How am I doing?

[scruffies]

I am about 10 days into using a CPAP machine. I am using it about nine hours per night, but I am seeing 2 to 6 AHI events per hour. The doctor set my pressure at 8 to 10. I will be checking in with him for the first time in about a month and assume it may take some adjustments and time to get it down lower, but wondered if I was doing OK so far.

[LSAT]

I am about 10 days into using a CPAP machine. I am using it about nine hours per night, but I am seeing 2 to 6 AHI events per hour. The doctor set my pressure at 8 to 10. I will be checking in with him for the first time in about a month and assume it may take some adjustments and time to get it down lower, but wondered if I was doing OK so far.

Sounds like it, but how can we tell without knowing anything about you or your therapy. Display some charts showing a typical night.

[scruffies]

Ahaaa. Makes sense, but I will need to figure out how to get the SD card out, get the data into my computer, and for the first time work with sleepyhead, and then figure out how to get that data onto this thread. I know there are threads that deal with all of that, but I will just have to take the time to figure it all out.

So it might be a little premature for me to ask my question. When I get my act together I will re-ask it .

[Goofproof]

At least you are on the road and driving between the lines, that's better than many do. Get that steering wheel bolted down and continue your ride. Welcome to the Highway! Jim

[TedVPAP]

A friend of mine has been using APAP for 1.5 years and his AHI is ~9. The doctor keeps telling him that he is doing well since his AHI is under 10.
After some help from me (via what I have learned at this forum), he is now AHI~3 and dropping.

Don't wait to learn. Help yourself and your doctor.
Read the three links below.

[scruffies]

Thanks Ted for the links. Will check them out.

[scruffies]

Well alrighyty then...

Thanks for the links, so I have loaded the SD card, run SH, seen the graphs (of which I understand nothing!) and ran imgur with the following result:

https://imgur.com/a/084zu

That should be a screen shot of my graphs from last night.

I am a first time CPAP user, I am 74 years old, and my AHI from the sleep study was a stunning 98.6 AHI.

So, to my original question: How am I doing?

[TedVPAP]

Well alrighyty then...

Thanks for the links, so I have loaded the SD card, run SH, seen the graphs (of which I understand nothing!) and ran imgur with the following result:

https://imgur.com/a/084zu

That should be a screen shot of my graphs from last night.

I am a first time CPAP user, I am 74 years old, and my AHI from the sleep study was a stunning 98.6 AHI.

So, to my original question: How am I doing?

That was fast - congrats.
See how your pressure reaches the maximum value (10). That usually means that the machine wants to go higher to fight OSA but is limited.
Now click and drag a few minutes over the events after 7AM. This zooms in so you can better see what is going on. Look at the flow. Does it look like breathing that way would cause problems?

[Pugsy]

Looks like you are spending the bulk of the night at your max pressure of 10. I suspect your doctor will want to increase that maximum pressure a bit.
It's not urgent but your AHI while it is technically below 5...there is some clustering of the events and that with the maximum being pegged out so much means that the pressure is not quite optimal just yet.

Your leaks are within acceptable limits....the machine can easily compensate for the leaks you are having. Leaks aren't an issue unless they are waking you up. Anything that wakes us up is unwanted...even a teeny tiny leak.

Actually a pretty typical report and quite decent for being new to therapy. Much better than mine was at weeks (took me that long to get the software and card reader back then...the dark ages).

I see at least 3 breaks in therapy...so you woke up at least 3 times and turned the machine off and back on again....any idea why you woke up?

It's a decent report but there's room for improvement and I would hope that with improvement you might be able to sleep a little more soundly.
The wake ups really mess with our sleep architecture and can have a negative impact on how we feel during the day.

The CAs/Centrals which make up the bulk of your AHI...I suspect those are probably more related to being awake or semi awake...what we call SWJ or Sleep/Wake/Junk and when you are finally able to sleep more soundly with fewer wake ups they should reduce.
Even if some of them are real they are probably sleep onset centrals which are normal and not a big deal unless present in much larger numbers than you are showing. Again even if they are sleep onset centrals if the sleep onset times are reduced (sleeping more soundly with less wake ups and thus less chance of having to transition to sleep so many times) there should reduce a bit on their own. I wouldn't worry about them right now.

All in all...a decent enough report for 10 days into therapy. Some room for improvement but that's to be expected. Much better than mine at 2 weeks...and you will get there. I suspect increasing the max will be a big improvement. Unsure how much might be needed because you are using such a tight range right now it's hard to make much of a guess but I doubt if it will need to be much.

[ajack]

I would raise the min to 9 and max to 12 and see how it went.

[scruffies]

Pugsy - Thanks so much for your detailed feedback! Next on my CPAP todo list is to study up on how to read each of the graphs.

As for getting up 3 times, they were bathroom visits. Before therapy started, I would wake up about every 2 hours to go to the bathroom. Not sure which was the chicken/egg, OSA waking me up or my bladder doing the waking. In any case I am hoping over time I am sleeping sounder as you suggest and that might reduce the incidents of waking up and going to the bathroom.

I am a little reluctant to change the pressure setting as the 8-10 was set by my sleep doc. I see him for first follow-up visit in about 5 weeks, so will probably wait until then and discuss with him my options for presssure settings.

Thanks all for the responses.

[Pugsy]

If you are male....have your doctor also look into the chance that prostate issues are a factor in the bathroom breaks.
While sleep apnea is a known culprit for nocturia it will usually go away when therapy is optimal and your therapy is so close to optimal I don't see untreated sleep apnea as being the culprit here. Wouldn't be impossible but usually we see a lot more apnea events slip past the defenses than you show on your report.

I didn't suggest changing pressures only because I know you are going to be seeing a doctor and have all this evaluated very soon. Don't blame you for wanting to hold off on changing anything. It's not something that is super urgent anyway. I only mentioned the maxing out thing because it is likely the doctor will see it and should/would raise that maximum.
I don't know that I would consider doing anything with the minimum at this time. Your range is so tight right now that maybe all you need is a little bit more maximum available with the current minimum. At this point with such a tight range we have no proof that more minimum is even needed. Might get that proof later but as of now...I don't see it.
But it's up to your doctor and how he wants to address things. I figure might as well give him a chance to earn his paycheck first and then consider DIYing things only if the doctor drops the ball.

[scruffies]

I am in remission from 2015 prostate cancer, so have been fighting bathroom issues for a while. I will wait for the doctor’s recommendations, but I am a take charge kind of patient so will want to know how to read the graphs and decide for myself what my treatment should be after considering all inputs, and that includes advice from this very knowledgeable community.

So far I am having no problems with the nasal pillow mask, but I know that when I get a cold or have sinus issues it will be a problem. Probably will need to decide on a full face mask for those times and how my insurance is going to pay for the periodic parts for both a nasal and FF mask. Maybe I just take meds to clear out my sinuses and stop CPAP for the few days it will take for my sinuses to clear up? Not exactly sure how I am going to deal with that, but seems that I am doing OK so far,so thanks for the feedback.

[Pugsy]

Okay the bathroom breaks are what they are and not much can be done about them at least from the cpap side of things. There is a very plausible non sleep apnea cause. It is what it is.

As far as what to do in the event of a cold or upper respiratory infection that might cause nasal congestion and thus a need for a full face mask.

In terms of supplies for both a FFM and the primary nasal mask...don't worry too much about insurance and replacing something on the FMM.
If you don't use it much you won't need much in the way of replacing anything and if you do insurance won't care. They pay by the DME using the billing code and the replacement allowance. You just ask the DME for what you want or need and they deliver it. No matter which mask it might be.
A couple of months ago I used my replacement allowance for nasal pillows to help out someone whose insurance wouldn't pay but for 1 pillow a year...yep...a year. So I go into my DME and request my allowed supply of the nasal pillows for her mask...it's not my primary mask...they don't care.
They sold me the pillows and will bill my insurance and once the insurance pays I get the bill for my co pay and the person will reimburse me.
It's the deal we worked out so she could get some nasal pillows that she could afford. She has limited funds like most of us.
I tell you this so you will know it's not a big deal. DMEs don't care....they just want to sell you something and your insurance doesn't care because most of the time they don't even have a clue what mask you are using. They go by HCPCS billing codes and the replacement schedule and that's it.

What you do have to do is make sure that it is clear to the DME exactly which part you are requesting. Lots of people use more than one mask...you aren't tied to any one mask unless you just want to be.

As for planning ahead for that cold that you may or may not need a full face mask for...check with your insurance company and find out exactly what the replacement schedule is for a complete mask package. At that time you can get with your DME and figure out which FFM you want to try out.
Or you can wait until you have your first cold and see what happens. You might find out that you end up doing better than you think.
Some of us manage through a cold quite well with nasal pillows...we crank up the humidity and treat the cold symptoms just like we normally would and we get through it still using our nasal pillows. I have been on cpap for over 8 years and have had my share of colds and even the flu but so far I haven't had a time where I couldn't get the nose opened up enough to use the nasal pillows and almost always I wake up breathing better through my nose than when I went to bed.

Now I did finally get a full face mask to use ...just in case...but I got it 2 years ago..my first 6 years I didn't even own one because I couldn't find one I liked and could sleep with. Other than the week that I used the FFM that I got 2 years ago just to test it out to see if I could even sleep with it...I have never used it.
And I just got over a nasty cold this past December...still used my nasal pillows.

So if you want to get a full face mask...go ahead but you don't have to put yourself under stress and worry right now over getting one.
Heck, watch the forum...lots of times people give away, or sell dirt cheap, masks that don't work out for them.

[scruffies]

Thanks Pugsy. Good advice.