New to treatment

[jbee18]

Hello everyone,

I am brand new to this forum and OAS treatment as well. Started treatment 20 February this year, and to date have been able to wear the mask all night every night without any real issue. I am trialing equipment from local sleep center (ResMed Airsense 10 Autoset with Dreamwear head gear and nasal cushion). Things seem to have gone well for the first bit, AHI was cut drastically. My over night home monitoring showed and AHI >91 which has been reduced to an average of 8.36 over the first week. The Respiratory tech has made two changes since the 28th of Feb. and I am not sure they were for the better. Primarily she has changed from APAP (6 -15, EPR 2) to CPAP (Fixed 9, EPR1),and then CPAP (fixed 11, EPR off). The changes have not made any real change in my AHI and surprisingly I don't feel as rested in the morning. I would post images but need a few more posts first.

Thanks in advance for your help.

[Sleeprider]

Hi Jbee, you don't need a minimum number of posts to attach a Sleepyhead image. That went away when the attachment limits were removed a few weeks ago. Tutorials for attaching images are in my signature. We can help, but really need to know the type of apnea that remain with your therapy, and when and how they occur. Take a look at the tutorials. and post some attachments, and we're glad to help. Welcome to Apnea Board.

[mesenteria]

Welcome.  For what it's worth, I would have to say I generally feel less energetic, or less eager to get out of bed, since starting CPAP three months ago.  Part of it may be my AFib medication, as was cautioned, but I don't attribute any great and positive change to my health now on my third month of CPAP over and above what my statistics tell me each morning...and that is that my AHI have dropped from a pre-treatment average of 30/hr down to less than two.  I have to take that cue as my beacon and just assume my heart and brain will do better over the long term.  I hope you find that you feel more positive about the CPAP experience in time.

[jbee18]

Thanks Sleeprider and Mesenteria,

Here screenshots of the first few days. I will attach some from after the changes in another post.

[jbee18]

Shots from after changes

[mesenteria]

You have several clusters of purple "clear airway" indications in the first set of charts, and that is not ideal if I recall my learning over the past few weeks (in the 'flow rate' graph).   Clear airways are an indication of central apneas.  I don't know enough to coach you about this, but you'll get good feedback from very savvy people very shortly, and I'll soak up as much of what they learn us as you get.    Hope you don't mind me lurking here.....

[fitmart]

First let me congratulate you on taking the initiative with your apnea, using sleepyhead,  and joining this group.  Judging by your post, you are waiting for the medical supplier to make adjustments to your APAP.  If you don't know how, it is simple on the ResMed Airsense 10.  Just hold down the big round button beside the screen while simultaneously holding down the home button.  Hold for 5 seconds and it will switch to "clinical mode" and you will be able to make your own adjustments.  

You stated you were originally set on APAP 5-15 and had just as good success as you do after the adjustments.  I am not sure why they used CPAP mode instead of just setting the max pressure at 9 or 11.  That way during the hours of night you don't need the higher pressure you will be able to breath easier.  Might be why you are experiencing more fatigue with the CPAP setting.

Lastly, I would be remiss if I didn't recommend you experiment with a soft cervical collar.  Just buy a 3" soft collar from Walmart and try wearing it one night and see if it affects your apnea.  It reduced mine by almost 2/3.  The theory is that it help hold you chin up which actually opens the airway more.  This is more effective with those that have minor/moderate apnea, but certainly worth a shot.

Good luck my friend.

[trish6hundred]

Hi jbee18,
WELCOME! to the forum.!
It's great that you took charge of your Sleep apnea therapy.
Good luck on your CPAP journey.

[Sleeprider]

Jbee, it looks like you started your therapy with autoset pressure from 6 to 15 EPR 2 and recently tried fixed pressure at 9.0 with EPR 1, then 11.0 without EPR. I think your approach is sound, but your last change just went too far too fast. From 9.0 EPR 1, I would have suggested increasing pressure in 0.5 cm increments, to avoid triggering the CA that became more prominent at higher pressure.

You are clearly sensitive to pressure, have mixed (complex) apnea, and may eventually need a different therapy approach. I can't think of a good reason the majority of your events occur at the end of the night after 6:30 AM. Maybe we will have to put you to bed earlier and get up earlier. Can you think of anything about your physical position in the morning that might be going on that could contribute to positional apnea?

[jbee18]

Thank you everyone,

Fitmart-  I will look into the collar.

Sleeprider - I spoke to the Res. Tech. about the clusters earlier this week. She thought it might have something to do with the sleep stage I'm in.

AHI last night 2.47 which is the second time below 5 since starting therapy. Again more CA than OA.
One thing I have noticed since the pressure increase is that I now have trouble with leakage through my mouth. This morning I turned the EPR back on and hopefully that will make a difference.