Feel like I'm suffocating

You can buy 3M micropore tape in drugstores (not hard to get off in the a.m.) but ask for it because it may not be easy to locate in the aisle! A lot of us have used that. It's a good idea to fold over one end by 1/8 of an inch for a pull to get it off in the a.m. or any time.

flyingwithoutwings wrote:When I got home from work I got a call from my PCP because she received a fax from DME saying that I was refusing treatment. Way to go!

Wow! How totally snarky that DME sounds!

flyingwithoutwings wrote:she received a fax from DME saying that I was refusing treatment. Way to go!

That's sort of what happened with me with the first DME that I fired...I never brought the machine home...saw it and flat out refused it...and they refused to get me the brand I wanted.
"Oh...you are refusing treatment" "I will tell your doctor".

So I was nice and said that I fully intend to proceed with treatment but I am REFUSING to do business with your establishment....and marched my little hiney out the front door.
They probably called me a little bitch behind my back..that's okay ...I called them worse behind theirs.

Amazing how I don't think I slept that much yet the machines says I slept 6+ hours. Guess it's because I wake up a few times during the night and pre-CPAP I would fall asleep as soon as I hit the pillow and sleep straight thru the night. Wouldn't even wake up when my husband got up to go to work at 4:00 am. That's why I would say I slept like a baby.

Don't forget to change your machine in your profile to the PR System One 60 Series Auto CPAP.

There can be an adjustment period for some people where we just wake up often during the night because the brain hasn't yet grown accustomed to having the mask on the face of its owners body.
It is sort of like the brain waking you up to say "Hey Dude...did you know you have an alien plastered on your face"
Eventually the brain grows accustomed to the friendly alien and those wake ups should diminish.
Now some people are just sensitive to the least little thing and maybe it takes a long time for the brain to be okay with the alien on its face.

It took about 6 weeks before my brain quit alerting me to the mask on a regular basis.
And that's when I had all the mask issues sorted out. Let's face it...it just isn't natural.

It will get better and easier with time. Short term...talk it over with your doctor if you think the wake ups are excessive and a problem. Maybe consider an OTC sleep aid (small dose of Benadryl maybe) or if the wake ups are really bad consider RX sleep aid.

Pugsy wrote:It will get better and easier with time. Short term...talk it over with your doctor if you think the wake ups are excessive and a problem. Maybe consider an OTC sleep aid (small dose of Benadryl maybe) or if the wake ups are really bad consider RX sleep aid.

I don't consider it a problem yet. I usually fall asleep again except for the couple of nights that I just couldn't fall asleep and then I would get mad at myself and would end up aggravating the situation. I'm optimistic that I will eventually start sleeping through the night like I used to.

We all have nights where we can't get to sleep or stay asleep from time to time.
I had one last night because of the new little stray dog who has adopted me. She wants to be with me 24/7 and I think that includes being in bed with me but the cat doesn't agree with that decision.
First couple of nights she was content to be on the couch...not last night. Whining...then scratching at the door while whining because I closed the door....and finally barking at 3 AM...she and I have to have a little talk today.

It's up to you to decide if the wake ups become a problem and if so what to do about them. You know your body the best.

Pugsy wrote:Instead of cpap mode how about in APAP mode setting minimum pressure to equal maximum pressure. It will then function like cpap mode with one pressure that is fixed but we don't lose Flow limitation data with it done this way.

I did go ahead and set min pressure equal to max pressure.
AHI has gone from 4.49 to 10.56

And what was that pressure setting and what was the event breakdown for that AHI and did you wake often or sleep better?

Pugsy wrote:And what was that pressure setting and what was the event breakdown for that AHI and did you wake often or sleep better?

Pressure setting = 7
AHI = 10.56
Hypopnea = 5.47
Obstructive = 2.22
Clear Airway = 2.87
RERA = 0.52
Flow Limit = 1.04
VSnore = 0.00
PB/CSR = 2.56

I slept better even though I did wake up a few times but went right back to sleep. I actually went to sleep an hour earlier than I used to.

Roughly 3/4 of your AHI is obstructive in nature..that would be the OAs and hyponeas. We address obstructive issues with a little more pressure. If the Clear Airway events had been the 3/4 of the AHI then we don't try to fix them with more pressure since the airway is already open. This is why we always evaluate the event category breakdown instead of blindly increasing the pressure just base on AHI alone. If your CA index had been 7...we wouldn't want to increase the pressure but it isn't so we can try a little more pressure to see if the airway will stay open better.
The 7 cm setting doesn't appear to be high enough to do a good job preventing the airway tissues from collapsing.
This could just be a fluke but I have my doubts.
Did you spend any time up around or over 80 to 90 L/min on the leak graph? Unless you spent a lot of time up there in large leak territory I doubt we can blame leaks.

If you want to continue using the minimum to equal maximum then I would suggest try 8 and see how you do and then maybe 9.
I think you are going to need more than 8 but sometimes it's an easier adjustment going up slowly and sometimes we get lucky and don't need as much pressure as originally thought.

Or you might try a small tight range...like 7.5 minimum and 9 or 10 maximum. See what the machine wants to do.

Pugsy wrote:Did you spend any time up around or over 80 to 90 L/min on the leak graph? Unless you spent a lot of time up there in large leak territory I doubt we can blame leaks.

If you want to continue using the minimum to equal maximum then I would suggest try 8 and see how you do and then maybe 9.
I think you are going to need more than 8 but sometimes it's an easier adjustment going up slowly and sometimes we get lucky and don't need as much pressure as originally thought.

Or you might try a small tight range...like 7.5 minimum and 9 or 10 maximum. See what the machine wants to do.

How do I read the leak graph to answer your question above? There are two lines (one greenish and one purple) the highest for both was 45.0 at 3:00 am (I remember waking up and adjusting my mask) and went right back to sleep.

The top line on the leak graph is total leaks which is the mask's expected vent rate (all masks have them and the vent rate varies by mask type and pressure used) plus any excess leaks.
With the Respironics machines they seem to flag large leaks somewhere around 80 to 90 L/min (they never give us an exact number) with your machine and your mask at your pressure. I am drawing on past experience to come up with that number. EncoreBasic software will show large leak flags but Sleepyhead doesn't.
Since the highest your leak ever went was 45 L/min then that is roughly half of what it takes to make it to large leak territory and well withing acceptable limits and thus leaks aren't impacting therapy negatively.
Now if you had told me you spent 2 hours up at the 95 L/min line...then it probably would have impacted therapy and allowed some events to sneak past the defenses and I would have suggested fix the leaks before changing the pressure.
Since you didn't have any time up near (much less past) the large leak line beginning we go straight to changing the pressure to reduce the obstructive events. Hope this helps.

Oh...the bottom leak line is going to be a close approximation of excess leak only. We are never told anything about where large leak begins when using excess leak only calculations. Most people just use the top total leak line. I just ignore the bottom leak line.
I don't have large leaks get flagged often enough to play with Encore to see if I can spot where large leak begins using the excess leak only reporting...there's a way I could use Encore to do it but I just don't see it enough to come up with much of an idea.
So I pretty much stick to using Total Leak for leak evaluation.

Pugsy wrote:Or you might try a small tight range...like 7.5 minimum and 9 or 10 maximum. See what the machine wants to do.

OK, very helpful information.

I think I will increase the pressure range to 7.5 min and 9 max as you suggested and see what happens.

I just picked up a copy of my Sleep/Titration study.

Recommendation #3 - The patient had an elevated ESS of 22/24. Due to the history of hypersomnia and obstructive sleep apnea/hypopnea syndrome, this patient requires close follow up by her PCP with an early CPAP download in order to see the acceptance and tolerance to the CPAP therapy.

Recommendation #4 - Close follow up by the patient's PCP is recommended with an early dowloand at week 4 and week 8 to see the acceptance, tolerance and response to CPAP therapy due to the history of severe obstructive sleep apnea/hypopnea syndrome, hypersomnia and the presence of central events during this study...........................

I wonder how my PCP was supposed to download this information when the DME refused to dispense a data capable machine. Hmmmmm