Replies to This Discussion

Permalink Reply by Glen England on April 1, 2009 at 11:46pm

How tight are you wearing your head gear? I was really worried when I started CPAP because I cannot wear a hat without getting a headache. I find that I usually don't get headaches from CPAP, I got more morning headaches WITHOUT CPAP. But, if your headgear is too tight, this may give you a headache. It does take some time getting used to CPAP, but, this is more from the pressure and continuous air flow. It's hard to exhale at first. But, a few weeks after I started CPAP, my headaches lessened in the morning.

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Permalink Reply by Judy on April 1, 2009 at 11:51pm

How are your sinuses? Stuffy? Irritated? Its not unusual for those NEEDING CPAP to have headaces but I've not heard of CPAP therapy CAUSING headaches.

There are what are called RDIs (respiratory disturbance index) which counts apneas, hypopneas and breathing episodes that don't quite develop fully into apneas or hypopneas so that there could be an RDI and an AHI w/different numbers. There is a "syndrome" (for lack of a better term) referred to as UARS (upper airway resistance syndrome - I "think" I have that right) that is only recently being recognized.

Your first in-lab night would have been the sleep evaluation study. Had they woken you up to put the CPAP on, it would have been what we call a split-night study. Actually, a full night of evaluation is the better for detecting the various sleep disorders as well as OSA. The second night in-lab was what we call the titration study wherein you do wear the mask and have the CPAP.

The 5 times stopping breathing as normal is actually 5 times PER HOUR (the AHI). A higher RDI is required to qualify as OSA. An AHI of 5 usually requires other symptoms of sleep deprivation such as a daytime sleepiness, exhaustion, etc., etc. I'm taking a guess the question you have regarding 30 vs 50 may have to do w/the AHI or the RDI numbers and their requirements.

One desaturation to 88% as your lowest desat was nothing to worry about. BUT, you can still have desaturations that don't drop below 90% and those desats can disturb your sleep.

Keep in mind, I'm just a patient myself, I am NOT a medical or sleep professional. I'm sure the doctor's dictated results (1-2 pages each) and the full scored data summary report w/condensed graphs (5+ pagaes each) will help to clarify things for you. There is so much new to absorb during the short consultations we usually or at least often encounter "information overload" and its hard to remember everything in correct context.

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Permalink Reply by Glen England on April 1, 2009 at 11:58pm

Something else I thought of is headache might be a sign that you are still having apnea's. You could ask your doc to give you an order for an auto CPAP to be used for 30 days. My DME provider loaned me an auto CPAP when my doc felt that my pressure needed be to adjusted. I used it for 30 days, and the DME sets a low pressure and a high pressure. The machine detects when the pressure needs to be adjusted and does so accordingly. There were some nights my pressure got up to 19 with 20 being the greatest possible. In the end, they adjusted my 16 down to 13 from the results of the 30 day auto CPAP study.

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Permalink Reply by RockRpsgt on April 2, 2009 at 12:18am

The way the RDI works out is this(at least the way it has been explained to me). 0-5 events per hour is healthy(which is the target for titration), 6-15epr is moderate, 16-29epr is high 30 and above is severe. I know the difference between 30 & 50 is alot, but I don't see it as all that much different severe is severe. As for desats one time at 88% that is not all that bad. typically we want to keep them above 90% with cpap titration. 11cmwp is a good average number for cpap. keep in mind that this number does not go by the severity of your apnea, but rather the lowest possible pressure needed to open your airway. yours is 11 someone else with the same RDI of 50 might be 18, another might be 9, and yet another 13. This is why they say that titrations are more of an art than an exact science. To be honest some days I feel like Van Gogh painting the Mona, Lisa and others like a toddler getting his first set of finger paints.

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Permalink Reply by Judy on April 2, 2009 at 2:26am

Giggle. Choke. Snork.

"To be honest some days I feel like Van Gogh painting the Mona Lisa and others like a toddler getting his first set of finger paints"

LOVE your honesty with such humor, Rock Hinkle!!! I'm glad it was water and not coke I just snorted up my nose when I read that comment!!!

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Permalink Reply by Barbara on April 2, 2009 at 11:18am

Thank you everyone!
I just got off the phone with sleep lab. I'm going to pick up copy of the study this afternoon. I asked for the detailed study with graphs and everything (hope they actually copy all of it).
Woke up with another dadgum headache this morning. I don't think the head mask is too tight but that’s a good idea. I think I'm going to drop by the medical supply place today and have them re-fit it for me. I wake up over and over grabbing it and sticking it back up my nose - geez. Irritating. It doesn't fall off but more specifically the holes in the pillow thing shift and don't line up with my nose holes (lol, I can't believe I wrote 'nose holes'). I've adjusted over and over. Maybe my head is rejecting this new velcro hat and I need anti-rejection meds. The exhale thing might be it. It feels like I'm using muscles inside my brain to blow air out. I set the machine on the lowest "blow-out pressure". I think I suck in a lot better than I blow out. I hope brain matter doesn't start coming out my nose. I WILL GET BETTER WITH THIS STUFF. I WILL. I WILL. Oh, sinuses do feel irritated along with my right lung which feels like it has a dry area inside the lung. I'll try to turn up the humidifier part of the machine tonight. I'll ask medical supply people if there's a way to turn up the moisture without the air getting warm. You all seem like Van Goghs to me and I'm the one slinging paint on the walls right now.
THANK YOU ALL SO VERY MUCH for answering my concerns. I know how it can be irritating to answer newbie questions over and over and over. You were all very kind to respond so quickly. I'll pick up copy of results today and start the learning process ASAP.
Barbara

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Permalink Reply by Monica on April 2, 2009 at 3:06pm

Barbara - as a newby myself I can tell you this - the group of people on this forum seem never to tire of answering the endless questions of a newby. The main reason - this forum is in place to be an educational tool as well as a place to vent problems and acquire answers and solutions. I thank God every time I come here for people who are ready, willing, and able to use their experience and knowledge to inform someone who is not so.

As I said - I am only a newby myself, but 3 things come to mind about your headaches:
1. as mentioned before, the headgear may need adjusted to get a better fit, or you may need to try a different type or size of interface between you and that tube/machine
2. the sinus thing - maybe that congestion is causing you to not get the full amout of oxygen you need when sleeping. Oxygen deprivation causes some nasty headaches. You may need to discuss some options with your dr. My sinuses were swollen and causing me problems before CPAP - my dr prescribed a spray (generic nasonex, I think) that was supposed to help (for most "normal" people it probably does. In my case, I was already waking up most mornings with a headache and the med just made it worse. I stopped using it - it was also causing bloody noses because it dried out my nasal passages and the smell of it made me gag!). Dryness in the nose can cause headaches also. Increasing the humidity on your machine may help - it has for me. I don't have the stuffiness issues I used to since using my machine with the humidifier. I keep it at 3, or 4 if I am especially stuffy. I haven't had to deal with am headaches since using my machine - PTL! It may be as simple as using some saline nasal spray before bed and first thing in the morning to keep the nose moist or taking some kind of sinus or allergy med. If you are having problems keeping the interface in place through the night, there is a chance that it is blowing in your eyes - dry eyes can be a cause of headaches also.
3. pressure adjustments by the machine itself - you just may not be used to it yet. Do your ears feel like they need to pop when you first turn on the machine? Try using the ramp or opening your mouth to release some of the pressure. That may help also.

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Permalink Reply by sleepycarol on April 3, 2009 at 7:01pm

Please keep us posted about your headaches.

I have severe allergies and used to wake up with headaches so bad that at times I wished my head would just ahead and blow up to get relief. I know now that part of it was allergies and part of it was lack of oxygen to my brain due to apneas. The allergy headaches are seldom know since I use my cpap nightly. But I still will get them, especially now that things are blooming out. You might want to try an over the counter allergy med to see if it would help.

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Permalink Reply by Barbara on April 4, 2009 at 12:04am

UPDATE:
I was so excited this morning. The Doctors office had all paper work ready for me to pick up. It’s 12 pages long - wowza! When I got home tonight was exhausted but hit the computer to google abbreviations and look up definitions of words I’ve never seen before. The reason for such excitement is I have had some bad health problems (for past 7 months) and docs have not been able to figure out what’s wrong. I had to become my own full time doc along side my doctors when in December and January things got so bad I thought I was going to die. Everyday I had to figure out whether or not I was going to be admitted into hospital or not. When one doc suggested I get a sleep study and briefly explained how a sleeping disorder might correlate to parts of my ill health I felt there may be some hope! Sometimes a little bit of hope can get a person through what seems like an impossible time.
Although the sleep doc diagnosed OSA & sent me home with CPAP the day of the sleep study (I waited for Medical supply person to drive to the office) after reading over this paper work tonight I can not see anything SO SERIOUS as to cause the degree of sickness I had. Now some of my hope is melting away. The severity of what even I could see as a sleeping problem prior to sleep disorder ever being mentioned went away all by itself before the sleep disorder or test was ever mentioned. I would fly off the expressway to a screeching halt because I could feel myself falling asleep while driving and having ZERO control over being able to stop it. That was when it was bad. I stopped driving for a couple months until those episodes stopped. The same thing happed while I was at home cleaning house. Would have to catch myself from literally hitting the floor from falling asleep. All that stopped before sleep study, before diagnosis, before CPAP. It all stopped without any sleep disorder treatment. Stopped by itself. I want some hope back .... it felt better when I thought I might be able to fix something and feel better. Sounds pathetic I know. I should go to bed.
When looking at the two tests I don’t know if I believe them to be accurate. The test center is suppose to be top notch but they report on first study I never even snored one time. On the second test it said the snoring intensity was 1 (what does that mean?) but on the graph it is totally BLANK and in the charting box it's nothing but ZEROS for snoring. My mother says she’s heard me snore. I have been asleep and heard myself snore (or gurgle) a couple of times.
If I post lab results here is it more helpful to you pros to see certain pages while other pages may be obsolete?
Or is it easier for yall to read the quicky numbers like o2, RDI?
Should I post within this thread or start a new thread?
Are the important numbers from the first test or the second test?
I’d really like yalls thoughts about the results especially since I’m trying to decide if I believe them or not. Maybe the electrodes slipped off my brain and landed on my stomach & the numbers documented are actually my growling stomach instead of brain wave activity ........ hummm. And OMG yall should see the photographs of my face that they printed on the front page of the laboratory results. All hooked up to the study wires with that glue stuff in my hair, no makeup, no lotion, exhausted, weak eyes, pale sickly white skin, and zombie looking LOL. I could be the star of a HORROR movie. I’ll have nightmares for months after seeing the two photos.
Happy Friday everybody!!!
Barbara

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Permalink Reply by sleepycarol on April 4, 2009 at 10:18am

This is only my nonexpert opinion and others with a lot more knowledge will chime in.

With the symptoms you are saying you are having -- what is the time line on them? When did they start? How long before they stopped prior to your study? What other health issues are you having?

Without more info it is really difficult to determine what is going on. Please post your results and more info.

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Permalink Reply by RockRpsgt on April 4, 2009 at 1:24pm

The first test should be a diagnostic. The second is the CPAP titration. Both are very important. Although I have seen worse, an RDI of 51 is pretty bad as far as sleep related breatihng goes. The extreme fatigue you have been experiencing is a symptom of severe apnea. You can post your study info if you like. I personally think that you should move forward with the CPAP therapy. If the problems persist you may want to get tested for narcolepsy. However you must treat the apnea first before they can evalute your sleep any further. As for the snoring sometimes it is hard to completely immitate a persons sleep in a lab setting. Without the stresses of home some people sleep better in the lab, others can't sleep without their normal street noise, fan, or baby monitor. In some cases people can't sleep without thier spouse snoring beside them(WIERDOSLOL). You could also be a positional snorer. Meaning that you only snore on your back or side, or when you drink(if you drink). There are a whole list of reasons that would make you not snore, or only snore a little. None of them however are a reason for yoou to doubt your treatment yet. At least give it a chance, embrace it, you might like it

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Permalink Reply by White Beard on April 4, 2009 at 11:34pm

Barbara
You know even after you are using the CPAP machine it can still take a while before you might notice any real differences, also you mentioned having all sorts of medical problems, what type of problems were you having? Sleep Apnea can cause allot of different medical problems from high blood pressure, to urinary frequency, I know that for years I was having severe night sweats, I mean I would have to get up and change my cloths and sheets because I sweat so bad that they would be soaking wet some nights I would have to do this two or three times. My Doctor ran just about every test in the book trying to find out what was causing it. He never once asked me about my sleeping habits or anything like that. Do you know that within two week after finally getting put on the right treatment ( for me it was the ASV) my night sweats completely disappeared, I mean gone! And I also was not having to get up every hour or hour and a half all night long to pee! With the the ASV treatment I now can go 6, 7 I have even went 8 hours sleeping without having to go to the bathroom! A urologist even scoped my bladder trying to find out why I had nocturia. Here it was the Sleep Apnea!

Barbara give your CPAP treatment some time you might find that it just might fix some of your medical problems too! As far as fixing the tiredness and fatigue, well my Doc said to give it about 90 days or so, and he was just about right, in about 3 months after I started treatment the fatigue and tiredness started to loose its grip on me, and slowly it has went away, Oh I still have my days, but even people with out sleep apnea have days like that too! I wish you well Barbara and hope your treatment works well for you! Good Luck to You White Beard

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