Newbie.

[Naomi402]

I am new here so be patient. Out of the blue a month ago I started experiencing rapid heart rate waking me up and a huge rise in BP. ..during the day. It started gradually waking me up at 5 am then a week later 3am and now 12:30 and so. Every time I doze off i wake up with a rapid heart rate which I am sure is responsible for the increased BP. Historically I never have slept well and my quality of sleep has been terrible for years. I have spent the last 4 years in and out of hospitals not for myself but my daughter. As she began to heal I started to fall apart. Doctors can not figure out why I am having night time rapid heart rates and big blood pressure increases. I have suspected sleep apnea for years but never got tested. I was just recently tested and I have sleep apnea. The doctor is putting me on a APAP. I guess my question is for those of you that are on one.....please tell me if you ever had the symptoms I described and if it has helped. I am sleep deprived and at my wits end on finding a solution.

[Julie]

Many people have had some atrial fibrillation ('a-fib') and other arrythmias (plus high BP) before going on Cpap. And going on Cpap usually makes most of it better if not completely gone. Some get lucky and have relief within days or weeks, others can take longer because adjustments need to be made re pressure settings, mask fitting, etc... but we can definitely help you get going and answer any questions you have when that happens.

What's important is that your doctor write the prescription for a 'data capable' machine, meaning that if you use the most common (and free) software we use once on Cpap (something we'll help you get set up with - doesn't come with machines) you can keep track of many factors overnight that are involved in treatment - not just a machine that tracks 'compliance' for the insurance company so they'll pay for the machine - they should pay in any case if you're insured of course.

Also as important is getting an 'auto' machine - Apap vs plain Cpap - as autos can still do Cpap if at some point it's discovered you do better on that, but Cpaps won't do auto, and therefore your options for tweaking things as you go along (using the software) are limited.

[naomi402]

Thank you for the information. I am receiving a APAP and not a CPAP. I will ask about the other things you mentioned. I am just hopefully looking forward a lowered heart rate and BP on top of some quality sleep.

[Arlene1963]

Hi Naomi,

I had a racing heart at night and would wake up drenched in perspiration quite often but I just thought I was going through menopause being at the right age (51)

Eventually I landed in the Emergency Room with atrial tachycardia which is a type of Supraventricular Tachycardia (SVT).

Luckily the ER doctor was astute enough to suggest I have a sleep study where it was discovered that I have moderate sleep apnea.

Let me tell you that since I've started using CPAP my heart rate is much, much improved and my night sweats are a thing of the past.

On adequate APAP it WILL get better for you! Be happy that you discovered that you have OSA and now you can get proper treatment.

PS My blood pressure was very high about 2 years ago as well despite being on 3 meds, and now it is 100/60, taking only 1 tablet per day, and I will probably no longer need any soon.

Also, my sleep is better, not great yet, but better. I fall asleep much faster, but sometimes other things apart from OSA cause sleep issues unfortunately, and my sleep specialist thinks that in my case my fragmented sleep is likely hormonal and she even suggested that in some cases HRT greatly improves sleep architecture.

Hang in there!

[naomi402]

Thank you for the words of encouragement. I got my APAP today. Its a Phillips respironics. The setting is on 5 which is what the doctor ordered for it to be at. I tried taking a nap for the first time and it seemed okay but every time I would start to fall asleep I would jerk back awake. I'm assuming that is normal and something in have to get use to. There is the ability to use the ramp button (sorry all these terms are still new to me). Which if I use as I understand it will start me at a lower number which is 4 and gives me a small window of time to fall asleep. Is that a suggested practice when your new to this device?

[Julie]

Using the ramp is helpful to people whose starting pressure is higher than yours - often by quite a bit, but as 4 is the default machine low level, using ramp to go to 5 is fairly pointless. Most people have a difficult time inhaling at 4 or 5 altogether and usually end up with their low pressure settings closer to 10. You only gave the brand name (Phillips Respironics) of your machine, but that applies to very, very many models, years, features, etc., so try to find the most words you can on the machine itself. If you use a humidifier, empty the water, then turn the machine itself (not the humidifier) over and find a 'Ref" #, and/or whatever other ID you can which would help us to know what you have. And what mask?

So many doctors, who don't actually understand the machines properly, however much they know the science of apnea, prescribe auto settings 'wide open' to defaults of 4 and 20 for the high one, thinking the machines will prevent apneas at any level because they're autos, but that's not at all true, as a very low bottom setting cannot intercept higher level apneas in time to prevent future high ones, which is why we end up raising the low to a more reasonable one. If you find inhaling 'normally' at 5 is difficult, we can help you adjust things if necessary.

[naomi402]

It is a Dream station auto cpap Hum. Ref no. DSX500H11, SN J1670460117F2. I am not sure if he started at this setting because I have a tendency to be anxious and claustrophobic. With that said though I chose the AirFit F10 Full Face Mask...because I'm a mouth breather some and I didn't like my chin being strapped up.and closed with the Nasal mask. My insurance will let me have 2 different kinds so I might try the nasal one. I'm open to suggestions. Thanks again for all the help

[naomi402]

First night..I had a little bit of a rough first night. Every time I started to doze off it was as if I wasn't getting enough pressure and I would wake up. Masked worked okay. This morning it says I had 7.5 therapy hours, 90% pressure with 12 (I'm assuming that was the highest pressure it ran on) though it is set to start at 5. I downloaded the dream mapper app and it says I had 100% mask fit but my AHI was 14 last night. Am I to assume that is not good? I think the beginning setting is to low.

[Pugsy]

I think the beginning setting is to low.

Every time I started to doze off it was as if I wasn't getting enough pressure

The starting pressure is a bit low for you and your situation. While 5 cm works well for some people there's a lot of people who simply aren't comfortable at that low of a pressure.

90% pressure with 12 (I'm assuming that was the highest pressure it ran on)

No...that's not what a 90% number means. The actual definition of a 90% number is at OR BELOW that number for 90% of the night...so it went higher for 10 % of the night but it was at or lower for 90 % of the night. People tend to forget the "OR BELOW" part of the definition. We don't know how much time might have been spent at 12 or 11 or 10 or 8 or whatever.....we just know that added up all those times was 90% of the night.

AHI was 14 last night. Am I to assume that is not good?

Obviously not good but it was the first night and you likely had a lot of awake time spent and awake breathing can and will cause the machine to flag awake/semi awake irregular breathing by mistake.
But it is cause for concern and does warrant further investigation.

You need to be able to tell what made up that AHI...there's 3 categories of events that make up the overall AHI
Clear Airway Index (these are referred to as centrals)
Obstructive Apnea Index
Hyponea Index

You really need to use the available software to see for sure exactly what happened and when it happened.
https://sleep.tnet.com/equipment

Most likely the AHI is primarily OA or hyponea but until we know for sure we can't say for sure if that 5 cm starting point is the problem or not. I suspect it is if you spent much time over 10 cm pressure but again we need to see the actual software graphs to accurately evaluate the results.

DreamMapper gives a generic overall picture and it is sufficient if the AHI is nice and low and there are no leaks and the person sleeps well....it isn't enough detail when there is a problem that need further investigation.

We need to see exactly what kind of events were getting flagged...along with when they were getting flagged and what the pressure was doing at the time.

This thread has some examples of what we look at.
viewtopic/t103468/Need-help-with-screen-shots.html

[naomi402]

Thank you for the info. The app said that I had:

Clear Apneas - 49
Obstructive Apnea - 21
Hypopneas - 33

Mask Fit
Disconnects - 7
Large leaks 0:01Hrs
Large Leaks 0.2%

[Pugsy]

Those are total number of events in each category. To get the index/average you must divide that number by the number of hours using the machine.
At any rate...about half is clear airway and more pressure won't fix those.
More pressure might be indicated if you were for sure asleep during the OAs and hyponeas.
The problem is that the machine could easily have mistaken awake/semi awake breathing irregularities as some OA and hyponeas and any awake/semi awake event flags have to be ignored.

This is why the graphs themselves from the software are so important. You can see when the events are flagged and if there's a big cluster of them right next to a known awake time then we can probably assume they aren't real.

Now I am not saying that all your events aren't real...I am just saying that we have to consider that there is a possibility that some of them aren't real so we have to carefully evaluate what is really going on.
It was the first night and let's face it...sleeping with all this stuff plastered on our face isn't normal and it does require a bit of adjusting.

If you felt like you weren't getting enough air at that starting point of 5 cm....it's going to make falling asleep and getting comfortable a much harder adjustment.
If you are like most people you would probably do better with a little higher starting point...something like 6 or 7 cm...plus I suspect you are going to need it anyway to deal with the OAs and hyponeas.
If we saw your software report from last night I am betting there were some snores and flow limitations also flagged which would point to the minimum pressure not being optimal.

How do you feel about changing that minimum pressure yourself? Are you okay with doing it or do you prefer to let your medical care team take care of it?
It's easy to do yourself if you are comfortable doing it.

Do plan on getting the software...you are going to want the level of detail it offers. We will help you with the evaluation process until you are comfortable with what you see. I know it looks like a huge learning curve right now but if you take it step by step it really isn't all that big.

[naomi402]

Thank you for all the information. The "provider' supposedly is the only one that is suppose to change the settings but I found somewhere that shows you how to change your setting so I can change it to 6 and try that. The provider was emphatic about not taking out the SD card and doing anything with it because it might mess up the information that is downloaded every night. I think it would be okay if I lock protect the sd card so nothing happens to it when I download info to my computer.

[Pugsy]

Bunch of hooey from the DME about not messing with the SD card...they just don't want you to be able to do what they do.
Even if you messed up the card (which is highly unlikely anyway) the machine stores almost all the data on its internal memory and will put it right back on that card or any card as soon as you put the SD card into the machine.

Write protect it for extra layer of safety if you wish but the machine won't care one way or the other and you can't mess it up unless you do/did something directly to the files on the card on purpose.

Oh..in case you didn't know...hooey equals bullshit here in the Ozarks.

[LSAT]

Thank you for all the information. The "provider' supposedly is the only one that is suppose to change the settings but I found somewhere that shows you how to change your setting so I can change it to 6 and try that. The provider was emphatic about not taking out the SD card and doing anything with it because it might mess up the information that is downloaded every night. I think it would be okay if I lock protect the sd card so nothing happens to it when I download info to my computer.

DMEs (providors) are noted for lying. It's your therapy do what is best for you.

[naomi402]

thanks for the support