Newbie with some questions..

[membus]

Hi everyone,

First of all, Merry Christmas and a happy new year to all.

I’m a 36 years old male who’s been diagnosed with OSA. After a couple of months of my first sleep study just had my titration sleep last week. However, around these parts of the world, getting the report and prescription will take around 1.5-2 months.

In the meanwhile, I wanted to start to educate myself on the issue so that when my report and prescription is ready, would like to have an idea on which machine to buy and what to look for.

But of course, as a newbie, I have so many questions that I’m trying to figure out. Would love to have some expert advice.

I’ll try to be as thorough as possible.

1st Sleep (PSG):

• AHI: 35
  
• O2 Saturation: Awake 97, Lowest 83
  
• Weight: 115 kg (254 lbs)
  
• BMI 31.2

2nd Sleep (Titration):

• Supine Pressure 7 (according to the sleep tech when asked in the morning)
  
• Non-supine Pressure: 5 (according to the sleep tech when asked in the morning)
  
• Weight: 106 kg (234 lbs) (My wife says after losing 20 pounds my apnea episodes have decreased a lot.)
  
• BMI 28.8

Medical Conditions:

• Non-Alcoholic Fatty Liver Disease - Grade 2
  
• Long-term elevated liver enzymes. (a liver biopsy is scheduled to check for possible underlying factors and determine damage to the liver)
  
• Have slight deviation in the right nostril and thus gets easily half or fully congested.
  
• Having a nasal deviation operation is out of the equation for the moment due to the liver condition.
  
• Quit smoking 1.5 years ago and only drink occasionally, 1-2 glasses of wine. However, for the last year almost didn’t drink anything at all.

With above information in mind, I’d very much appreciate your answers to the following:

• Is there a situation where a person won’t really benefit from an APAP, like low-pressure needs, or is APAP a must for everyone in the long run?
  
• If a person has nasal deviation and the nose is prone to congestion, limiting air flow through the nose, does this mean that this person will need higher pressures during such times?
  
• If the answer to the above question is yes and that person has a normal CPAP, is it logical to increase the prescribed pressure setting to let’s say +2 pressure to compensate for any extra pressure needs that may arise? This’ll mean the person will get higher pressures during normal times of course.
  
• If you already live in an area where humidity is high, like in Istanbul, does it still help to use a standard or heated humidifier?
  
• Are there any forum members with fatty liver disease and/or elevated liver enzymes that got better in time with CPAP use?

Those are the questions I have so far. Would very much appreciate your help and advice.

BTW, after extensive reading, I think I have decided on buying the S9 AutoSet. I just couldn’t justify paying the extra for AirSense 10.

Also, I can’t express how grateful I am to all of you who spend hours answering questions and providing more value to the wealth of information here. Thank you all.

With love from Istanbul..

[DariaVader]

marhaba, membus



You have a diagnosis of severe OSA based on the information posted. I am glad you are getting the S9 Autoset, members have a lot of familiarity with that machine. You are young - that means you have better odds on improving your medical profile with cpap use. Apnea likely contributed to many of them, and treating it will give your body a chance to heal over time.

I believe that the deviated septum just makes it harder to use nasal pillows, but if you are able to get a seal with them they are the best at keeping the nasal passages open.

[DeepBreathing]

G'day membus. Welcome to Apnea Board.

As Daria said, you have severe apnea, but the good news is a) you're still young enough to do something about it and b) your titrated pressure is quite low, so you shouldn't have too much trouble adjusting to the treatment.

Is there a situation where a person won’t really benefit from an APAP, like low-pressure needs, or is APAP a must for everyone in the long run?

There are alternatives including oral devices and surgery. Both are invasive and have mixed results. The problem with the device is that you can't get any data to monitor your progress. And surgery is (apparently) very painful and doesn't work for a lot of people. CPAP treatment is the gold standard for treating apnea. Even though your pressure needs are low, without treatment your apnea is severe enough to be a genuine health risk.

If a person has nasal deviation and the nose is prone to congestion, limiting air flow through the nose, does this mean that this person will need higher pressures during such times?
If the answer to the above question is yes and that person has a normal CPAP, is it logical to increase the prescribed pressure setting to let’s say +2 pressure to compensate for any extra pressure needs that may arise? This’ll mean the person will get higher pressures during normal times of course.

This should have been considered in the titration study. The S9 Autoset (in auto mode) can adjust pressure as needed between set limits, so it doesn't run a constant pressure all the time. It's probably best to set the minimum pressure at your lowest titrated pressure and the maximum a bit above you highest titrated pressure and let the machine go from there. Get hold of SleepyHead software, which can monitor your progress in great detail and gives you the information necessary to fine tune your treatment. http://www.sleepfiles.com/SH2/

If you already live in an area where humidity is high, like in Istanbul, does it still help to use a standard or heated humidifier?

That's entirely up to the individual. Some people (like me) run the humidity at max all the time (even on holiday in Bali). Others never use it. All I can say is give it a try and see what works best for you.

Are there any forum members with fatty liver disease and/or elevated liver enzymes that got better in time with CPAP use?

Sorry I can't help with this one. I didn't actually know about fatty liver disease, but found a simple write-up here: https://www.betterhealth.vic.gov.au/heal...er-disease

[trish6hundred]

Hi membus,
WELCOME! to the forum.!
The S9AutoSet is a good machine, I’m very happy with mine.
Respironics is another comparable brand of CPAP machine.
Here is a link to give you guidance on which machines to buy and which ones to avoid: http://www.apneaboard.com/wiki/index.php...ne_Choices .
Hang in there for more responses to your post and much success to you as you start your CPAP journey, and merry Christmas and happy newyear to you also.