"please keep me updated about oximeters "
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Rem sleep
When I had my sleep study done the lady told me that I never couldn't get to rem sleep. They set my pressure at 8 to 14. I got the soft ware and checked my data. I was helped with cpap therapy but I wanted to sleep without constantly waking up. I gradually raised my pressure until it was at 14 to 18. That really helped but I got concerned that I was over doing it. I changed back to the prescribed numbers. I had a horrible night. It was like no therapy. I have problems with my mask at higher pressure but I feel more rested. I have even had a few dreams. Very few and very short but I feel like I sleep deeper instead of just lite napping. Does anyone have any suggestions on how to get comfortable with a mask at higher pressure? I left my machine on auto the other night and it went to 20. I was just miserable at that pressure. I couldn't exhale. I hope someone can give me good advice here.
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Replies to This Discussion
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Permalink Reply by Stormy on
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18. I wish I could stand it at 20. I think maybe I could get to the deeper stages of sleep.
j n k said:At what range of pressures do you have the lowest AHI for the week?
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I always sleep on my side.
j n k said:At what pressure are you able to best keep your leak under control?
Have you seen what your ideal pressure is if you rig up something to stay off your back all night? Sometimes that can get pressure down a cm or two.
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I can do 18.
Stormy said:I always sleep on my side.
j n k said:At what pressure are you able to best keep your leak under control?
Have you seen what your ideal pressure is if you rig up something to stay off your back all night? Sometimes that can get pressure down a cm or two.
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My leak rate is always pretty high. I have never been down to no leaks. Is this even possible? I feel like my leaks are under control if the leaks don't wake me up. I have fewer leaks with a nasal mask but that causes my nose to burn and that wakes me up.
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My last leak rate showed 44.64. That is the best yet. My pressure was set from 17 to 20. That was with a full face mask. Maybe I just can't expect rem or deep sleep anymore.
j n k said:The software is a valuable tool in that you can check your exact leak line on a graph and compare it to the intentional leak rate of the mask you are using. Or, if you use ResMed software for one of their machines, it graphs the amount of leak above the intentional vent rate.
Do you have the software for the machine you use? Or will your DME give you printouts from their version of the software? The conventional wisdom among many patients active in their own therapy is that controlling leak is step #1. If all the therapy is leaking out of your mouth much of the night (in the case of a nasal mask, like what you are using, according to your profile) or leaking largely from around your seal (in the case of a full-face mask), you won't be getting much benefit.
It is important to have the right mask for you and that you find a way get leak consistently low. (Zero leak is only possible in the context of a ResMed machine telling you there is zero leak above what is expected. But I see from your porfile that you have a Respironics machine, which reports total leak.) Other than that, there will always be some reported leak, and that's fine. But if leak is extremely high as reported by your machine and software, you can't trust the reported AHI numbers or know what amount of pressure you actually experienced in your airway overnight.
If you can start giving specifics of your exact leak numbers, maybe even finding a way to post links to screen shots of your software, there are experienced people at this forum and at other forums who can help you troubleshoot in a methodical way.
Step one is to make sure leak is OK, and you can't judge that by whether or not it wakes you up.
Once leak is OK, then you start finding a pressure that gets your AHI as low as it can go. But you can't start doing that until you know you can trust your numbers, and that doesn't happen until you have the right mask for you that isn't leaking all your pressure away.
If you are using a nasal mask and opening your mouth during sleep without knowing it, then you may do better with a full-face mask, because that way, even if you open your mouth, you get the pressure anyway.
Stormy said:My leak rate is always pretty high. I have never been down to no leaks. Is this even possible? I feel like my leaks are under control if the leaks don't wake me up. I have fewer leaks with a nasal mask but that causes my nose to burn and that wakes me up.
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Before cpap I was up every few minutes during the night. I thought it was bladder problems. Now on a good night I am only up about twice during the night. I believe I am still having events that wake me up. My reports look pretty good but if I am being woke up then the events that are causing the problems wouldn't show up.
j n k said:Don't worry about REM and deep sleep. They take care of themselves. Just concentrate on the right pressure with leak under control.
You sound to me like you are determined to make this work, so I'm sure you will.
What I would do would likely be to use the full-face mask at around 15 straight pressure while rigging something up to keep myself off my back. (A bike helmet with the sharp edges belted securely against the shoulder blades worked for me.) Do that for a week and get a printout of your leak and AHI. If your leak line is straight, take note of what your AHI was for that week. Then try one cm higher for a week and see what that does for your AHI. If AHI goes down, you went the right direction. If it stays the same, go back where you were.
Straight pressure works better for some. It is still good to have the auto, but having an auto doesn't mean you have to use it in auto mode all the time for treatment. But don't give up. You may find that steady pressure and making SURE you aren't on your back may make a world of difference in controlling your pressure, leak, and AHI.
Hopefully, you have a sleep doc that encourages your concern and active interest in making the therapy work for you.
HOpefully some of the other members here will give you their suggestions. I'm sure I've missed something. I always do. There are a lot of good, experienced users here who are better at helping people than I am.
jeff
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Permalink Reply by Mark Douglas on
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Stormy -- jnk rocks, I learn more reading his stuff than anything. I don't understand everything he says, but intelligence never was my strong suit.
As far as no leaks -- is it possible? Well, my new machine , 5 weeks old now, reports no large leaks ever. Not one.
Until your post and jnk's answer, I didn't know it was such a big deal.
I wake up once a night or so. My AHI averages are 5.2, and I hope to get those down. My auto is set to up to 15.
I use a full face mask. This new machine seems to help -- the last one did not. Finally, 17 months after I got it, I took it in for testing, and they discovered it was defective anyway, blowing out 25% less than it was claiming.
Since jnk said controlling leaks is "step number one" Im happy. I don't have any large ones, and now I will know if they happen. With my old machine, I had no clue.
I'm also a believer in recording your own oxygen overnight, which of course takes a different device. This is a huge added piece of information. Do you know if your oxygen is messed up overnight? Id like to see overnight oxygen as part of the CPAP data, because that seems to be what this is all about -- getting that good oxygen at right levels, in a steady way.
Ask jnk, but I would assume that if your overnight oxygen is good, and your AHI's are under 5, you are doing good. At least those are my guiding stars until I learn different.
Congratulations on being aggressive and seeking answers. I was stupidly passive about my first CPAP when it didnt seem to help --- and I just quit using it.
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Is it counted even if it wakes me up?
j n k said:Once your treatment is optimized (no large leak, the right steady pressure), you may be surprised how good things can get after a few months of that.
Home machines never miss apneas or hypopneas. They all get counted. (AS long as the leak is not extremely high and intermittant, anyway.) Home machines even count events that are not counted in sleep studies.
And once you settle in to good mask, right pressure, low events, THEN the REM and deep sleep should happen on their own. That's the general idea, anyway.
Hang in there. You'll get there.
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Thank you so much for the information. Last week I ordered a machine that is supposed to lower the pressure if you are starting to wake up. Maybe that was a stupid thing to do but I was desperate. It is the Sleepstyle 254. Do you have any opinions on that machine?
j n k said:This chart, by a guy on another board who goes by "Velbor," shows when different brands of machines report "apneas" and "hypopneas." As far as I know, waking up does not, of itself, keep a machine from reporting an event, unless the awakening keeps the event from meeting the definition.
Once you are at a good pressure for you, with a good mask for you, you experiment to get as few home-machine events as possible. But a home-machine-counted "apnea" or "hypopnea" is not exactly the same thing as a sleep-test apnea or hypopnea, because home machines, as the chart shows, all have different ways of measuring and reporting the events.
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