Don't know what I don't know.... newbie...

[jimcaffey]

[attachment=13678]Hi folks,

So here's the basics... Was diagnosed with severe Apnea (AHI=68) on June 7th. Got my machine 3 weeks ago... I had no issues falling asleep with the nose mask on... no angels signing on the first morning but I'm not falling asleep on my keyboard every afternoon, and no morning headaches.... so i'm declaring a win. having said that.... 

I've been reading this board for the last several weeks and see folks that are taking as long as up to a year to tweak their systems... etc.

here's what I don't know what I don't know... 

with a couple exceptions during the first week, according to Oscar my AHI score hovers around 3 to 3.5.... 
Should I be shooting for as close to zero as I can? (I'm told anything below an AHI score of 5 is good)

I still see on the Oscar charts that i'm still experiencing OA and Hipopnea events through the night, albeit dramatically less than at the level they were during my sleep study. Do I interpret this as these events are actually happening or are they events that could have happened had the A-CPAP machine not prevented from happening? does this mean i'm still waking up on average 3 times an hour? 

Vibratory Snoring... Oscar shows that I am having +/- 45 VS2 events and +/-10 VS events a night, i'm a back sleeper for the most part now... (at least since using the CPAP... before, I could only comfortably sleep on my side). Should I be concerned that my mouth may be dropping open while I sleep with the lower jaw causing some of the OAs that are being recorded etc? My bride has been awake for one of these events and she described it more as a snort... and that compared to what it was this was nothing.... (she is singing the machines' praises because I am now so much more quiet while I sleep)...

I have no complaints with the nose mask now, does it still make sense to see what other masks feel like? (again, I don't know what I don't know)

Am I just over thinking all this and in fact am doing fine or should I be thinking of ways to tweak my system? [attachment=13678]

[DaveL]

Welcome to the forum! My DME tried to tell me that anything under 5 was a cure. Then I (over)reacted.

"If I have to wear all this crap and still try to sleep I want results close to zero." Then I asked if they had ever worn a mask all night with a machine turned on. The answer was no.

people here know so much more about treatment and sleep quality than the few sleep doctors and techs I've had in over 30 years of use.

Others here know so much more than I do. They'll be able to help.

[DaveL]

I'd sure like to see you get your numbers down, so that you're resting better.

[jimcaffey]

Thank you DaveL... sage advice... I admit all the info is a bit overwhelming and the learning curve has been and is still very steep.... I see my "events Flags" summary and it looks nothing like the others i've seen on these boards.... which lead me to ask... What should I post to give the best info to interpret? I just took a "snapshot" of the top of the daily summary, should I be posting the Stats? or the rest of the Daily summary?

[DaveL]

I have so much to learn. I've been doing this a long time. My treatment only improved when i found this forum and asked for help here. The results: my numbers are close to zero. I sometimes mouth breath (and have no treatment when I do.) So I use a special wedge under my jaw (recommended here) that keeps my mouth closed. It works!

If you remember using your machine and waking up and thinking, "I feel better now!" Keep that memory. Savour it. Keep it special.

Meantime, there are wonderful caring people here with so much more knowledge than I have. They'll help!

[Sleepster]

I still see on the Oscar charts that i'm still experiencing OA and Hipopnea events through the night, albeit dramatically less than at the level they were during my sleep study. Do I interpret this as these events are actually happening

Yes, but let's let things calm down a bit before jumping to any conclusions. It's typical for the AHI to drop as a new patient adapts to the therapy. You've likely been sleeping with apnea for decades, so it will take a few weeks for your body to adapt to the new situation. Although you seem to be adapting at a well above average rate.

You might want to change your pressure range to something like 6 to 14.

[Sleeprider]

Jim, Welcome to the Apnea Board. Your settings are nearly at the machine default at 5.0 to 20.0 pressure and unknown Flex. We can ignore VS2, but we won't ignore the VS events which cause pressure to rise, and of course we'd like to drop the flow limitations as much as possible as well as reduce hypopnea and obstructive apnea. All of your events show continuing obstruction. The Philips Respironics Auto CPAP is not very proactive in preventing these events, and compared to a Resmed Autoset, Philips raises the pressure too slowly, and allows it to drop too quickly. So your results are pretty typical for a Philips Auto that has not been optimized.

Your Median pressure is 9.8 and your 95% pressure is 12.1 I think you are going to end up with a minimum pressure of 9.0 and maximum pressure of 14, and this will not only significantly reduce events, but snores, flow limits, RERA and sleep disruptions from events and pressure changes. So that's the goal, and whether you increase minimum pressure all at once, or do it gradually, this is where you will find effective therapy and ultimately more comfort. You have experienced these pressures, so it's nothing too dramatic, and you can see my starting pressures are 13 inhale/9 exhale. Let's start increasing your minimum pressure and watch the events, and I am certain you are going to feel a lot differently about the therapy shortly.

[Sleepster]

My DME tried to tell me that anything under 5 was a cure. Then I (over)reacted.

That number "5" comes from a classification used by medical researchers. They need to classify their patients so they can do research on them!

Thus, a AHI in the range of 5-15 is used to declare the diagnosis "mild sleep apnea". So if you're under 5 you're "normal" and don't need CPAP therapy.

We generally interpret a AHI of 5 as good. Some people can't get that low, others can get lower. For years mine would waver from rarely below 1 to rarely above 2, and never above 3. But now it's almost always below 1.

What can be taken away from all this? Try to get your AHI as low as you can, but don't become obsessed with it. Life is about the stuff that happens to us when we're awake. We need good sleep so we can enjoy that stuff.

[DaveL]

See Jim? You're in good hands.
So am I.

I have severe sleep apnea diagnosed over 30 years ago when I was tested first time.

[DaveL]

How are you doing Jim?