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Permalink Reply by Mary Z on February 4, 2011 at 9:30pm

bump

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Permalink Reply by RockRpsgt on February 4, 2011 at 10:17pm

I would at least give it a couple of days if not a week Mary. See what happens.

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Permalink Reply by Mary Z on February 7, 2011 at 10:21am

Machine is in  S mode.

j n k said:

What mode is your machine in, Mary? VAuto, S, or CPAP?

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Permalink Reply by Mary Z on February 7, 2011 at 11:10am

Thanks jeff.  I do take Hydocodone/apap during the day and at night and I know it's sedating, but if I don't take it I have terribly disrupted sleep. from  severe leg pain. ( Doing PT right now).  I know I had some central apneas the last hour of the study  when I was essentially awake, unable to get back to sleep. The doc said "no apneas" at that pressure. They were specifically looking for central apneas. Even if I ignore the hypopneas I am having varying numbers of AIs- 3 to 8.  I'm going to try this pressure for a week and get some advice about titration if I don't have any better results.  I still have to take Provigil for significant daytime sleepiness.  Perhaps because of these tradeoffs I make medication wise I'm just not going to get the numbers  I want.  I am waiting for a copy of the sleep study report.

Thanks for you comments.

j n k said:

Oh, and I agree with Rock that you should give it a week or so.

 

The reason some of us tweak our pressures are (1) to make sure most OBSTRUCTIVE events are prevented and (2) to find the most comfortable pressure that makes us feel better without raising our AHI.

 

So the first things to figure out before touching that dial are the following: (1) Are your events obstructive? (2) Is the pressure comfortable for you? (3) Is the machine helping how you feel?

 

If the events your home machine is counting are central, there would be NO reason to raise pressure above 4/8 other than for comfort if you feel you aren't getting enough pressure to breathe with the mask on. That is because central events are not lessened (as a general rule) by raising pressures in a CPAP or bilevel.

 

If that AHI is caused by medication or other medical conditions that cause central apneas and central hypopneas, addressing those conditions would be the place to look, not self-tweaking pressures.

 

The reason I say all of that is the possibility that the titraion may have found that 4/8 is enough to prevent obstructive events. If so, what the doc is saying is very wise, in that he knows that raising pressure won't bring down the number of significant events.

 

But if that is the case, it may be time to see if other changes in your life, other than the amount of pressure your PAP machine gives, may be the key to feeling better and improving your health.

 

If that is the case, worrying too much about the numbers your home machine gives may be counter-productive for you.

 

Those are nothing more than my opinions as a fellow patient, though.

 

-jeff

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Permalink Reply by Mary Z on February 7, 2011 at 4:26pm

Thanks Jeff, that makes perfect sense.

Mary Z.

j n k said:

Some people on certain medication and dealing with chronic pain are always going to show high AI, no matter what they do. And that may be fine in their particular case. You may be one of those people.

 

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Permalink Reply by sleepycarol on February 7, 2011 at 7:49pm

Sorry Mary that you still haven't resolved your issues.  I don't have any experience with your machine so can't offer any sage advice -- thank goodness there are those that are much more knowledgeable to help us.

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