[CPAP] How long to reduce apnea episodes <5 ?

[RWN59]

My apnea episodes reduced from 45/hour to 15/hour, however my machine's pressure is maxed out at pressure of 20 at least 90% of the time. I know the target is to get to less than 5 episodes/hour; does it normally take days or weeks for machine to become effective in achieving desired results ? I don't care to get stuck with a machine that can't be effective running at max.
I'm raising this question after using cpap for only 2 nights. I do know that bipap can run higher pressure but at this time I'm not sure that it is necessary.
Please Respond

[trish6hundred]

Hi RWN59,
WELCOME! to the forum.!
You haven't been at CPAP that long. I'm not sure why you are hanging at the higher pressure of your machine but hang in there and someone more knowledgible will be able to help you.
Best of luck.

[Christenson-the-Geek]

15 AHI is much better than 45. Keep working, be patient.

It's taken me 40 days to hit 5 per hour, and I'm on day 55 and still not getting that consistently. I've gone through half a dozen masks, and am wondering if I should try one more next week or wait and see how this one does with the latest twist in adjustments.

The problem?? I'm having trouble stopping mask leaks during the night; that still runs around 40 liters per minute. If I get around 25, everything works, no change in the pressure, just the 14cm from the titration study done in the lab 2 months ago. In the lab study, the tech adjusted my mask constantly and got an AHI of zero for the few hours towards the end of then night I actually slept there.

If you are leaking heavily, the machine won't actually achieve the 20cm pressure -- it's made to do so with a compatible CPAP mask with a particular vent versus pressure curve sealed to your body.

I'm not familiar with the Respironics model in particular, but I hope it also reports some kind of leakage numbers and you will pass those on to us. Be aware that any numbers reported will wait until the next afternoon to change for the previous night. Also, if your insurance paid for your CPAP, you've paid a pretty penny for your machine and mask, partly because your DME is supposed to help you with it. Call them up, explain the problem, get an appointment. Ask if you can lie down and bring your pillow.

I ended up changing full face masks a half dozen times, ended up with the Resmed Nasal pillows FX model. I only paid for one mask. The pillows have changed sizes up and down twice, been greased with Eucerin, tightened, loosened, added a chin strap, tried fixodent cream, ace bandages on the head, a (hair-)do rag for both beard and hair (recommended). My nose bridge and nares have been sore. The last change was to breathe through my nose only during exercise. I'm logging everything that might affect sleep, including food eaten, drugs used, work stress, and amount of exercise. I shower now twice a day with baby shampoo and Dr Bronner's unscented castile soap. I have a heated hose on my CPAP, and I'm going to top that with a cozy -- an ace bandage actually works, but mine comes undone after a few days. I take naps, and have a urinal to pee in when I wake up in the middle of the night instead of actually getting out of bed. There's a flashlight next to the bed, and the CPAP goes with me to work for those naps -- I unroll a camping pad on a desk and close the door to the office and turn on my CPAP.

Be aggressive about getting help, because you will get much better once everything works as it is supposed to. Be aggressive about getting some extra sleep, too. And be patient with yourself -- you have a problem, and these people are supposed to help you solve it.

[RWN59]

Thanks for the input. Machine recorded large leak 3% of time last night. Machine also recorded periodic breathing of 8% last night and 14% the previous night. I will talk to supplier, but I want to be informed as much as possible, so I joined this site. I believe I've had apnea for at least 10 years so I am motivated to get this right and I have the patience to do so.
Thanks Again,
RWN59

[cbramsey]

Welcome to the forum!!! We are glad you joined us!!!

Are you using any software to trend your machine's data or just looking at what the screen on the device is telling you?

You should be able to use SleepyHead software to give you a better idea of how well your therapy is going.

You may need to install the Series 60 patch in order to read meaningful data from your machine.

[zonk]

however my machine's pressure is maxed out at pressure of 20 at least 90% of the time.

Not exactly .. means your machine spent 90% of the time at and below that number (don,t forget the below part)

If wanted to see whats going on, follow the link "cbramsey" gave you to download the software

unlike Resmed, PR don,t define large leak other than:
Large leak is defined as the level of leak that is so large, it is no longer possible to determine respiratory events with statistical accuracy

Not sure how bad the leak has to be, to be flagged as a large leak
Good mask fit is essential for effective therapy

Don,t over-tighten and wash cushion each morning to remove facial oils
Quattro FX fitting guide: http://www.youtube.com/playlist?list=PLA23652FAF5627F3F

[Sleepster]

I'm raising this question after using cpap for only 2 nights.

It took me a couple of nights to get my AHI below 5. If yours doesn't go down in a few more days check the composition of the AHI. Three types of events are added together to get the AHI. If the biggest of the three numbers is the CA index then that may indicate that your pressure is too high. Sometimes these machines that automatically set the pressure need to be reigned in.

It's too soon to make that determination. You need at least a few more nights of data, meanwhile just relax and be glad that you are one of the lucky ones who can immediately tolerate CPAP therapy. Some of us were not so lucky.

[Shastzi]

all the above suggestions willl help you narrow down that fuzzy thing called "truth"

You might want to try 'The Backpack" too. (An inexpensive laptop backpack loaded with three tubes of tennis balls)
Then choose what side you are going to sleep on. Since you wont be on your back.



I am having excellent results with it.

Cheers!