[CPAP] First week of CPAP: experience & questions

[sskblr]

Hi,

I was diagnosed with Sleep Apnea 2 weeks back (I have been having this for 20 yrs perhaps, but was ignorant about SA) with AHI of 65, lowest O2 saturation of 63, longest OSA episode of 72 sec and longest CA episode of 60 sec. Titration study at the lab reported 0 RDI at pressure 14 and above. For past 3 days, I have been using Philips Remstar auto cpap with starting pressure of 4 and automatic adjustment. I use a nasal mask.

For the last 3 days, the device reports AHI of 6, 12, 6 respectively with average pressure of 13.8. I woke up in the middle of night with dry throat and difficulty swallowing due to air pressure and restarted the therapy after 10 min of mask-off. All 3 days, I have been getting up very early and slept well for 5-6 hours. I did not feel the usual burning in the eyes and headache when I woke up. Felt energetic for first 4-5 hours and then back to usual less energy, sleepy, lack of attention & lack of focus routine.

My questions:

1. Are my results in line of what to expect?
2. Is it normal to sleep less during early CPAP days? My normal sleep time was 7-8 hours, but now it is 5-6 hours.
3. After starting the therapy, before falling asleep, I drift away thinking about something only to realize that I have stopped breathing. Then I start taking deep breaths. Is this normal?

Thanks folks. Best regards,
sk

[silversnore]

It takes time for your body to get used to cpap therapy. I think that you need to submit your sleepyhead reports to the forum so that members can get a better idea of how your therapy is progressing, I think that you will get some replies that will improve your AHI. Your sleep patterns will probably even out and you will probably be more energetic as well. You have been suffering for 20 years, your body needs some time to adjust. Post your sleepyhead so that you can try to get your AHI down, you may need to make some adjustments, Good Luck and keep coming back.

[DeepBreathing]

G'day sskblr. Welcome to Apnea Board.

I agree with SilverSnore - your body will take a little while to adjust to this new way of sleeping. You've had severe apnea, apparently for a long time, so the results won't be instant. Though it sounds like you've made a very good start.

If you can share your SleepyHead data, we may be able to give some advice to optimise the treatment.

[chill]

As others have said, you can look forward to months of slow and continuous adjustments as you brain gets used to this new reality and your body heals.  You have made good progress so far.

I woke up in the middle of night with dry throat and difficulty swallowing due to air pressure

That would be because of opening your mouth while sleeping, aka mouth breathing.  There are a few ways of addressing this: 

• wear a soft, cervical collar to bed
  
• use a chinstrap
  
• train yourself in the "tongue suck technique"
  
• use a adult pacifier to cause sucking
  
• use a full-face mask
  
• tape your lips shut (not joking, some people actually do this)
  

After starting the therapy, before falling asleep, I drift away thinking about something only to realize that I have stopped breathing. Then I start taking deep breaths. Is this normal?

Yes.  You may have always done this but just not paid attention before.  This happens to some people as the brain switches from awake breathing, where you are in control, to sleep breathing which is automatic.

[Sleeprider]

Hi,

I was diagnosed with Sleep Apnea 2 weeks back (I have been having this for 20 yrs perhaps, but was ignorant about SA) with AHI of 65, lowest O2 saturation of 63, longest OSA episode of 72 sec and longest CA episode of 60 sec. Titration study at the lab reported 0 RDI at pressure 14 and above. For past 3 days, I have been using Philips Remstar auto cpap with starting pressure of 4 and automatic adjustment. I use a nasal mask.

For the last 3 days, the device reports AHI of 6, 12, 6 respectively with average pressure of 13.8. I woke up in the middle of night with dry throat and difficulty swallowing due to air pressure and restarted the therapy after 10 min of mask-off. All 3 days, I have been getting up very early and slept well for 5-6 hours. I did not feel the usual burning in the eyes and headache when I woke up. Felt energetic for first 4-5 hours and then back to usual less energy, sleepy, lack of attention & lack of focus routine.

My questions:

1. Are my results in line of what to expect?
2. Is it normal to sleep less during early CPAP days? My normal sleep time was 7-8 hours, but now it is 5-6 hours.
3. After starting the therapy, before falling asleep, I drift away thinking about something only to realize that I have stopped breathing. Then I start taking deep breaths. Is this normal?

Thanks folks. Best regards,
sk

Your therapy setting is 14+ and your setting to start at a pressure of 4 cm is too low. Is this a ramp setting, or auto CPAP minimum pressure setting?  It would help to know your settings for the machine.  If you need to access the clinician menus, read this tutorial. http://www.apneaboard.com/dreamstation-c...structions

[trish6hundred]

Hi sskblr,
WELCOME! to the forum.!
Good luck to you with CPAP therapy, hang in there for more responses to your post.

[Hydrangea]

I'll chime in about the sleep hours. For me, yes. I went from sleeping 10-12 hours a night (and never feeling rested), to sleeping 7-8 hours (and feeling rested).

My "problem" when I wake up now, after 5-8 hours, is that my brain is on *and thinking clearly*. In the past, if I wake up feeling that way, I know I need to get up and be productive. So now I'm trying to retrain myself that if I wake up like that after just 3-5 hours, I really do need to go back to sleep.

It's weird, adjusting my mindset. For the past 20 years, I thought more sleep = more rested. But now I'm learning that better quality of sleep = more rested.

[sskblr]

Thank you all for the kind replies, they are very helpful. I am already learning a lot in this forum.

@silversnore @DeepBreathing : I downloaded data from SD card and ran SleepyHead. Here are the images:
[As a new member, I cannot post links, please add http:// to the links below.]
imgur.com/NJ4VwGY
imgur.com/zSnv99p
imgur.com/rOP1YKQ

@Sleeprider : Yes, makes sense. I have been prescribed 14 cm pressure and 4 cm start is indeed low. CPAP supplier set it for me and I am yet to explore the settings. Thanks for the link to tutorial. Current settings:
PAP Mode : APAP(Variable)
Pressure Min: 4 cmH20, Max: 20 cmH20
Flex level: x3
Flex mode: C-Flex+
Ramp pressure: 4 cmH20, Ramp Time: 5 Minutes

I read the mask setting primer on this board and made some strap adjustments last night. Today's AHI was 5.x (data not yet downloaded into SleepyHead) and felt much more comfortable with the mask than the past 3 days!

Thank you,
sk

[PoolQ]

min pressure and ramp pressure both at 4 means you are not using/getting a ramp and at least for me I needed at least 6-7 ramp start to not feel like I was being starved for air. Then I have 8 for therapy start pressure. Betting you end up at 2-3 below your average for therapy, 6-7 for ramp start, ramp time as is comfortable for you 0-45 minutes
max therapy 2-3 above average.
as far as what you are going through, basically yes to it all, does vary some, but yes. You now have an alien sitting on you face blowing air up you nose-not "normal" at all.

What helps is that with this you will actually breathe throughout the night. You can play with the humidity and temperature settings, along with ramp time to find what you like.

Step one is get the therapy tuned in, then get the comfort settings right so you will use the therapy. your on the way!

[ajack]

with significant centrals on a sleep study. I'd be asking why an ASV wasn't on order. I would be asking for a titration sleep study, where the best machine is chosen