Obstructive sleep apnea – My Nightmares are bad.

[Pirate Bob]

I’m 73 years old male and a few months ago I had an overnight hospital sleep test which concluded that I suffer from Obstructive sleep apnea .

My symptoms include …

Abrupt awakenings accompanied by gasping or choking.

Nightly bad dreams that some thing is stuck in my throat .

On the advice of the hospital doctor I purchased a ResMed AirSense 10 machine which I currently use with a ResMed AirFit N30i mask.
 

My  ResMed AirSense 10 current settings are …

Tube Temp – 20° C
Pressure Relief – On 
Smart Start – On
Mask – Nasal
Ramp time – off 
Climate Ctrl – Auto
AB Filter – No
Essentials – Plus
Response – Soft
EPR – On
ERP Type – Ramp only
EPR Level – 3
Therapy – Mode – Autoset
Max Pressure – 20.0
Min Pressure – 4.0

The above  ResMed AirSense 10 settings were made by the hospital doctor , but I have moved to another country , so no longer have access to that doctor to ask advice .

I have tried the following supplements ( without much success ) 

Melatonin
Magnesium
Passion Flower

Before using my ResMed AirSense 10 at night  , I clear my nasal passages using a nebulizer spray as I tend to have nasal obstructions ( stuffy nose ) .

In bed I sleep on my side .

I now sleep in a separate bedroom from my wife , because when I start dreaming that there’s some thing stuck in my throat , I tend to panic and erratically move about thinking that I have to some how physically remove the object stuck in my throat, this leads to me having  an anxiety attack.

Today I have just installed Oscar CPAP analysis reporter program on my computer 

The constant nightly dreaming / panicking are slowly wearing me down , but I’m hoping that may be some thing in my ResMed AirSense 10 settings are not correct and may be altering some thing in the settings option will eventually lead to me finally not having my nightly dreams and feel generally much better.

I’m really hoping  some one here can offer me some advice or suggestions that will help me in my quest to feel better. 

Thanks – Bob

[Phaleronic]

You need to raise the min pressure to at least 7 for EPR3 to work correctly, and 4 is much too low for minimum, please follow the guides here to raise it to 7 as a start (you're starving for air).

[staceyburke]

7 may even be to low - my min pressure is9 or I’m pulling off my mask to get enough air. Start at 7 but don’t worry about raising more if you feel you are not getting enough oxygen.

[OpalRose]

Pirate Bob,
Welcome to Apnea Board!

Your description "abrupt awakening, gasping/choking" are symptoms of "untreated" apnea.   With the current settings on your machine, your doctor pretty much left you
the same as being untreated, even though you are using your machine.

I don't like to recommend changes without seeing some data, but until you can post an OSCAR chart for evaluation, go ahead with the following changes.

Set you device to Auto Mode (standard setting, not soft).
Set your pressure to 8 cm minimum, 15 cm maximum, and EPR 3 (full time).  
Your current EPR says ramp only.  (Keep ramp off).

This is just basic pressures to get you started and to feel more comfortable.
Note, that after we see a chart, there may be further adjustments.

Be sure you have an SD card in your Apap while you are sleeping.  

Follow the link in my signature line below to help guide you in setting up an
OSCAR chart.  
Use the Attachment Feature to post a Screenshot of the daily page.

[Pirate Bob]

You need to raise the min pressure to at least 7 for EPR3 to work correctly, and 4 is much too low for minimum, please follow the guides here to raise it to 7 as a start (you're starving for air).

Many thanks for taking the time out to reply , its appreciated  .





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7 may even be to low - my min pressure is9 or I’m pulling off my mask to get enough air. Start at 7 but don’t worry about raising more if you feel you are not getting enough oxygen.

Your comment is really appreciated   


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[quiescence at last]

The others covered most of it, EPR will help but may need adjustment later, and a post of an Oscar plot will certainly help us help you. At the very least, you should be able to read the main CPAP panel, and you should see what the AHI value is and the 90 percent value for pressure is, and you can post those as some indication.

QAL

[Pirate Bob]

The others covered most of it, EPR will help but may need adjustment later, and a post of an Oscar plot will certainly help us help you.  At the very least, you should be able to read the main CPAP panel, and you should see what the AHI value is and the 90 percent value for pressure is, and you can post those as some indication.

QAL

Thanks for the suggestion / advice. I am having a problem posting my OSCAR results , but will keep trying


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Thanks Opal Rose for the advice 

Well last night for the first time ever I used OSCAR , I set my ResMed AirSense 10 as per your suggestion  but my report only covers just over 2 hours . As I had to quickly turn off the machine due to a large snake finding its way into our lounge , so it took a long time to deal with that .

I'm trying to interpret and fully understand the OSCAR results .

Any thoughts or suggestions most welcome.


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[quiescence at last]

I think there is a minimum # of posts needed before you can attach graphics to your posts. I actually thought this was 5 post, and now see you above 5, so give it another try. If you have the graphics, but just can't post them you might be able to put them in a cloud location somewhere (google drive, one drive, or imgur) and send us a link to it.

QAL

[OpalRose]

Your leak rate is high and persistent throughout the night. Are you aware if you're mouth breathing? Are you waking with a very dry mouth?

Your mouth/jaw may be dropping open while you sleep. If you want to continue using a nasal mask, you'll have to find a way to control that.

Also, take note how your mask fits. Feel for air leakage and adjust headgear as needed.

Although your chart looks good, the results may not be accurate when the leak rate is too high.

http://www.apneaboard.com/wiki/index.php..._The_Guide

Once you tackle the leak issue, I think you should be able to sleep more than a couple hours.

[staceyburke]

As opal said the leaks mean you are NOT getting therapy. Any place you see the gray your machine can NOT give pressure to stop the apnea. The air is going out your mouth and not helping.