New hosehead for the new year

[shawnavonsr]

Hello everyone.
Finally was convinced to have a sleep study done by my girlfriend after she went to an ENT visit with me and told the doc I stop breathing during the night. That was in August and had first study done 9/2/15. I haven't had a chance to print out study results so I have transcribed them here. These are results from first part of split study with the following:
Slept for 131 minutes
Recording time 156 minutes
Sleep Efficiency 84%
Time in N1 - 75 mins 57.3%
Time in N2 - 56 mins 42.7%
Time in N3 - 0 mins 0%
Time in REM - 0 mins 0%
Respiratory Disturbances
# Index Duration Longest Time(min)
OA 140 64.1 17.6 49.5 41
MA 0 0 0 0 0
CA 1 0.5 21.5 21.5 0.4
Apea 141 64.6 17.6 49.5 41.4
HYP 83 38.0 19.9 44.5 27.6
A+H 224 102.6 18.5 49.5 68.9
RERA 3 1.4 18.3 23.5 0.9
Total 227 104.0 18.5 49.5 69.9
Arousal Summary
NREM REM TOTAL
Spontaneous 8 0 8
Respiratory Event 7 0 7
Resp w/Desat 211 0 211
Limb Movement 0 0 0
Snore 0 0 0
Totals 226 0 232
Index 103.5 0 106.3
Oximetry Summary
W R NR Total
Average % 93 91 91
# Desats 2 206 206
Desat Index 94.5 94.5
Oxygen Low 77%

Here are the results from the 2nd part of the sleep study with CPAP:
Slept for 208.5 minutes
Recording time 255 minutes
Sleep Efficiency 81.8%
Stage Latency Time TST%
N1 0 119 mins 57.1%
N2 - 6.5mins 83.5 mins 40%
N3 - 144.5mins 5 mins 2.4%
REM - 196mins 1 mins 0.5%
Respiratory Disturbances
# Index Duration Longest Time(min)
OA 60 17.3 19.4 45 19.4
MA 0 0 0 0 0
CA 1 0.3 13 13 0.2
Apea 61 17.6 19.3 45 19.6
HYP 59 17 21.8 44 21.4
A+H 120 34.5 20.5 45 41
RERA 0 0 0 0 0
Total 120 34.5 20.5 45 41
Arousal Summary
NREM REM TOTAL
Spontaneous 102 2 105
Respiratory Event 2 0 2
Resp w/Desat 116 0 118
Limb Movement 0 0 0
Snore 0 0 0
Totals 220 0 225
Index 63.6 0 64.7
Oximetry Summary
W R NR Total
Average % 95 94 94 94
# Desats 1 111 111
Desat Index 32.1 31.9
Oxygen Low 83%

So there showed great improvement with the CPAP. Pressure was raised to max at 20 for 89mins with high leakage.

On 12/14/15 went back in for Bi-level tritration study. Below are the test results:
Slept for 286.5 minutes
Recording time 398 minutes
Sleep Efficiency 72%
Number of Awakenings 42
Stage Latency Time TST%
N1 0 99 mins 34.4%
N2 - 43 mins 64.5 mins 22.5%
N3 - 57 mins 110 mins 38.4%
REM - 340.5 mins 13.5 mins 4.7%
Respiratory Disturbances
# Index Duration Longest Time(min)
OA 21 4.4 17.6 36.5 6.2
MA 0 0 0 0 0
CA 0 0 0 0 0
Apea 21 4.4 17.6 36.5 6.2
HYP 52 10.9 21.1 35.5 18.3
A+H 73 15.3 20.1 36.5 24.4
RERA 0 0 0 0 0
Total 73 15.3 20.1 36.5 24.4
Arousal Summary
NREM REM TOTAL
Spontaneous 42 2 44
Respiratory Event 8 0 8
Limb Movement 0 0 0
Totals 111 2 117
Index 24.4 8.9 24.5
Oximetry Summary
W R NR Total
Average % 96 94 95 95
# Desats 3 62 62
Desat Index 13.7 13
Oxygen Low 86%

So with this data I am being prescribed ResMed Aircurve 10 S set IPAP 20/EPAP 15 and choice of mask. Will be getting set up first part of next week as machine was ordered this past Monday. I have already down loaded Sleepyhead and ResScan so I can monitor and make adjustments as things get started and I get used to sleeping with the equipment.
Anything being a newbie that needs to be watched or pointers from some seasoned hoseheads would be appreciated.

Shawn

[justMongo]

I'd try to get an Aircurve 10 VAuto.
If you ever need pressure >20 the VAuto can cupply up to 25.
The VAuto will do the job of the S; but can vary pressure as needed.

Likely your doc won't approve of a VAuto.
The VAuto can be run in S mode. (fixed pressure bilevel)

[shawnavonsr]

JustMongo, if I would have had a choice I would have got Vauto but this was ordered by the doc. Already the DME is concerned that insurance might not buy the machine and would have to rent. The 10 S can support up to 30 if the specs are correct.
I will be looking to get another machine as I work away from home half the year and transporting gives to much chance for damage.

[cate1898]

Welcome to ApneaBoard shawnavonsr! Good luck getting going with your therapy! If you need any help, there's lots of experience hoseheads here to guide you along.

[trish6hundred]

Hi shawnavonsr,
WELCOME! to the forum.!
Much success to you as you start your CPAP therapy.
Hang in there for more answers to your questions.

[shawnavonsr]

Thanks, I am excited to start on this journey of better sleep. We all know that feeling, tired of being tired. Also glad to have found the forum for any questions and software to take an active roll in my treatment. I have a brother in law that has been on CPAP for 6 years and never read the data from his machine. And another guy I work with that hasn't either. I will learn and then pass the info on to them to help with their treatment.

[vsheline]

JustMongo, if I would have had a choice I would have got Vauto but this was ordered by the doc. Already the DME is concerned that insurance might not buy the machine and would have to rent. The 10 S can support up to 30 if the specs are correct.
I will be looking to get another machine as I work away from home half the year and transporting gives to much chance for damage.

Hi shawnavonsr,

Yes, be very careful when traveling with your CPAP to carry it with you in carry-on luggage. The CPAP machine in its case (travel bag) is "medical equipment" and should be free to take with your carry-on luggage, exempt from counting toward your luggage limit. (If you don't have a written copy of your prescription, ask your doctor's office to mail you one, and, especially for international travel, be sure to keep a copy of your CPAP prescription in the travel bag, just in case someone needs to see it.)

When traveling by car or bus, don't place it on metal floor where road vibration is greatest. Shock and vibration can ruin a CPAP machine or can make it operate more loudly ever afterwards.

I suspect that the many reports of patients receiving bothersomely-loud machines is likely caused by shock and vibration experienced during shipment.

Were you mostly sleeping on your back during the bilevel titration?

If yes, can you mostly sleep on your side at home? Usually sleeping on our back is worst possible sleep position. If you are able to sleep on your side and the AHI is very low, you may be able to ask your doc to gradually lower both pressures an equal amount, such as 14/19 and 13/18, etc.

If your AHI remains close to 5 even in your best sleep position, you may want to work with your doc in gradually raising the pressures, if you are able to tolerate the higher pressures. (Many are not.)

Also, if feasible, it would be good to buy a recording pulse oximeter to monitor your blood O2 saturation percentage (SpO2). Supplier 19 is reputable. (Link to Supplier List is at top of all forum pages.) The type which is worn on the wrist like a watch, with separate finger sensor, is more comfortable for wearing all night occasionally.

The difference between EPAP and IPAP (5 in your prescription) is called Pressure Support (PS). The larger the PS, the larger your SpO2 will tend to be. An SpO2 between 94% to 96% is ideal, I think, and spending hours on end at 98% and above is bad for our health, I think. Too much O2 causes oxidative stress on the body (which can lead to ill health) and can strongly reduce the effectiveness of various medications.

By the way, although the blower may be capable of producing pressures in excess of 30 cm H2O in a malfunction situation, the treatment target pressures can be set only between 3 to 25 cm H2O for AirCurve S, VAuto, ST, and ASV.

[shawnavonsr]

Your right and why I will be looking into another machine to leave at my work place. I work a rotation schedule 2 weeks on 2 weeks off and fly by helicopter which is not good for the machine.
The first split test was on my back as directed by technician. The 2nd study I was allowed to sleep on my side through the night. Sleep position will be mostly side as I have been a belly down sleeper and will adjust to side sleeping. So study results listed above were from the side but I believe at home results will be better as I relax in my own bed.
Will monitor everything I can and look into oximeter as treatment progresses.
Shawn