New cpap user and need advice please

[Sleepless706]

Hi! I have chronic insomnia, I kept waking up 4-5 times a night. Some times feeling like I was high on adrenaline !
After trying several sleep meds, lunesta, ambien, trazodone (works great at knocking you out!) I was sent for a sleep study.
I should have asked army doctor for one MUCH SOONER!!!

I was just diagnosed after a sleep study with OSA , obstructive sleep apena. I had 176 apena events in 7 hours, (dr said this was severe sleep apena) so I was prescribed a Philips a system one cpap machine (set on auto!) I am using a optilife nasal pillow mask. (machine and supplies are free for me I'm us army!)

I have a few questions:

When the machine is running (therapy mode) the pressure displayed is 4cm (my rx ange is 4-14). When I get up to use the bathroom at night, the display still says 4cm. Should this pressure change/get higher on display as time goes on, or does it not rise when there's a airway obstruction (hence stuck at 4cm) I check the secret provider menu and indeed the pressure is set to 4 and 14.

I am also using this on the aflex setting of 3.

Also, when I hit the ramp button, it displays the ramp icon and then it disappears but I see no difference in the pressure when first donning the mask or as time passes. Is this normal also? (I saw NO RAMP ADJUSTMENTS or ramp time setting when in the normal or secret provider menu settings)

Lastly, it seems it's very hard to exhale at times, even though the hose is not pinched and the nasal pillow is not covers and is fitted correctly to my nose. Again it's showing 4cm as the pressure on the screen after hitting the therapy button to start.
This might be the style of mask as the air in forced directly I to my nostrils?

The medical supply place didn't really explain the machines display nor settings to me, just showed how to start and stop the machine, and how to clean mask and tubing.

Thanks for your help and I look forward to participating in wha appears to be a great group!

[Airstream]

Hi: I can't answer you question, however, I am sure someone here will.

In the mean time, there are videos about your system om youtube. Maybe that will help.

I would call Philips Respronics tomorrow if you don't get the information you need tonight. The phone number was 800-345-6443, unless it has changed.

Good luck.

[zonk]

the ramp button lowers the pressure level to the minimum pressure setting
whats the 90% pressure displayed on your machine
you can download SleepyHead and check pressure movement during the night
for 60 series machine, you need to install the patch with SH

this blog might be of some help with insomnia
http://adventures-in-hosehead-land.blogs...er_19.html

[trish6hundred]

Hi Sleepless706,
WELCOME! to the forum.!
Hang in there for more suggestions and best of luck to you with your CPAP therapy.

[PollCat]

While I can't address you issues with the machine, I would point out that hopefully you are already asleep by the time the machine ramps up to the full 14 cm. If you want to feel what the full pressure is like, turn off the ramp, if possible. There are several members of this forum who have your machine, who should be able to answer your other questions.

BTW,

[Sleepster]

When the machine is running (therapy mode) the pressure displayed is 4cm (my rx ange is 4-14). When I get up to use the bathroom at night, the display still says 4cm.

That's not right. The pressure should rise above 4 cm as you experience apneas. It sounds as though the machine is not working correctly.

I recommend you make an appointment with your equipment provider and have the machine checked out.

The next time you notice that it's hard to exhale against the machine's pressure push the ramp button and see if that makes it easier to exhale.

[jgjones1972]

I have a few questions:

When the machine is running (therapy mode) the pressure displayed is 4cm (my rx ange is 4-14). When I get up to use the bathroom at night, the display still says 4cm. Should this pressure change/get higher on display as time goes on, or does it not rise when there's a airway obstruction (hence stuck at 4cm) I check the secret provider menu and indeed the pressure is set to 4 and 14.

When set to Auto 4 - 14 the machine should start at 4cmH2O and raise pressure as needed in response to events or indicators. If and/or when events subside it should gradually decrease pressure until it detects another event or another indicator that an event is likely. It seems to me that it is unusual for the machine to still be at 4 every time you wake up. To check and see if things are going properly you should check out a couple of things. Does your machine display give you nightly information? If so, do you see something labeled "Pressure" or "95% pressure" or something like that? If so, is the number it gives each morning somewhere in between 4 and 14? This number should be either telling you the average pressure the machine ran at, or the pressure the machine stayed below 95% of the time. Another thing to look at is AHI. AHI is the Apnea Hypopnea Index. This will tell you the average amount of Apneas and Hypopneas (shallow breathing) events you had that night. Anything below 5 is considered good. The numbers you said your doctor gave you would mean you had an AI of 25.14 without PAP for instance. AHI would be higher because Hypopneas would be added in.
If the machine is showing average or 95% pressure of 4 cmH2O through the night and your AHI isn't extremely low, like below 1 (but not 0), then something is probably wrong with the machine or it is set wrong. If average or 95% pressure of 4 cmH2O and AHI is 0, then the machine is probably either defective, malfunctioning or; best case scenario, you don't have OSA. Let us know what Avg. pressure or 95% pressure and AHI is running and we can help you from there; but my inclination is to believe that something is wrong with the machine.

I am also using this on the aflex setting of 3.

The machine can't deliver pressure under 4. So when it is running at 4, a-flex will do nothing. When pressure raises, a-flex should start working (i.e. pressure goes to 5, inhale 5 - exhale 4; pressure goes to 6, inhale 6 - exhale 4). A-Flex set at 3 means biggest difference in inhale pressure and exhale pressure is 3, so if its at 7 it drops to 4 on exhale, at 10, just down to 7, etc.

Also, when I hit the ramp button, it displays the ramp icon and then it disappears but I see no difference in the pressure when first donning the mask or as time passes. Is this normal also? (I saw NO RAMP ADJUSTMENTS or ramp time setting when in the normal or secret provider menu settings)

As with A-Flex, the machine can't deliver a pressure lower than 4, so it can't start out any lower to ramp to 4. If your minimum pressure was set higher than 4, like 8, then you could set it to start out at a lower pressure than 8 and gradually increase to 8 over a specified period of time.

Lastly, it seems it's very hard to exhale at times, even though the hose is not pinched and the nasal pillow is not covers and is fitted correctly to my nose. Again it's showing 4cm as the pressure on the screen after hitting the therapy button to start.
This might be the style of mask as the air in forced directly I to my nostrils?

This is something most people experience. You should get used to it with time.

[Sleepless706]

I just returned from the DME supplier, where I was given a new size large full face mask, a resmed Quattro fx.

Anyway, DME rep said IGNORE most readings from Info screen on my restronics system one menu (it's on auto cpap setting with aflex of 3)

Here's the numbers from the therapy data software pulled from sd card in cpap machine:

I've been using cpap machine for 1 day 12 hrs 22 mins 57 sec
Auto cpap mean pressure was 5.5 cmh20
Peak average pressure was 5.6 cmh20
Average device pressure 6.7 cmh20
Average AHI 4.2
Average flex is 2.6

[Sleepless706]

Ps thanks for all the replies! I appreciate your time!!!

[Shastzi]

Hope this works for you Sleepless!