 cmH2O (vs 8 normally) for about an hour and had 23 Apneas - an AHI of 23. Only did it once as I am a quick learner - No more back sleeping for me!

I trained myself, like Rooster and others, to NOT sleep on my back. It took me a month - I used a tennis ball attached in the middle of my nightshirts plus three large pillows as wedges. I'm now working on sleeping on my left side all night. I can do it most nights but, sometimes, my neck gets sore from sleeping on my left side, and I sleep on my right side for part of the night. Taking 2 - 3 Tylenols at night (none during the day) has been a big help in allowing me to sleep on my left side all night. I consider the Tylenols a small price to pay for a more restful sleep. Please note that I still use three pillows as wedges to keep me sleeping on my side (either left or right).

I'm unwilling, as is Rooster, to increase my pressure to the point where I could sleep on my back without a high number of events. I'm not even willing to do it for any future studies!

Weight loss can reduce pressure need for some people. Pressure induced apneas -- which happen sometimes when the pressure is too high -- can make the machine raise its pressure in a vicious cycle.

williamco, you never mention a PSG, diagnosis or titration in any of your post, you haven't replied to my questions about that. I take it you're self diagnosed, and self titrating. Self medicating with Afrin as well.

Den and Dori have said all that needs to be said about Afrin.

Raising pressure after 3-4 days at one level is a mistake -- you body has to get used to sleeping at a certain pressure and unless you get horrid results (AHI much higher that 5, ditto for desaturations) you should stay at a new pressure for 2 weeks - or even a month.

I would run the first night or 2 at a fixed pressure of 10 or 11, and move higher only if the AHI there exceeds 5, or you get desaturations. I'm suggesting 10 because that's the vicinity where the majority do well, and I'm not sure you gave it a fair trial when you were there.

Not sure what makes you think Lexapro should improve your sleep disordered breathing --

O.

jskinner : no I didn't have wide range- I was moving in 2-3 points range and when the machine starts to reach upper limit and stay there for extra time and AHI was getting up, only then I move the range up. I will take measures to stop Afrin yes, I will start on Nasal steroids till I do the surgery "turbinate reduction"

cinco777 : Wow! it is not only side sleeping but I even need to check which side is better - from AHI 0.3 to 3 .. !!! interesting point

ozij : yes I am self diagnosed and treated. I came from a forum "www:apneasupport.org" who used to blast people who self diagnose and treat and I didn't want to be subjected to the same attacks here too, so I tried to avoid this question but you cornered me

now you say that I need to take 2 weeks to a month on each point up before I move up again, that will take almost a year if my pressure is in upper 10s . my main guid was titratation by symptoms and relief. if I am still tired after 3-4 days or AHI is high above 5, I move up
last stop was 15-17 cmh2o and AHI gradually reached 5.5 - so tonight I am starting on 16-18 cmh2o, tomorrow will do it CPAP 16
am I wrong in this move?

regarding your question about Lexapro: some doctors have tried antidepressants to treat mild forms of apnea with some success- I have friend of mine who was on CPAP but got off it after his Doctor put him on another type of antidepressant, TCA (tricyclic)

I think the idea was that depression inhibit every neural function in the body including muscle tone (mood, appetite, energy, sexual, muscle tone which contibute to fatigue,..etc) as such, some antidepressant might help by indirectly increasing muscle tone in the process of treating depression

williamco wrote: back sleeping: do you think people with high pressure should all be side sleepers? what I mean, is this a big issue for all high pressure- is it common issue among people with high pressure?

Most people who use XPAP treatment find out that side sleeping lowers their need for pressure. It's your choice, how and what you use, all we can help with is the facts. I use 15 CM with no problems with the pressure but my data shows when I am on my back my AHI goes up. I sometimes go to sleep on my back at the start of sleepI then wake up (from a apnea event),and turn on my side. Jim

I say 2 weeks or even a month, unless the result are unbearable. I'm not saying stick to a pressure that gives you an AHI of 10. I am saying you should be more relaxed about small changes in your AHI. If the machine reaches the top of the range, that's no reason to move the minimum up. Maybe you need high pressure only in one position? Maybe you need high pressure only in REM?

I still think you should start at a lower fixed pressure -- it will give you important information about how to continue. Driving a narrow pressure range further and further upwards in no way to go about finding your optimal pressure.

Often, the body and brain need time to adapt to whatever pressure is thrown at us. Which is why, if I were in your situation, I would get myself a base rate of a few nights at 10 -- with software to see what is going on.

I also think that a 10-20 range for getting an indication of your optimal pressure -- left like that for a week - is a good alternative way of using an APAP. Mind you, we're talking titration, not optimal therapy; Done like that, you get a pretty reliable indicator of what a sleep lab would have recommended. You may discover your optimal therapy is a specific fixed pressure, and you may discover automatic mode is better for you. But either way, you can't rush the process. You really need more patience. Please read links in the first post of this thread: viewtopic/t35702/Where-A-CPAP-Newbie-Should-Start.html

We don't blast people here for trying to treat themselves. We don't blast self-diagnosis either, but it is more problematic -- since sometimes, once obstructions are treated, other sleep disorders are revealed. If you want to treat yourself, you owe it to yourself to become knowledgeable.

I hope your friend checked his oxygen saturation after he got off CPAP.

O.