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I've been using the CPAP (S9 Elite straght CPAP) for about three and a half weeks.  For all but the last two nights my AHI was 0.0.  Then, all of a sudden, it was 12.1 on Thursday, and 11.0 last night.  I have had minor  leak issues, but nothing out of the ordinary.  Still having the horrible aerophagia/gastric insufflation.  My pressure is set at 6 cm H2O, with a 10 minute ramp.  I was using nasal mask on Thursday, nasal pillows yesterday.

 

Any ideas why this sudden change for the worse?

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You might be mouth breathing and not be aware of it.  Often our mouths will become slack and allow some air to pass between the lips.  You state that you have had minor leak issues, but nothing out of the ordinary -- still might be possible.

 

Do you have the software for your machine, or are you using the LCD data from your machine?  I know I am using a ResMed S8 Autoset and the LCD was showing 0 leaks, but the software showed that I was having some leak issues even though the LCD screen info wasn't picking it up. 

 

I think we have good days and others are less than ideal.  Have you had any congestion or sickness that might be contribute to the higher numbers?

Not happening.  I'm wearing a cervical collar to keep my neck hyperextended and my airway open.  Res Med does not allow consumers access to their proprietary software so, no, I do not have it.  I know how to access the clinician's menu, ,but it is not allowing me to do that either, for some reason.  There is no leak info on the patient's report menu on the S9 elite....only hours used, mask fit and AHI.  I'm CONSTANTLY congested with chronic sinusitis and air/fluid levels, and the CPAP just makes it worse.  Thanks for the ideas, though.
Any big difference in how you're feeling on the nights the AHI was higher?  I would work on the leak/mouthbreathing angle.  Good luck.
Yes, the gastric dilitation is worse.  I can barely breathe because  I am so distended.  And last night, AHI was 0.0 again, but the machine somehow shut itself off iin the middle of the night, and I woke up feeling like I was 'suffocating' due to lack of air flow.  Can't seem to win for losing.  Needless to say, I didn't put the mask back on after I fixed the glitch, and I slept very nicely for an hour or two (my max sleep on most nights anyway).

Mary Z said:
Any big difference in how you're feeling on the nights the AHI was higher?  I would work on the leak/mouthbreathing angle.  Good luck.

At only three and half weeks into using your machine, you haven't worked out all the glitches that  come with using a machine.  For the vast majority of us, there is a huge learning curve. 

Do a google search for the software for your machine, you should be able to find it.  I know it is out there as I was able to find it and download it. 

As far as the cervical collar keeping your airway open, I know others have used this method and appear happy with their results.  Yet, it doesn't address the issue of mouth breathing.  Even slightly parted lips will allow air to escape, defeating the use of your machine.  Unless I misread your posts and it is the cervical collar you are depending upon to stop the apneas and not the machine. 

Have you discussed your issues with your doctor?  This isn't a quick fix for most of us and we often find that the beginning of using our machines actually make our sleep more disrupted and worse until all of the issues surrounding the use of it are fixed. 

I'm a licensed health care professional with many years of experience with CPAP, BiPAP, mechanical ventilation and the use of the machinery for it.  That's one reason this is sooooooooooo frustrating to me.

 

The C-collar is only to keep my head properly positioned while I am sleeping, as I tend to "dip" my chin, which partially closes the airway on its own.

 

I would talk to my doc if I could only "find him."  He is only in the local office one day a week, and defers to a PA when he is not there.  He (the PA) has been totally unhelpful to me.  I think that an autotitrating machine might be helpful, as my RRT has told me, but who knows unless I can convince them to change their arbitrary "no auto machines" rule that the practice has.  I will be seeing him on 21 June, if I can manage to survive and continue to use the machine until then (which is starting to look doubtful due to the pain I wake up with every morning).


Thanks for the suggestions.  They are much appreciated. Don't want you to think I am being argumentative, I'm just pragmatic about these things.

sleepycarol said:

At only three and half weeks into using your machine, you haven't worked out all the glitches that  come with using a machine.  For the vast majority of us, there is a huge learning curve. 

Do a google search for the software for your machine, you should be able to find it.  I know it is out there as I was able to find it and download it. 

As far as the cervical collar keeping your airway open, I know others have used this method and appear happy with their results.  Yet, it doesn't address the issue of mouth breathing.  Even slightly parted lips will allow air to escape, defeating the use of your machine.  Unless I misread your posts and it is the cervical collar you are depending upon to stop the apneas and not the machine. 

Have you discussed your issues with your doctor?  This isn't a quick fix for most of us and we often find that the beginning of using our machines actually make our sleep more disrupted and worse until all of the issues surrounding the use of it are fixed. 

Any doctor can prescribe you a machine.  Have you talked to your family doctor?  I would try that route to get an apap.  It is less frustrating to me to go through my family doctor for scripts. 

Good luck, hope you figure it out.

"Unfortunately", my PCP is an Emergency Department physician, new to Internal Medicine.  I'm having nto "train him" as we go along, and he is not comfortable with a lot of routine things yet, but I will work on him.

sleepycarol said:

Any doctor can prescribe you a machine.  Have you talked to your family doctor?  I would try that route to get an apap.  It is less frustrating to me to go through my family doctor for scripts. 

Good luck, hope you figure it out.

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