2nd night cpap report

Here are the reports from my 2nd day of Cpap--had a short nap, and then 6.5 hours during the night. I had
bumped the pressures from a low of 5 to 6, and a high of 8 to 10.

The leak peaks are when I tore my mask off to adjust it, get a drink of water, or go to bathroom. I noticed that on the LED Detailed Data, the leak said .14 L/s, (mask-on time only). Is this a more accurate figure to use?

My inner geek is going crazy with all this stuff. I'm so glad I followed the advice here, and got the software.

Katie,
You're doing great. For a 2nd night, I'm jealous. Now I'm not a doc, and I have all of 3 months of experience. you AI of 0.6 is very good, and you're HI of 3.5 is not that bad. (Magic number is to have AHI less than 5).

If you're feeling good, you might want to stay where you're at. But if you're looking for the perfect "sweet spot", you might still want to increase your settings, as you're hitting your max pressure setting 95% of the time.

If you can tolerate, I'd raise the minimum to 9 and max to 12 or 13. Maybe others will have similar recommendations.

But with your results, there is no reason to rush anything. Looks like you're doing great. And at two days. WOW.

You are doing great! I would leave everything alone for a few nights and just keep an eye on the charts. If after afew nights(a week is better) you still feel the need, go ahead and make a change. But remember to make only 1 change at a time, and give each change a few nights to allow yourself to adjust to them.

Brenda

Katie, that is an excellent second night--your AHI is already in the normal range. That didn't take long, and that much compliance to start is great!!!

Katie, you're really off to a great start. I have a feeling you're going to be an inspiration to all of us.

Fantastic, Katie! Again, I agree with GaryG about raising your pressure. Your median is 9.8cm and 95% is 10, so I'd raise the minimum pressure to 9 and max pressure to 13.

As others have said, you don't want to change things too quickly, but maxing out like that, I'd make the change and see what happens.

Katie,

It looks to me like 4 of the 5 events that are marked on your chart came during the initial ramp up when the machine was adjusting from the lower pressure to the higher pressure. You might want to bump up the low end pressure so the machine doesn't have to take time to ramp up. That might have kept those 4 events from happening.

The 13 second event was when the machine was maxed out on the high number. That suggests that you might be able to make use of a little more pressure on the high side, but at the same time, that event might have happened more quickly than what the machine could have reacted to. It will be interesting for you to watch that over time. A few random events like this per night is probably not going to ruin your sleep, and they might be hard to totally get rid of. For example, finding the pressure where you don't have any events, then locking the machine into CPAP mode rather than auto mode might do the trick.

Since you are doing pretty good right now with a low AHI, you might want to let things settle down and build up some adjustment time to get used to it...perhaps after taking GaryG's advice on the settings.

Another geek experiment to try is different sleeping positions. Some folks are very sensitive to position. For example, there is no pressure high enough for me if I sleep on my back. Some folks need much less pressure when on their side, and for others, it makes no difference. Raising your head up a bit can also make a difference.

-john-

Thank you everyone, I really appreciate your comments. This is so new for me, and I'm still getting used to the mask, the swooshing sound of the air, being tethered to a hose, etc. I think introducing changes in small increments is a good idea. Tonight I will raise my min and max pressures by 1 cmH2O and see what happens.

At my sleep study, my AHI was 55.6, AI 11.6, HI 44. So I'm pleased to see these numbers, and that I'm responding to cpap therapy. I am mindful about being patient, and not just striving for perfect numbers.

John, your analysis of the apneas was very interesting, and makes sense. Thanks.

This process is so empowering, isn't it?

Ok, bumped my pressures up last night, to min 7, max 11. And I found my threshhold for gastric insufflation. I didn't know what was happening, so stumbled out to my computer, came to this forum, and did a search under "gas". Saw a long list of posts, and realized it's a common problem. Took some Maalox and went back to bed, propped up with pillows, and no cpap (since I figured I already had enough gas).

This morning, I have read everything I can find. Thank you to Old Lincoln for his excellent explanation: Bloating is the evil twin of CPAP therapy.
viewtopic.php?f=1&t=37517&p=327082&hili ... ed#p327082

and suggestions at:
viewtopic.php?f=1&t=38809&p=387846#p387846

and Rooster, for the tummy sleeping position:
viewtopic/t43663/Aerophagia--How-It-Was ... -Case.html

and to pjwalman and sleepydoll for their suggestions in:
viewtopic.php?f=1&t=32020&p=273358&hili ... ed#p273358

It helps to know that it's a common occurrence and that there are things to try. As Scarlet said "tomorrow is another day."

Ok, bumped my pressures up last night, to min 7, max 11. And I found my threshhold for gastric insufflation. I didn't know what was happening, so stumbled out to my computer, came to this forum, and did a search under "gas". Saw a long list of posts, and realized it's a common problem. Took some Maalox and went back to bed, propped up with pillows, and no cpap (since I figured I already had enough gas).

This morning, I have read everything I can find. Thank you to Old Lincoln for his excellent explanation: Bloating is the evil twin of CPAP therapy.
viewtopic.php?f=1&t=37517&p=327082&hilit=gas+bloated#p327082

and suggestions at:
viewtopic.php?f=1&t=38809&p=387846#p387846

and Rooster, for the tummy sleeping position:
viewtopic/t43663/Aerophagia--How-It-Was-Finally-Solved-in-My-Case.html

and to pjwalman and sleepydoll for their suggestions in:
viewtopic.php?f=1&t=32020&p=273358&hilit=gas+bloated#p273358

It helps to know that it's a common occurrence and that there are things to try. As Scarlet said "tomorrow is another day."

Gas is extremely common, as you're walking a tightrope between the minimum pressure that keeps your airway open, and the pressure that will force air down your digestive tract. Without getting into specifics that have been debated here before, gas is a side effect of finding the appropriate pressure, and is something with which to deal. Keep your Gas X around, for the time that it gets intolerable--I find that works well with bloating and noxious posterior emissions.

Katie, you were doing fine the previous night and your 95% percentile and max were both 10. I wonder if maybe you should just have a constant pressure of 10.

Katie, what did the data tell you? Were you hitting the max most of the night? Just my opinion, but you might want to give your original settings a few more nights until you really establish a better picture of where your "sweet spot" is going to be and also avoid all that discomfort right now when you're still adjusting to this new life. In the beginning I made too many changes too soon and got thoroughly confused as to what settings were and were not working. It takes patience which is not my strong suit, but I 'm learning. Dori

DoriC wrote:Katie, what did the data tell you? Were you hitting the max most of the night? Just my opinion, but you might want to give your original settings a few more nights until you really establish a better picture of where your "sweet spot" is going to be and also avoid all that discomfort right now when you're still adjusting to this new life. In the beginning I made too many changes too soon and got thoroughly confused as to what settings were and were not working. It takes patience which is not my strong suit, but I 'm learning. Dori

Yes Dori, I'm being too impatient. Would I rather have a few AI and HI and a lower pressure. Or a higher pressure, with better numbers, but the discomfort of bloating....duh.

KatieW wrote:I'm being too impatient. Would I rather have a few AI and HI and a lower pressure. Or a higher pressure, with better numbers, but the discomfort of bloating....duh.

It's your body and your therapy but your numbers weren't bad to start with. I am still relatively new at this cpap thing (nearly 5 months) and I still see variations in AHI from less than 1 to 5. Even with no leaks to speak of.
If the added pressure causes discomfort then back off for a while. Give your therapy a chance to settle in and see where it wants to land and see how you are feeling as well. It is very possible that the 4.1 AHI you had could have ended up cut in half the next night on the same pressures. These numbers can and do vary from night to night depending on many possible factors besides just the pressure.

It doesn't help things much to strive for that perfect number and ruin your entire night of sleep in the process from painful abdominal discomfort from the air. It is not about just numbers, we have to look at how we feel overall.
Just my opinion. While I do understand the data thing, please don't lose sight of the big picture. The numbers can drive you nuts if you let them.

The best advise I have seen on this forum is to give yourself time and observe your response to settings. Here we have someone with two days in, and a pretty successful therapy, that made changes that totally removed them from therapy. Make small changes, one thing at a time, and watch the results for as long as a week before changing something else. In this case, go back to your original settings and at least get a baseline for your response to XPAP. It will take you several weeks just to settle in and become acclimated.