Apnea and Pulmonary Hypertension

[OpalRose]

Do you have an SD card reader (slot) on your computer? If not, you may have to purchase one to read the card.

You may have to adjust your minimum pressure to tackle the hypopneas.

What is your pressure range set to now?

EDIT: Is your Cardiologist advising you in regard to your pressure settings? We would not want to go against his advice as we are not doctors.

[Haynbo]

I have not been advised by the cardiologist or the pulmonologist about pressure settings- my machine was set when I received it- in fact, the advice or more correctly, the lack of advice has been part of my problem. After I was diagnosed, I went in to the sleep center to make a choice of masks- since I am a mouth breather, I was advised to get a full face mask- I received little or no instruction other than to change the water every night and the filter once per month. I had no idea as to the settings, what they should be, how to make changes etc. It was about 6 weeks or so till I thought about the fact that I have not heard from anyone or have no idea how I was doing with the machine so after reading the manual more thoroughly I found out how to set up the Dream Mapper so I could see the nightly results.
The only thing I have done is increase the starting pressure to 6.0 which doesn't seem to be a problem- my concern so far has been the fact that even though my AHI has been relatively ok at under 5.0, the hypopnea's have been consistently in the 20-45 range. I called Respira medical today and talked to one of their reps and he said all they are concerned about is the AHI- not the individual numbers. In light of the fact that my pulmonary pressures are elevated and this could become a serious issue, I want to do everything I can to bring these numbers down as low as possible- since the number of hypopneas are part of the formula it makes sense to me to try and bring those down. The feeling of my cardiologist is that oxygen desaturation at night over a longer period of time is what has caused the elevated pressures.

  Shortly after I was diagnosed I went to a sleep certified dentist to get fitted for an oral device (Somnomed Classic)  since I anticipated a problem for me adapting to the mask. Shortly thereafter I had the first echo which showed the elevated pressures I decided to preserve and use both- a subsequent echo did show a significant reduction and, as a result I feel it makes sense to continue with the same regime.

Bottom line is that I feel like I am operating in the dark- I have received more insightful info on this site than I have from anywhere else. I am scheduled for another sleep study this week. I called today to find out why another study and received a call back message saying that they wanted to test me with just the mouth piece to see if that is sufficient. My feeling, and maybe I'm off base, is that wouldn't using both provide more benefit than just using the mouthpiece alone? I want to do all I can to bring those elevated pressures down to a more normal range- the last echo showed 44-  36 to 40 is considered top normal.

Thanks for your help!

[SuperSleeper]

Haynbo,

Keep in mind that no one here is a medical professional.  The advice you've received is not medical advice, but rather personal opinion.  I would advise you to talk to your Cardiologist before making any changes whatsoever.  You can keep on getting advice here of course, and the best thing would be to post SleepyHead screenshots showing the specific data so folks can better help you.  But again, due to your other medical issues, I'm sure all who are giving advice here would agree that you need to coordinate any CPAP changes in accordance with your doctor's knowledge and professional help.

Good luck to you and I hope you get SleepyHead up and running.  If you have specific software-related questions, we do have a Software Support Forum here - in there you can post a new thread regarding the software itself.

[Sleeprider]

Haynbo, take a look at your INFO screen on the CPAP and copy down the average and 90% pressures for 1-day, 7-day and 30-day. It would be good to see what's going on. We can help you with that information.

[Haynbo]

Hi- I just checked it and found- 9.0 for 1 day, 10.3 for 7 days and 9.2 for 30 days- do these numbers seem low to you? Thanks again for your interest!

[Sleeprider]

Is that the average or 90%. What you need to do is to increase your minimum pressure from 4.0 cm to be equal to your average pressure, or your 90% pressure minus 2.0. A starting pressure of 4 is very low and it takes a long time for the machine to reach therapy pressure, and the machine algorithm attempts to reduce pressure toward the minimum causing hypopnea. Increasing minimum pressure is a well proven method of improving your results.

You have already increased your minimum pressure. If the numbers you quoted above are your average pressure, then I recommend increasing minimum pressure to 9.5 cm.

[Haynbo]

I just checked my 90 percent readings and they were- 12.0- 1 day, 10.3 - 7 days and , 9.2 - 10 days- 

I was really anxious to check my AHI on DreamMapper this am because I felt like I slept really well last night- actually, I have been consistently sleeping better-rarely waking up to go to the bathroom or, for that matter, waking up at all. So, from that perspective I have really felt like my sleeping has been much better. 

To my dismay, the AHI did not reflect what I had felt- it was a 5.0 with 9 clears, 5 osa's and 30 hypopneas. I know that the literature says that under 5 is the goal, I feel like with the pulmonary pressure elevation I have, I need to get that number down to as low as possible. Again, the issue that seems to be responsible for most of the number with me is the total number of hypopneas that I have each night- I'm not sure how much that could potentially contribute to any oxygen desaturation (which the Dr. feels was the cause of the elevated pr sures) but it kind of makes intuitive sense that it could be a contributing factor.

Another thing I would like to mention is that upon waking up this morning after what I felt was a very good night, I had that old feeling I used to get( before mask) of feeling somewhat drugged- I assume that is related to not getting the quality of sleep that I felt that I did get- anyway, it is frustrating. If my feeling about hypopneas is correct, can they be helped by increasing the pressures or, is there something else that needs to be done. Thanks very much!!!