Survived my first night with CPAP, but just barely

[cate1898]

You will get multiple points of view on that one. I prefer to wash mine out daily. Yes, just a tad OCD.

[eseedhouse]

I generally empty it once a week for cleaning. Other nights I just top it up. I have yet to have a cold or any respiratory infection while doing this.

[StoopidMonkey81]

Ugh, and now we're back to not falling/staying alseep. Got 4 hours or so in last night. Really hoping this doesn't last much longer.

Another observation: a couple of times last night I noticed (in a half asleep state, but SH backs me up) that I stopped breathing for about 4-5 seconds or so, and then my body remembered "Oh yeah, I'm supposed to do that" and have a sharp inhale. It's not long enough to register as a CA (of which I only had one confirmed for the whole night), but it's odd nonetheless. I wonder if that's an indicator that I need to up the pressure or enable APAP mode. Still at static 9 at the moment.

[Tacoma Droner]

My concern with setting the APAP range that high is 1) my ENT might get P*ssed because he was reluctant to write me an APAP script even CPAP is what the sleep study physician recommended, and 2) I'm concerned that if the APAP jumps to the higher pressures it'll either keep me awake or wake me up. Falling asleep and staying that way is my goal for the next few days. I'll be keeping an eye on SleepyHead to make sure my hypopneas are under control.

I never worry about any medical professional getting "P*ssed" at me. My attitude is that they should be worried about doing something that will get ME P*ssed at THEM!

They work for me, I pay their salaries, they are my employees. Well, really not employees--they are independent contractors so they don't take orders from me, but still . . .

Look at it this way--do you worry about your car mechanic getting P*ssed at you? Of course not. But if your car mechanic tells you to never drive your car faster than 90 miles per hour, well he's an expert, right? So you should listen to him, but you should get an explanation why you should not go faster than 90mph. Maybe he has a really good reason. But if he can't explain it to you why 90mph is the only correct speed, if it doesn't make sense, even though you feel like varying your speed from 60 to 120 might be better, well then I'd either ignore his advice or go get a new mechanic. . . . Maybe that's just me.

I believe many of the folks who seek out this forum do it because they want more control over their sleep therapy. Sounds like you're reluctant to do that, even though the straight 9cm of CPAP is not letting you meet your goal of staying asleep. We all have "off" nights, of course, so one wakeful night is not a month of wakeful nights. But, if you're really devoted to using your APAP machine in CPAP mode, then you might consider keeping it that way for a couple of weeks, then looking carefully at your SleepyHead stats to see if your goals are being met. If not, maybe then it will be time to reconsider.

But definitely, the next time you go to see your ENT, I would ask him to explain the 90mph speed limit. :grin:

[StoopidMonkey81]

Yeah, I'm getting the feeling he's not an expert when it comes to this issue and I might seek an actual sleep specialist. He didn't even suggest I schedule a follow-up once I got the machine and wasn't too forthcoming with answers to the questions I had. I guess I was set on trying to make the static CPAP work in case I had to go back, but I'm weighing my options.

And as I said before, my other reason why I haven't tried switching it to APAP is my concern that I'll do something weird breathing-wise while awake and/or turning over that'll cause it to jack up the pressure to something uncomfortable and not come back down unless I restart the machine (and knowing my luck it would happen right before falling asleep). Has this been an issue for anybody?

[OpalRose]

Ugh, and now we're back to not falling/staying alseep. Got 4 hours or so in last night. Really hoping this doesn't last much longer.

Another observation: a couple of times last night I noticed (in a half asleep state, but SH backs me up) that I stopped breathing for about 4-5 seconds or so, and then my body remembered "Oh yeah, I'm supposed to do that" and have a sharp inhale. It's not long enough to register as a CA (of which I only had one confirmed for the whole night), but it's odd nonetheless. I wonder if that's an indicator that I need to up the pressure or enable APAP mode. Still at static 9 at the moment.

Those CA's of 4-5 seconds are nothing to worry about. Most of us do that daily without thinking about it.

You are overthinking this, and for some reason seem "afraid" to use APAP.

A lot of folk use an APAP in Cpap mode at a straight pressure. There is nothing wrong with that as long as it produces results.

I still stand by my earlier post. Switch to APAP mode, and set a range. Now that you know you can tolerate a pressure of 9, then set a range of 9-14. Watch for a week to 10 days. That is the only way to see what your AHI breakdown is and what pressure is optimum for taking care of events.

Set an EPR of 2 or 3 for comfort.

Only you can take control of the situation. Stop worrying about your DME or RT or Doctor. It's your therapy, not theirs.

[StoopidMonkey81]

Well, you guys convinced me. I switched it over to APAP mode last night and when I popped the card into SleepyHead this morning I was greeted with:

AHI 0.0


I had some trouble falling back asleep after my first bathroom break (still having 2 per night now) and figured I had to increase my starting pressure (again!) to 9.6 with a top end of 14. SH said the Autoset never raised the pressure above 12.1 and it mostly stayed around the 10s unless it was trying to deal with a flow limit. Snoring looks like it went down as a result. Looking forward to trying these settings tonight from the start so I don't struggle as much falling asleep. I'm very glad I found this board because if not I'd probably still be in sleepless agony with a static pressure setting that was too low for me.

[AlanE]

...my other reason why I haven't tried switching it to APAP is my concern that I'll do something weird breathing-wise while awake and/or turning over that'll cause it to jack up the pressure to something uncomfortable and not come back down unless I restart the machine (and knowing my luck it would happen right before falling asleep). Has this been an issue for anybody?

The A10 in APAP wants to be at the minimum pressure. It will always return to the minimum set unless it detects a snore, flow limitation or, after the fact, multiple OA.

If your machine, in APAP with a range, raises the pressure and stays at that level it is malfunctioning and should be replaced.

[OpalRose]

SM81,
Happy to see some results, but are you sleeping any better?

I should have said, watch for a week to 10 days before making anymore changes. :grin:

If you make pressure changes every day, you'll never get a feel for what works and what doesn't.

[StoopidMonkey81]

SM81,
Happy to see some results, but are you sleeping any better?

I should have said, watch for a week to 10 days before making anymore changes. :grin:

If you make pressure changes every day, you'll never get a feel for what works and what doesn't.

Thanks! Yeah, I understand that settings should be evaluated for a while to get a good baseline, but this was more about making it comfortable enough to fall asleep easy, not just zeroing out overnight events. I think I'm finally at a starting pressure that doesn't make it feel like I'm fighting to draw air in, which makes it very difficult to fall asleep and is mildly panic inducing.