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CPAP therapy really messed up
I have a quick question for everyone-- I have been back and forth from auto-set to straight cpap for several times now...I have told my doc I am staying with the auto-set cpap......my body was so confused that I couldn't use it for a couple of weeks...I am trying to get back into my therapy and find that I am waking up alot and could not keep my cpap on all night only until 2:30 am
Is this normal for my body to get all confused, and does this mean I will have to work up to a full night usage like in the beginning???? How long should this waking up last and when should I be concerned about nighttime awakenings (if someone out there could offer some sort of timeline I would appreciate it)
Thanks
Belinda
Is this normal for my body to get all confused, and does this mean I will have to work up to a full night usage like in the beginning???? How long should this waking up last and when should I be concerned about nighttime awakenings (if someone out there could offer some sort of timeline I would appreciate it)
Thanks
Belinda
Views: 237
Replies to This Discussion
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Permalink Reply by Judy on
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Its never a good idea to bounce back and forth - at least NOT for LESS than a week's minimum at one time in one setting or the other. You likely DO have your body confused.
Assuming you had an in-lab titration, set your auto to 1 or 2 cms below your titrated pressure and 2 or 3 cms above your titrated pressure and then concentrate on keeping that mask on all night long. Concentrate on the mask's fit, comfort and your leaks BEFORE making any more decisions.
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Permalink Reply by Melinda Hertel on
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Yes, it could be confusing your body to be going back and forth between auto and straight CPAP. Our bodies are accustomed to the pressure that we normally breathe at. Then, when diagnosed with sleep apnea, we introduce our bodies to a new pressure. After some time our bodies get used to the new pressure and we no longer notice it. The problem for many that use an auto-titrate mode is that the machine often adjusts the pressure too often to address only minor triggers that don't last long enough to be considered an apnea or hypopnea. Each adjustment causes an arousal, which if significant enough, will wake the sleeper. In this case, the body is not able to get used to any one new pressure since the pressure never stays the same. It is normal for everyone to have an apnea or hypopnea now and then. That's why insurance companies don't recognize an AHI of less than 5 to be of enough significance to pay for equipment. Unfortunately, the auto-titrate machines are not able to make that decision and end up arousing the sleeper for unnecessary triggers. Some people are more sensitive to the changes in pressure and some do just fine with it. It sounds like you are one of the sensitive people.
Why did you go back to auto mode? Were you not tolerating straight CPAP?
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I have a data capable machine and the data clearly showed I was having less episodes with the auto-set my AHI was 8.5 and on straight cpap it went up to 15.8.....the bad part is I was tolerating the straight cpap but the doc said we couldn't argue with the data....although many times on staight cpap I was waking up choking which was not good.....that never happened on auto-set......I guess I must be one of those sensitive people like you said....
Judy when you say to set my pressure at 1 or 2 cms below my titrated pressure it was set at 6 so does that mean I should set it at 4???? I would appreciate your feedback.....I don't neccessarily agree with my supplier...
Thanks
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If it was already set at 6 ... I don't think so. Not many can breathe comfortably at 4 cms or even 5 cms. Did you use Ramp when in straight CPAP mode and if so what was the starting Ramp pressure? You "might" be one who would be comfortable at 4 cms ... but .... I'd be inclined to stay at 6cms, or at a minimum of 5 for the lower auto pressure setting. I seriously doubt I would go 4 unless you are sure you can breathe comfortably at the low of a pressure.
By the way, Melinda has made a good point. There are quite a few people who don't do as well w/the constant pressure changes of an auto as they do in straight CPAP mode once their pressure need has been established.
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Permalink Reply by RockRpsgt on
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Belinda, I believe that the reason your AHI was so high was due to the fact that your pressure was too low on both settings. i personally prefer a straight pressure over the auto. It is a personal preference though. Your AHI was better in auto mode, but still alittle high.
Belinda Haman said:I have a data capable machine and the data clearly showed I was having less episodes with the auto-set my AHI was 8.5 and on straight cpap it went up to 15.8.....the bad part is I was tolerating the straight cpap but the doc said we couldn't argue with the data....although many times on staight cpap I was waking up choking which was not good.....that never happened on auto-set......I guess I must be one of those sensitive people like you said....
Judy when you say to set my pressure at 1 or 2 cms below my titrated pressure it was set at 6 so does that mean I should set it at 4???? I would appreciate your feedback.....I don't neccessarily agree with my supplier...
Thanks
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Judy:
I was ramping at 6 for 45 minutes.....while on straight cpap--I was waking up alot and choking--have you heard of that...even after they increased my level to 8.....
I had another question for you--I get a sort of gurgling noise happening for about 30 minutes before I fall asleep with the cpap....do you know what this can be from??? My hose is fine no water in it.....I do open my mouth a little but, I use a chin strap....if you can shine some light on this it would help because I find this very disruptive and have a hard time falling asleep because of this noise....
Thanks again:)
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Permalink Reply by sleepycarol on
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Even if you are using a chin strap, opening your mouth even a tad, will cause the air to escape and that is a bad thing. You must keep your mouth closed. That is vital to treatment. I bet that you are mouth breathing when you have the choking spells and waking up. This would indicate, I would think, that you are having an apnea. Raising your pressure will not help, if the air is going out of your mouth.
Not usre about the gurgling noise, could it be you are hearing the air escape from your open mouth?
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Giggle. I've just recently experienced just what you are describing. Not to laugh at your predicament, of course. Just at the coincidence of my encountering similar just recently.
I've realized that despite my tongue retaining that seal we need bits of air are sneaking past somehow and creating this gurgling! Yeah! Really! Usually it doesn't amount to much. Once in a while it will build up in my mouth enough a little air will escape thru my lips (the lip flutters). Most of the time it isn't, it just seems to dissipate in my mouth w/o interfering w/my therapy. BUT it CAN wake me up if I'm just dozing off. Either it doesn't happen after I get to sleep, or more likely its just not enough to wake me.
I'm NOT a pressure expert BY ANY MEANS but I'd WONDER if maybe 6 cms, and maybe even the 8 cms, is just too low?? I'd rather someone like Rock Hinkle, Rock Connor, etc. answer this question about the choking and waking.
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What machine are you using? mask? What is you pressure range? can you post your data so that Rock, Melinda , and myself can get a better picture of what is going on. This would help us narrow down a few things.
Judy said:Giggle. I've just recently experienced just what you are describing. Not to laugh at your predicament, of course. Just at the coincidence of my encountering similar just recently.
I've realized that despite my tongue retaining that seal we need bits of air are sneaking past somehow and creating this gurgling! Yeah! Really! Usually it doesn't amount to much. Once in a while it will build up in my mouth enough a little air will escape thru my lips (the lip flutters). Most of the time it isn't, it just seems to dissipate in my mouth w/o interfering w/my therapy. BUT it CAN wake me up if I'm just dozing off. Either it doesn't happen after I get to sleep, or more likely its just not enough to wake me.
I'm NOT a pressure expert BY ANY MEANS but I'd WONDER if maybe 6 cms, and maybe even the 8 cms, is just too low?? I'd rather someone like Rock Hinkle, Rock Connor, etc. answer this question about the choking and waking.
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Rock: I am using the auto-set Res Med S8, I am using the Lt swift nose pillows...I was able to take a nap during the day without that noise, but when I went to use it last night that noise started.....This noise was not there before all the changes back and forth from auto-set to straight cpap.....The only difference at night that I can think of is I prop myself up at night- now.....I never did that before all this back and forth.....I am really confused why all of a sudden this noise is there....I can't use my machine and I am so exhausted.....I can hardly see straight. It sounds like the noise is coming out of my mouth or nose.....Each night it gets worse.....
I have to wait to go to see my supplier on Tuesday to give you the updated data...I don't have the software program yet....to read my data on my own.
I would greatly appreciate any feedback.....soooooooooooo tired now!!! thanks to everyone:)
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While I am awake it happens constantly one after the other now, I keep my mask on for at least an hour or 11/2 hrs then take it off....
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