New to treatment, no guidance from PCP, OK to go it alone?

[Deej]

Hey guys!

I'm new here (2nd night of therapy). My apnea is pretty much self-diagnosed (well, by my wife) and I went to my primary care physician and asked for a sleep test. After bugging the heck out of the office for 6+ months, they finally ordered a home sleep test. A couple of weeks later, I got a call from my durable medical supplies vendor wanting me to come in for a mask fitting and to get a machine. I had not heard anything from my PCP or Novasom that did the home sleep test. I went to the medical supply vendor and they gave me an AirSense 10 Autoset and I picked a Phillips Nuance Pro because it looked the most comfortable. The supply vendor was pretty helpful, but their help is obviously limited since they aren't my doctor and don't have access to my records.

So I guess what I'm getting at (other than I am looking for a replacement PCP) is am I going to be OK doing this therapy on my own? Do I need follow-ups with my PCP or anyone else? I did not get any initial info such as my sleep test AHI or any goals I need to meet. I did download Sleepyhead and as you can see I am more of a "highly engaged" patient type, so I don't have a problem learning about my condition and setting the machine on my own, I just don't want to march forward using google as my doctor if it's not recommended.

Eventually I will probably get a new PCP and get them engaged in my treatment, but getting that ball rolling and getting settled will probably take months, especially since I will probably have to go out of town to get a new doctor.

[AlanE]

No need to go it alone when you have Apneaboard.

You're entitled to a copy of your sleep study report. I would attempt to get that since that will give you a good starting point.

The A10's default is wide open 4-20 on the pressure in Auto mode. You may find 4 is too low to start with. Keep checking Sleepyhead and let us know the numbers and when you can post some of the screen shots we will be happy to take a look at them.

Grab the clinicians manual here if you don't already have it: http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Some more helpful info on the A10: http://www.apneaboard.com/resmed-airsens...setup-info

[Deej]

I think they set mine to 5-20, but I felt like I was breathing through a straw.

I ran my first night through sleepyhead and it said my 90% was around 9 or 10 I think, and someone said to set it to 2cm lower than that, so I went with 8. It felt a lot better the 2nd night.

All of this is from one day of surfing on the boards at work, so I'm sure I missed or misread some things, but trying to take it all in.

[AlanE]

Great. After that initial pressure change, it's best to wait a week or two to get used to it and revisit the pressure again.

[Deej]

Awesome, thanks for the help!

I imported my SD card before I went to work this morning. I'll try to post some screens when I get some free time later today.

[justMongo]

I ran my first night through sleepyhead and it said my 90% was around 9 or 10 I think, and someone said to set it to 2cm lower than that, so I went with 8. It felt a lot better the 2nd night.

That should be, to set the Min pressure 2 cmH2O lower than the median pressure; and the Max pressure 2 cm higher than the 90% pressure.
That should not be done with a single night's statistics; more like a week or more. Plus, I would not set min pressure below 6. Below 6 most people do feel like they're breathing through a straw.

You should feel better as time passes and you keep using the machine.

[Geniale]

Just wanted to wish you good luck! I am in a similar situation as I'm also going at it alone (with the help of the great people here) and just completed my second night of treatment. I'll be following along to see how you're doing!

[Deej]

Here are my numbers if you care to see them. (I hope I posted these images correctly, they seem huge).

I took the mask off Tuesday night and didn't realize I did it. I woke up again about an hour later and put it back on. The graph is messed up because I was testing the mask after work and it logged it as sleep.


edit: The img tags won't work, says I can't post clickable links, so here is the imgur links.
Album: imgur.com/a/Daup8

http://i.imgur.com/KCQ89lz.png





And here are some shots from Wednesday night.

http://i.imgur.com/g9tCijy.png

http://i.imgur.com/ISAlcfQ.png

http://i.imgur.com/Jubh63O.png

[PaulaO2]

I fixed your links. You can do attachments if that works better for you.
http://www.apneaboard.com/forums/Thread-...ttachments

[Sleeprider]

Deej, looks like you're getting pretty good treatment. If you want to eliminate some of that OA, you might want to increase the minimum pressure a bit. You're using an EPR setting of 3, so your minimum EPAP pressure is actually your minimum pressure minus 3 cm. As you can see, your mask pressure drops to about 5.0 on each breath. It's still a low event rate, so you're doing fine if you don't change a thing.