Newbie

[Sunrise08]

Hi, all!

I'm new to the CPAP - been using about 3 1/2 weeks. I'm using a ResMed AirSense 10 and SwiftFX nose pillows, with a ramp up from 4 to 6. The SleepyHead software indicates that my AHI averages less than 5 a night. I'm still extremely tired, though.

I notice that last night, even though my AHI is 4.52, it spikes up as close to 18 in the wee hours of the night.

I went to bed about 10:50 PM, and from about 3:25 AM to about 4:45 AM, my AHI is consistently over 5 and going as high as 18. My total time in apnea was 00:08:17 last night.

Is this to be expected and considered good results? Or does it indicate that pressure of 6 is not enough for me?

I used the machine for a total of about 8 1/2 hours - one break of about 10 minutes near 1 AM.

I'll welcome any thoughts from this wonderful group!

[trish6hundred]

Hi Sunrise08,
WELCOME! to the forum.!
Hang in there for suggestions and answers to your questions and much success to you.

[kaiasgram]

Hi Sunrise: Could you clarify -- Is your machine the Airsense 10 Elite or Autoset?

And what is the breakdown of your AHI events (obstructive apnea, hypopnea, central apnea)? When the AHI is too high it is important to know what types of events are occurring before figuring out what to do about it.

The effectiveness of CPAP is generally based on the AHI for the night as a whole. It's not unusual to see events clustered in smaller chunks of time because apnea events often occur most frequently when sleeping supine and in REM stage sleep. So just looking at a one hour period isn't necessarily a good way to evaluate.

When you're able to post some screenshots of your SleepyHead reports we might be able to see some issues that aren't reflected in the AHI like snores and flow limitations. AHI is not the whole story of optimal CPAP therapy.

[zonk]

Is this to be expected and considered good results? Or does it indicate that pressure of 6 is not enough for me?

I used the machine for a total of about 8 1/2 hours - one break of about 10 minutes near 1 AM.

I'll welcome any thoughts from this wonderful group!

Sleeping 8 1/2 hours is good results in such short time ... congrats
Its not usual to have AHI on high side when starting out, will come down in due course


[should say "AutoSet, AutoSet for Her, Elite or CPAP"]

Which one is your machine?

[OpalRose]

Sunrise08,
Welcome to Apnea Board,
Until you are able to post screenshots, which is after about 8 posts, look on Sleepyhead, and give us a breakdown of your apnea events:
Hypopneas, Obstructives, clear airways, flow limitations, snores, RERAs.
Also, can you tell us your 90% and average pressure numbers?
It's possible that a starting pressure of 6 is just too low for you, but changes should only be made based on above information.

[Sunrise08]

Hi, all!

Thank you so much for your responses (including the reassurance from trish6hundred that I would get responses )

I'm using the Airsense 10 Autoset - thanks for pointing out that there's a difference between Autoset, Elite, etc. - I didn't know that, and have updated my profile.

Breakdown of apnea events for 7/23/15 -
Large Leak 0.00%
Clear Airway 1.79
Obstructive 2.02
Unclassified Apnea 0.00
Hypopnea 0.71
RERA 0.00

Last night (7/24/15) the AHI was 5.82 with a breakdown of -
Large Leak 0.00%
Clear Airway 1.40
Obstructive 4.31
Unclassified Apnea 0.00
Hypopnea 0.12
RERA 0.00

Pressure -
Average Pressure 5.79
Min Pressure 4.00
Max Pressure 6.00
90% Pressure 6.00

Duration of use - I was able to use the CPAP again for 8 1/2 hours last night, but last night and the night before were the first nights I've used it for over 8 hours. For any other newbies that might read this, I don't want to give the impression that it's been easy. I've really struggled with the CPAP machine - especially with anxiety, but I'm very motivated to improve my sleep.

Thanks, again! I'll greatly welcome any input.

[OpalRose]

Your clear airway events are low, so wouldn't worry about that. It could be from sleeping on your back, so try to sleep on side as much as possible.

Your Obstructives can come down with pressure adjustments. If the pressure doesn't bother you, you could turn off the ramp. A lot of folk don't like it, and it makes it harder to inhale at a low pressure.

If I were you, I would change the machine to Auto mode instead of straight CPAP, with a range of minimum 7 and maximum 10, then watch your number for a week to 10 days.

Get the Clinicial Manual for your machine (top of page) for directions on changing pressure.

[Sunrise08]

Thanks, OpalRose! I went to the link you directed me to, at the top of the page, and have requested a copy of the manual for my CPAP machine. Thanks for the information!

[AlanE]

Looks like you are in APAP if you have a range instead of a set pressure. I've only been in APAP since I started so not sure if CPAP mode gives the same range. I would agree with OpalRose on the pressure. 10% of the time you are at your max pressure of 6. Are you using EPR, Ramp?

Having increased pressure helps with the feeling of being smothered. It took me awhile to get used to wearing the mask. Sleep Study guy told me to force myself to use it for 8 weeks. That's pretty close to how long it took me. Now I won't go to sleep without it. It's sort of comforting now. weird, but I'm that way.

Also, good job on keeping the leaks down.

[Sunrise08]

Thanks for your reply! I'm not sure if I'm in APAP, or if it's CPAP but the Ramp feature makes it look like there's a range. I'll have to play around with the settings and read the clinician manual to start to understand the finer points. I appreciate your feedback!