First night, placebo or real?

[TT]

Last night was my first night with my BiPAP. Sure, I dealt with a few leaks, strange pressure feelings, and a little irritation from the mask. Due to going to bed late and having to get up relatively early for a Saturday, I only slept 6:49. My AHI from my sleep study was 39.2. According to the machine and my Sleepyhead data, my AHI last night was 12.47. Quite an improvement but not there yet, I know. I was 100% compliant and did not take the mask off at all until I woke up. I am normally a night owl and usually go to bed around 3am and get up around 10:30 or 11. Today I got up at 9 am.

This morning was the first time in at least 15 years that I did not wake up with a headache and today was the first time in a LONG time that I have not had a dull headache all day long. I also had good energy today and was not super sleepy around 5:30 like normal. Is it possible that treatment is already helping me or is it likely placebo since I believe in it and want it to work? Your thoughts?

[TASmart]

Sounds like a believable reaction to getting a good bit of quality sleep. I had trouble sleeping enough after starting my CPAP journey, so for the first several months, I had a lot of 5 AM wake-ups. Now its more 7 AM always going to bed 10:30 to 11.

Congratulations on a great first night!

[Pugsy]

What is the AHI breakdown into each category?
ClearAirway/Central index?
Obstructive Apnea index?
Hyponea Index

And what settings did you start out with?

Oh..it's probably not all placebo...
Maybe a little but not all. This stuff does work.

[TT]

ClearAirway/Central index: 2.64
Obstructive Apnea index: 8.51
Hyponea Index: 1.32

I started out with full auto set to 4-25 with a pressure support of 4.
EPAPExpiratory Pressure (cmH2O)
W-Avg: 10.93 Min: 5.10 Med: 10.86 95%: 15.24 Max: 16.72
IPAPInspiratory Pressure (cmH2O)
W-Avg: 14.45 Min: 8.00 Med: 14.58 95%: 19.18 Max: 20.72

MyAir from Resmed gave me a 92 for what it is worth!

[Pugsy]

Your are going to need an increase in the minimum EPAP.
Are you going to be doing that with input from your RT family member?
Or do you wish our thoughts?

I would be doing it pretty soon...increasing the EPAP minimum...probably at least to 9 and maybe even a little more.
I wouldn't spend an inordinate amount of time at these settings. Now once you get the AHI down to around 4ish...then you can take more time and go slow.

[TT]

Pugsy,

I will take all the help I can get, ma'am! When you say to increase epap to 9, isn't it already averaging over 10 or do I not know what I am looking at?

Couple of questions if I may...

-I guess at high pressure, you will always have a lot of air coming out of the exhaust of the mask (which of course makes noise!)
-I usually start out on my back, then roll to my side. When on my back last night, the pressure was really high but when I rolled on my side it was much lower. I am guessing this is normal since the airway is more open on your side?

[Pugsy]

When you say to increase epap to 9, isn't it already averaging over 10 or do I not know what I am looking at?

Well I can't see what you are looking at because I can't see the graphs.
What SH number are you looking at that makes you think you are averaging over 10?
That 95% number maybe?? You thinking that is where you spent 95% of the night? It's not. 95% numbers mean at OR BELOW for 95 % of the night.

When on my back last night, the pressure was really high but when I rolled on my side it was much lower. I am guessing this is normal since the airway is more open on your side?

Normal because it is common for OSA to be worse when we are on our backs. Also common for OSA to worsen when in REM stage sleep....and some people get the double whammy...worse in REM and when on their backs.

You aren't able to post image links yet because you aren't a forum member but you might read this if you are going to want member input because we need to see what you are seeing and more than just the statistics to be able to best help you.
In this thread I explain how to do the image sharing link thing.
viewtopic/t156463/Things-to-do-while-wa ... roval.html

[zonker]

Last night was my first night with my BiPAP. Sure, I dealt with a few leaks, strange pressure feelings, and a little irritation from the mask. Due to going to bed late and having to get up relatively early for a Saturday, I only slept 6:49. My AHI from my sleep study was 39.2. According to the machine and my Sleepyhead data, my AHI last night was 12.47. Quite an improvement but not there yet, I know.

congrats, tt! what you've had happen is rare, from what i can tell. that is, you benefited at once from your therapy. a lot of us don't and have to struggle with it for a while before getting all the goodness.

now, it's just a matter of dialing in the proper numbers to get your therapy going to it's fullest extent....

[TASmart]

MYair is a motivational tool to keep the user engaged. There is a more in-depth tool used for compliance.

[sleepybrit]

Mate, congrats on your first night... I can definitely attest that it's possible if not likely the treatment is already helping you.
I started with an AHI from a home study of 90 or so and my first night, two months ago, with an APAP it droped down to 5 or 6 as I recall, which in itself is awesome, but more importantly I immediately felt better, was more alert, felt refreshed for the first time in years and had more energy. It only got better from there.
My AHI now is typically 1 or less with a pressure of ~12, I rarely wake up during the night anymore and when I do wake up I feel so much better, am not nodding off all over the place anymore and can function properly all day until I decide it is time for bed
I too had a little discomfort from the mask when I wake up and continue to do so intermittently to varying degrees but that's a small price to pay and it always passes quickly after I get up.
Keep at it.. sounds like you're well on your way to reclaiming your life!

[Pugsy]

This stuff usually works. But does it typically work that fast ?

It can work that fast. Why not? Who cares if it is typical or not?

The bad news is that some 50% of folks are not compliant so did it really work for them?

Have no idea why other people give up. Not my day to worry about why people quit or if it worked for them or not.

Cpap CAN work quickly...there are overnight miracles happening.
Now why someone doesn't get the miracle...any number of reasons.

Even those who are compliant there is some 10% with CA that cant get enough improvement even with an ASV.

Your point is....irrelevant as usual. Nothing in life is ever perfect.

Mr. Negative Nellie. Why is it you just have to rain on everyone's parade?

[TT]

Well, second night done and once again, woke up with no headache. I ALWAYS had a headache before. Felt good to day again also. Actually had energy to do a bunch of clean up around my shop. Placebo or not, I don't care. It seems to be helping! My AHI went up, though and had a harder time with leaks on the mask last night but I will persevere!

[TASmart]

Good for you! Some of us, get lucky and feel results right away.

[TedVPAP]

I know people who responded immediately, while others (like myself) took a few months.
The difference is due to the unintended consequences of PAP treatment that some people have which can also impact sleep quality(claustrophobia, bloating, mouth leaking, mask leaking, noise, ...).

[chunkyfrog]

I noticed the difference right after the titration study.
Waiting for the machine was maddening.
Instant resolution for frequent nightmare wake-ups, morning headache, and afternoon desk naps.
It took longer to get more energy, a clearer head, and better concentration.