About to have my first night at home with the CPAP...

Popinka,

You asked for comments on your original query.

I think you need to provide more info on the indexes provided.

Is your index of 16 for Apnea, Hypopnea or both. What about the 47 ?

Are they obstructives or Centrals ?

What was your Oxygen Saturation level.

Since you're in Canada, I presume your sleep report is similar to mine (from Quebec).

I have a total "arousal" index of 35, while 18 of them are related to respiratory events. The balance are awakenings of unknown origin. I suspect you are the same, meaning you awaken 45 times an hour (every 1.3 minutes) , and 16 of them are due to respiratory events. If that's the case, it could be good news since many cases of obstuctive apnea can cured by losing weight. You would then need to address what is causing the other arousals (which is my current situation).

5-15 Apneas per hour (your index) is considered mild.

If you are having multiple arousals from REM sleep (again, you may not even know it), this means everytime you try to dream, you probably stop breathing and your brain wakes you up enough just to say, start breathing.

Insufficient REM sleep is believed to be the cause of many mental/emotional problems since REM repairs the mind, while stages 3 and 4 repair the body.

A sore throat is common during the beginning stages of treatment.

Regards

Hi Popinka,

Can you talk to someone at the sleep lab where you had your study? It sounds like the service person at your DME is not going to be much help. You said you woke up with a sore throat. This would make me think you are having leaks through your mouth. This could also cause the bad results. Do you have a heated humidifier with your cpap? This would probably do more to help your results than bumping up your pressure 1cm. It's good your asking about an autopap. If you had one it would take care of setting your pressure exactly where you need it. It would also (with the software) tell you if you are having any leaks that could be causing the problems. Ask for an autopap and if they give you a hard time about it drop a hint that your a litigation attorney. That may prompt them to be cooperative. I'm not suggesting you strong arm them but it irritates me when people have all these unecessary difficulties that could be quickly resolved with the help of an autopap and some software. The quality of your sleep should not be a trial and error proposition when the (affordable) technology is available to avoid that.

Thank you guys.

"Wade" in the other forum you suggested CPAP.com. How do you service the CPAP, adjust the pressure when you purchase online?

A heated humidifier --- what does it do exactly (I do have one on the trial c-flex but have not turned on the "heat" option b/c I quite enjoy the cool breeze).

You'd get it serviced same as you would if you bought locally. You send it to cpap.com and then rent a machine (locally) while yours is getting fixed. Many of us have a puchased a back-up just in case. You can buy the basic Puritan Bennett 420G fixed cpap for $299. It would probably cost you that much to rent one for a month or two. Whether or not you buy online, if something goes wrong the machine it will go back to the manufacturer for repairs. The great thing about cpap.com is that a knowledgable person will answer the phone 8am till 10pm. Try to get that kind of service locally.

The heated humidifier is not necessarily to make the air feel warm. Warm air hold more moisture than cold air. The constant air flow from a cpap can really dry you out and cause all kinds of sinuse problems. The heated humidifier allows enough moisture to be carried in the air so that your sinuses will stay moist. This is one reason you may have a sore throat.

Popinka,

As far as adjusting the pressure. You'll get the instructions along with the machine regarding how to adjust the pressure. You should only do so based on your doctors instructions though. A side note...If you purchase the auto-pap it does the adjusting for you. Keeping you at just the right pressure only when you need it. You spend the rest of the time blissfuly at a low 4-6cm depending on what the minimum pressure is set at. This can go a long way to making your experience a more comfortable one.

Echoing all of Wader's great suggestions.

Popinka, I'd far rather trust my treatment at the "hands" of an autopap machine bought online than in the hands of a local supply company where an employee has not even heard of an autopap machine.

The single pressure arrived at as your "prescribed" pressure based on your sleep study may or may not keep your airway sufficiently open all night, especially when you are sleeping at home, in your own bed - not in the sleep clinic. You're right that a pressure could be enough to prevent apneas (full closure of the airway) yet not be quite enough to keep it open as much as it should be. Partial closure would be an hypopnea. You can also have "limited air flow" if the partial closure is even less than the amount of partial closure that is defined as an hypopnea. Any way you look at it, you're not getting enough air unless the pressure is right for you at all times, in all sleeping positions, in all sleep stages. The time you spent being "titrated" at the sleep clinic is but a single snapshot of however long you slept there. It's usually pretty accurate, but is certainly not set in stone forevermore. An autopap machine used at home can vary automatically up and down all night long, depending on what your throat is doing while you sleep and what pressure is really needed to keep it open.

The fact that a prescribed single pressure is approximate and might not always be exactly what you need to keep the throat open is borne out by another fact - the fact that someone at the local supply store is authorized to up the pressure a notch, or maybe even two.

Again... if anyone's going to be guessing about what pressure I might need, I'd rather put the guesswork into my own hands. I'll do my own research (the message boards are a wonderful resource) and will use my own autopap and software - to treat myself. Some would rather trust a busy doctor or an oft clueless DME. I choose to do it myself, with the help of autopap, software, and the advice of experienced users on the message boards. I'll have only myself to sue. However, it's going great for me.

An autopap increases pressure if it senses your not breathing. And, a little pressure may not help at all, and a lot of pressure will cause problems you don't want to have.

Peter