Newbie to this board: Lots of questions

[Palmtrees]

I just found this board and am so thankful.  Information that is so helpful.  I was diagnosed one year ago with sleep apnea after going to the doc complaining of being tired, sleepy all the time, falling asleep anytime I sat to watch TV, and one episode of falling asleep behind the wheel.  THAT scared me enough to go for the sleep study.  I was given an AHI of 10, but the AHI during REM sleep was 23. 

I have been using the AirSense 10 CPAP (which I now know is a "brick") set at a pressure of 7 with an EPR of 3.  After trying several types of pillows, masks, etc. it seems the nasal mask with the hose on the top of the head is the best bet for me.  I use a chin strap for the dry mouth and sometimes I have to tape my mouth, but the full face masks just don't work for me.

Here is my question -- after about 3 months struggle and adjustment, I was doing pretty well... got "events" down to about 0.3 and the AHI was down, also....but for the last month or so, my "events"  are up to 3, 7, or even 10 and my AHI has jumped to 5.  I really don't know what happened.   Any ideas, anyone?

I really need to use the machine.  The difference in my life is major.  I still get sleepy at the end of the day, but I have a long, busy day, so that is not surprising.  The fact that I am awake and typing this at 11 pm is amazing.

Also, I am cleaning the mask, hose, etc. with soap and water and using a Lumin to sanitize twice a week.  Any comments on using that?

Thank you!

[Melman]

Welcome to the forum. Do you have a copy of your complete sleep study you can post. That will be helpful. It's too bad you got a brick. By events do you mean the total number per night. We are more interested in the AHI (events per hour) What was the AHI when you were doing well? It sounds like you are feeling better even though your AHI has increased to 5. Have you have many nights at 5 or are they just occasional? It's not unusual for AHI to fluctuate. I believe the Lumin to be an effective sanitizer as long as the items are cleaned first. UV light will not clean and will not effectively santize a surface that is not cleaned. As long as you clean before using the Lumin it should work fine.

[mesenteria]

You were the "you" you were at the time of diagnosis.  After a few months of initially great response, adoption, and treatment, you are no longer the person you were at the time of diagnosis.  Something about you, maybe including the way you sleep, has changed. That is why your AHI is changing, and unfortunately it's going the wrong way.  It might be time to re-evaluate your choice of mask, the pressures (fixed and/or EPR), the position in which you (now) sleep most often, a new sensitivity or allergy, and so on.

I don't have the savvy yet to suggest what, if any, changes to pressures you might do better with, but you could possibly consider altering some of the other factors that come to mind.

I trust melman's advice about the Lumin.  I don't use any device, just soap, warm water, a good rinse, and then I rinse the tubing and mask with potassium meta-bisulfite every two-ish weeks.

[Gideon]

Welcome to the Forum

I too would like to see a full copy of your sleep studies. The summaries tend to leave some important info out.

Your symptoms are/were worse than your AHI would normally indicate which has me looking for flow limitations and RERAs. The good news is that your pressure at 7 and EPR of 3 is definitely a good way of managing them.

Important is your AHI trends and how you feel. My numbers jump to the 2.5 to 3 range often enough that I notice. My Norm is a ,5. My "fix" is to ignore these. Spot jumps to higher numbers we also ignore. If your numbers have shifted to AHI of 5 for several days, especially if over time, not that we want to address

We do that with an experiment called titration. This means a change in pressure, usually up, then look for changes in both numbers and in how you feel. Both are important. The expectations are a decrease in AHI and a decrease in symptoms.

It can take several days to properly note changes so we want to take our time. In the lab these changes are made with a min of 10 to 20 minutes of data which we lack.

If the above defines you set your pressure to 8 and let us know the results.

[Palmtrees]

thank you for your reply.  Yes, by events I mean events per hour.  Actually, much better last night.    I will scan and post sleep study report.

[Palmtrees]

Good point about being different a year later.  Didn't think of that.   Learning how to add attachments.  Hope this works


  IMG_20190830_0002.pdf (Size: 557.96 KB / Downloads: 37)

[Gideon]

That is a summary, it contains no details on the makeup of your apnea. The full study should include some tables and/or graphs.

[Palmtrees]

  IMG_20190830_0004.pdf (Size: 683.63 KB / Downloads: 40)

[Palmtrees]

thank you.  I am scanning and the board is telling me that the files are too large.  So I will post one at a time.  Sorry for the problem.

  IMG_20190830_0001.pdf (Size: 429.9 KB / Downloads: 36)

[Palmtrees]

  IMG_20190830_0001.pdf (Size: 184.81 KB / Downloads: 32)