Hide the hammer I'd like to smash it! Feel worse then before I started

[MsDixie]

Howdy fellow hoseheads ;-)

I do feel like my pressure needs to be up some I called my sleep doc today but their on vacation till next week so will see then.
I am a bit leery of raising it on my own because what I've read about the CA on here.
I was able to download software today aided by some board members thankful for that help!
I don't think it looked too bad ? Here it is ( I can't get the attachments to attach)

Here is the report for 4/17 - 5/7

Avg % night in PB - 0.1
Avg CA index - 2.2
Avg OA index - 1.5
Avg Hypopnea index - 2.6
Avg RERA index - 0.2
Avg AHI index - 6.3
Avg FL index - 0.0
Avg VS index - 7.2
Avg % night in Large Leak - 2.1
Avg Large Leek - 5 min 34 sec

the other night when I had the AHI of 15.9 I also had a leek perhaps it was caused from that?
CA - 2.5
OA - 5.4
H - 7.9
FL - 0.0
VS - 26.3
RE - 2.5
AHI - 15.9
Min in Large Leek - 22.0
% of night in Large Leek - 13.2
Avg Leek - 41.8

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John, I do that too with heated it prior :-) I have C-flex set on my machine it's at a 3 is that supposed to be the easiest setting to exhale?

Thanks everyone for any and all comments, tips, and help!

[Sevensox]

Its your health and your choice. I would not hesitate to bump mine up a notch and see how I fell. But the more pressure you put on the mask the more it will probably leak.
Lee

[Shastzi]

Looking at your numbers, you have a good night when your leak values are down.
I'd start on a leak hunt.
Find a mask you can wear that has near 0 leaks at night (assuming all surfaces are clean and free of grease)

If your leaks get way down but AHI is still up, then it's a pressure issue.

[MsDixie]

I am wondering this about the leaks? I was taking my mask off when I had to get up at night leaving the machine running. I read on here about turning machine off and back on and am now going to start doing that to see if it makes a difference in the leaks shown.

Sevensox- I am also guarded because I am just reaching 30 days and they're still gathering my data card. One of the reasons I want to go in and see my sleep doc. I have no reluctance telling him I plan to adjust as needed and be part of my health care plan I just want him to be informed so if there are issues with ins I don't find out the hard way. I couldn't afford to pay for all this without my ins. I have a brother going thru that right now and am passing on to him all I am learning. Thanks for the thoughts though as I agree.

[SuperSleeper]

Also, I tried an "autopap" which was supposed to self-regulate the pressure and it was terrible. It didn't work. It wasn't responsive to my needs. I felt like I was suffocating, and it was making my condition worse. Zone in your optimal setting on your own.

Many times patients experience problems with APAP because the machine is not set up correctly. For instance, some prescribe APAP "wide open" (with the pressure setting at 4-20 cmH2O). Setting the lower pressure too low can easily make you feel suffocated, and having a wide range of auto pressures sometimes messes up the machine algorithm's ability to properly adjust to your needs in a timely manner.

Many people recommend setting an APAP at roughly 2-3 cmH2O below the sleep lab's titrated pressure on the minimum pressure setting and perhaps 3-5 cmH2O above the titrated pressure on the maximum pressure setting. A smaller 5-8 cmH20 auto pressure range helps the machine do it's job better - and it can help you not feel so suffocated.

[archangle]

... Overpressure on your CPAP may cause significant decreases in the O2 saturation ...

More pressure than is necessary can have lots of unwanted effects, but I don't understand how it could possibly decrease the O2 saturation.

Overpressure can cause central apnea. It might even cause some shallow breathing problems that don't get flagged as apnea, even though it reduces your O2 level.

Re: adjusting the pressure

Even with a well done in-lab PSG sleep test, sometimes it requires some tinkering with the pressure you use long term in the home. The sleep test was one night, and you were only at that particular pressure for a short period of time. Your body varies from night to night and changes as you adjust to CPAP. That's one of the reasons it's so important to have a fully data capable machine like your PRS1 auto.

[Tipiford]

... it seems I'm suffocating - I may be getting a bit claustrophobic not sure.

Being so new to this, I'm not one to advise, but my initial experience was to set the Min. pressure up 2 cm and that took care of my 'suffocation' issue.

[Sleepster]

More pressure than is necessary can have lots of unwanted effects, but I don't understand how it could possibly decrease the O2 saturation.

By inducing central apneas.

[John J]

... Overpressure on your CPAP may cause significant decreases in the O2 saturation ...

More pressure than is necessary can have lots of unwanted effects, but I don't understand how it could possibly decrease the O2 saturation.

In addition to possibly triggering Central Apneas, if I look at my titration test, once I reached 10 as the pressure was increased, you could see the 02 sats dropping. Pressure is a tricky thing. ALthough I've reviewed at a lot of sleep studies for other data collection, I am not a RPSG, nor do I play one on TV But I have been told by those who DO know that pressure can be a slippery slope and more is not necessarily better...or safe.

J

[John J]

I think I might make an appointment with my sleep doc it'll probably take a bit to get one so I could always cancel if I'm doing better.

Pollcat, I've ask myself the question what is different between here and the lab, which is one of the reasons I've been trying the full face mask I slept with that night. As well I've even tried taken a sleep aid as I had one that night. I have a good comfortable bed. My home is quiet. Room temp is good. I've even got high thread count sheets! lol. One thing that was different, they used the good old remstar pro c-flex that was the same as my old machine years ago. Now here I have this new fancy smancy billon dollar jewel I want to smack with a hammer and I may just need old faithful ;-)

I like the Wisp mask and is what i mask up with each night, but I've wondered if it was collapsing as it so soft. I do feel I'm having trouble getting air (in or out I'm not sure but trouble with it.) so thought trying the full face mask would help. I've never really been a claustrophobic person that I recall but it's about the only way I can think to describe it. What is the ERP setting your talking about Tez62?

I know how good I can feel after a good nights sleep on my cpap machine... I want that!

I really am so glad I found this board. If I had years ago I'm fairly certain I'd never stopped therapy and also fairly certain I'd duct taped my moms to her head. She spent a week in ICU from Co2 poisoning ando died way too soon due to sleep apnea complications. I look forward to when I've got everything clicking along fine and can help others as you are me. You're appreciated!

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Oh and no I've not tried any of the liners.

So here's my recent experience that might shed some light...

I found that the more I tightened my nasal mask or nasal pillows, the more leaks I had AND the more 'air hunger' I had. So I've loosened both and have better success.

I have the Mirage FX and Swift Nasal Pillows. The pillows are just ok. The Mirage is pretty good and doesn't leak much when new. Except that after about 3 weeks, I think the cushions need to be replaced because it loses it's firmness and then leaks a lot. DME tells me that I can have 2 new cushions per month, covered by insurance. So I think I'll take them up on it.

I'm waiting on the WISP because i'm a side sleeper and this might be my saving grace. I'm not a fan of the forehead piece and the WISP doesn't have one. It also seems like it's less prone to leaks as well.

Good luck

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More pressure than is necessary can have lots of unwanted effects, but I don't understand how it could possibly decrease the O2 saturation.

By inducing central apneas.

And man, you do NOT want those!