"please keep me updated about oximeters "
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Still Sleepy
I have been still sleepy after using apap. And I am having a hard time getting up out of bed as I was before I started therapy . My range is sat at 4 to 20. What might be causing this.
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Replies to This Discussion
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Permalink Reply by RockRpsgt on
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I would say that your APAP range being set at 4-20cm is the biggest issue. You are most likely still having events. How long have you been at that pressure range?
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Permalink Reply by Kath Hope www.hope2Sleep.co.uk on
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You took the words out of my mouth Rock! Also, some people (me included) seem to fare better on straightforward CPAP for whatever reason? That might be worth a try.
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Permalink Reply by Twy on
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For one week. I thought that would be a problem too. But the DME keeps pulling every excuse out of the bucket. They said it did not matter that my range is wide that the machine will give me what I need. I told her that my sister is a nurse and said that I should not be wide open like that. The DME lady said that doesn't mean nothing, she said,"my mother is a RN and she knows nothing about sleep apnea". I told her that my sister does. After she had interrupted me and further injected her thoughts for awhile I told her that my sister does know something about it because her husband has been treated for sleep apnea for years? I do not think I like that DME company. Today to make a long story short I called her up and told her I wanted to work with the other RT. I told her the one that was working with me took my med nose pillow and said it does not fit me. I brought it up 2x and he is not giving it back. I have the resmed FX for her and you are suppose to get 3 different sizes. The RT left me with 2 and took the other one but yet I am paying for 3,I checked before I told the DME lady. I told her I was not comfortable working with someone that seem dishonest (this guy is new to their co.). I said it was none of his business what I do with the one that does not fit. She to up for this guy. I know this is a bit off the discussion but I am so frustrated about my whole experience with care givers since I have been DX with this problem. I find them very controlling. Never have I had this problem before. I have a PPO so I want have to deal with being told who, what, where and how sometime is going to be done. And the NP who sent the order admitted to me she did not know much about these machines. When I called up and talked to the med assist about the machine she said The NP ordered a cpap 1st and you insisted on a apap!! She was rude. It has taken meza week to get in to see my NP and that visit takes place tomorrow. I don't want to see that assist I am afraid of what might come outfit my mouth. But I am going because I want to get well. I just hope I get listened to. I like my NP had no problems with her til this DX came up. I have been out of work for 7 mo & I have to get back quick. Oh, sleep study recommendations said nothing about a cpap. It said I would have a apap. I did not reach rem sleep in both studies. And yes I am having episodes. I have a recording oximeter that has been indicating that. When I mention that the response has always been,"it may not be accurate". That is not do it is brand new and I have 2 of them. I am tried of these professionals minimizing every little thing I have to say. I say A they say B. Now if I say B they say A.
RockRpsgt said:I would say that your APAP range being set at 4-20cm is the biggest issue. You are most likely still having events. How long have you been at that pressure range?
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I forgot to mention that in the sleep study it was determined that my therapeutic pressure is a 8. So would a apap be set at about 6 being the low and say 11 or 12 being the high. I like to have some number in my head when I go in tomorrow and see my NP. Bring that she does not know much on this subject. And I was wondering why is it important to have a range set on an apap if the machine can tell when you are going to have an apnea and give you the right pressure. My machine comes as 4-20 so even if my NP wrote the scrip for 4-20 really that is like not having a script. What kind a doctor specializes in this area of medicine that writes scripts.
Twy said:For one week. I thought that would be a problem too. But the DME keeps pulling every excuse out of the bucket. They said it did not matter that my range is wide that the machine will give me what I need. I told her that my sister is a nurse and said that I should not be wide open like that. The DME lady said that doesn't mean nothing, she said,"my mother is a RN and she knows nothing about sleep apnea". I told her that my sister does. After she had interrupted me and further injected her thoughts for awhile I told her that my sister does know something about it because her husband has been treated for sleep apnea for years? I do not think I like that DME company. Today to make a long story short I called her up and told her I wanted to work with the other RT. I told her the one that was working with me took my med nose pillow and said it does not fit me. I brought it up 2x and he is not giving it back. I have the resmed FX for her and you are suppose to get 3 different sizes. The RT left me with 2 and took the other one but yet I am paying for 3,I checked before I told the DME lady. I told her I was not comfortable working with someone that seem dishonest (this guy is new to their co.). I said it was none of his business what I do with the one that does not fit. She to up for this guy. I know this is a bit off the discussion but I am so frustrated about my whole experience with care givers since I have been DX with this problem. I find them very controlling. Never have I had this problem before. I have a PPO so I want have to deal with being told who, what, where and how sometime is going to be done. And the NP who sent the order admitted to me she did not know much about these machines. When I called up and talked to the med assist about the machine she said The NP ordered a cpap 1st and you insisted on a apap!! She was rude. It has taken meza week to get in to see my NP and that visit takes place tomorrow. I don't want to see that assist I am afraid of what might come outfit my mouth. But I am going because I want to get well. I just hope I get listened to. I like my NP had no problems with her til this DX came up. I have been out of work for 7 mo & I have to get back quick. Oh, sleep study recommendations said nothing about a cpap. It said I would have a apap. I did not reach rem sleep in both studies. And yes I am having episodes. I have a recording oximeter that has been indicating that. When I mention that the response has always been,"it may not be accurate". That is not do it is brand new and I have 2 of them. I am tried of these professionals minimizing every little thing I have to say. I say A they say B. Now if I say B they say A.
RockRpsgt said:I would say that your APAP range being set at 4-20cm is the biggest issue. You are most likely still having events. How long have you been at that pressure range?
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I have COPD and concern about getting the CO2 exhaled. My air sacs are already hyperinflated. I am not on oxygen I am functional and quit smoking 9 yrs ago when I was DX. I do not see cpap as being the best thing for me. I don't want to take a chance of resolving one health issue while knowing or unknowingly making another one worse as a result. I try to study upon health issues that I personnelly encounter so I can make better choices about my care. I have a fear of being some doctor's mistake. And I fear thinking something is old age when it turns out it could be something treatable. Plenty of people in my family has died because of the thinking it just old age when they could had been saved if their thinking was other wise.
Kath Hope www.hope2Sleep.co.uk said:You took the words out of my mouth Rock! Also, some people (me included) seem to fare better on straightforward CPAP for whatever reason? That might be worth a try.
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Permalink Reply by 99 on
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two things it takes severn years to quit smoking so congratulations!!
secondly by limiting you range you stop the APAP running away or going higher should a leak occur as higher levels may cause centrals
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Hmm where to begin. Let's start by saying that without seeing what the techs or doc saw I can't say whether they were right or wrong. That would not be fair or professional.
An auto setting of 4-20 is an "auto-titrating" or exploratory pressure." You are basically going through a titration study every night. This means that every night your machine titrates or searches for the best pressure for you. In order for the machine to change pressures you must register breathing events. With this type of wide open setting it is also possible that insignificant events such as swallowing, biting, or holding your breath will be counted as events. Not only could the pressure be going to high but the constant changes could be causing arousals as well.
You are correct int that your ranges should be slowly reined in to meet your specific needs. ideally you are gonna want a 3-4cm difference or as tight as possible.
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Great explanation Rock.
What's an NP please Twy? Am slowly learning the US language LOL.
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NP stands for Nurse Practitioner.
I want to thank Everyone for your input. I think it will be very helpful when I talk with my NP today. I will let ya'll know how I make out. Appt. is very late in the day.
Kath Hope www.hope2Sleep.co.uk said:Great explanation Rock.
What's an NP please Twy? Am slowly learning the US language LOL.
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Thanks Twy and good luck for today :)
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Thank you for your reply this will help. It makes sense. I work directly with many medical professionals. They are human therefore they do make mistakes at times. I think most of it has to do with communication and assumptions. Not to mention many health care personnel are over worked and sleep deprived . I have had sleep apnea for years not knowing it. I thought being so tried all the time had to do with all the force over times for the last 10 years. And being treated for depression. I went out on disability due to stress and months later I notice I was still tried. I could no longer blame it on work (force overtime = another 8 hrs and usually happens every other day). Then my brother visit me and said he did not sleep well because of my snoring. I told him I do not snore. Well I ended up recording me while I slept. Boy did I ever snore. I live alone and had no one to tell me this. I put 2&2 together = possible sleep apnea. I then asked my NP for a sleep study. I am grateful I was so stressed that I had to stop working other wise I would had never known.
I would like to mention that I am a shift worker which really has messed up my sleep.
I am grateful that this site is here. This is helping so much.
RockRpsgt said:Hmm where to begin. Let's start by saying that without seeing what the techs or doc saw I can't say whether they were right or wrong. That would not be fair or professional.
An auto setting of 4-20 is an "auto-titrating" or exploratory pressure." You are basically going through a titration study every night. This means that every night your machine titrates or searches for the best pressure for you. In order for the machine to change pressures you must register breathing events. With this type of wide open setting it is also possible that insignificant events such as swallowing, biting, or holding your breath will be counted as events. Not only could the pressure be going to high but the constant changes could be causing arousals as well.
You are correct int that your ranges should be slowly reined in to meet your specific needs. ideally you are gonna want a 3-4cm difference or as tight as possible.
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I have read something about that in somewhere but I read so much and was getting bit confused. I was overwhelm. Thank you for putting it in simple terms.
99 said:two things it takes severn years to quit smoking so congratulations!!
secondly by limiting you range you stop the APAP running away or going higher should a leak occur as higher levels may cause centrals
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