TOO MUCH PRESSURE CAN'T SLEEP, TOO LOW, HIGH AHI?

[tammyem]

I am having all sorts of trouble with getting used to my Dreamstation auto machine. I wear of full mask as I am a mouth breather. The first night I could only wear it for 2 hours and felt like I was hyperventilation when I tried to breathe out and too much pressure was going in. The second night, I changed some settings. I turned the min. pressure down to 4 and high of 20, changed the flex to c-flex, and changed the time to 45 minutes as I have a really hard time getting to sleep. So I could breathe easier and had the full mask on until 4:30 this morning, but my AHI said it was 55.5! zero leaks, 90% was 5, and had 8 disconnects. I am not sure what to do and why my AHI was so high last night. I cannot have the pressure of the first night as I cannot breathe out. Please, any help would be great.

Tammye

[Klock1]

Might need to switch to a bipap that has one setting for when you inhale and another (lower) when you exhale.

[Pugsy]

Get SleepyHead and lets see what the settings were the first night.
https://sleep.tnet.com/equipment

I suspect the high AHI was from awake breathing irregularities getting flagged by mistake...not real. You couldn't sleep and fought the machine and got a bunch of false positives.

Wear the mask with machine on while awake watching TV or reading a book when not under the gun to get to sleep.

Actually the reduction in starting pressure to 4 cm could well be causing some problems with air circulation and a suffocation feeling making it feel like it's hard to move enough air. What was the starting minimum before you reduced it?
Are you using the ramp?
Flex won't help you at 4 cm...because the machine can't drop below 4 and that's what Flex does...drop the pressure on exhale to make it easier but if it can't drop then it doesn't help.

[tammyem]

I felt like I could breathe better with the lower settings, but mask is hard too get used to, so I guess that could be it. The setting was at 5 before I lowered it. I do have the ramp on and the time is 45 minutes. Another question: If I have the ramp time set at 45 min. Does this reset every time I wake up? If this is the case, then I could see why my AHI might be high (if the number is correct), I wake up then I get a gradual increase over 45 minutes and the pressure is not enough to keep me asleep. I don't know. I just want to lay down and close my eyes and not wake up until morning:)

Tammye

[Pugsy]

Ramp only engages if you push the ramp button to start it but if your pressure minimum is 4 it doesn't matter if ramp button is pushed because the ramp starting point is 4 cm. Again...can't go lower than 4.

The ramp would be more noticeable if your minimum was quite a bit higher.
Right now the ramp is useless with the minimum already at 4. It's not going anywhere anyway.

[Julie]

Most of us disable the ramp altogether within a very short time after starting out... as she said unless your min. setting is quite high (e.g. over 10-15) you're only delaying useful therapy by 45 mins as things are now. Pointless.

[mesenteria]

Most of us disable the ramp altogether within a very short time after starting out...

Really? I hadn't realized that I am in a minority.

...as she said unless your min. setting is quite high (e.g. over 10-15) you're only delaying useful therapy by 45 mins as things are now. Pointless.

I suppose this follows necessarily if most don't use ramp because it has little or no utility. I had understood that the ramp feature can be circumvented by the machine if it detects that you are asleep and needs to commence pressure treatment. Or that some machines can....

[zonker]

hi, tammyem and welcome to the forum!

what you are going through is fairly typical. what it means is that your "therapy isn't optimized". yeah, i know, that sounds like gobbledy gook.

we are all different and bring our differences to cpap. what works for me may not work for you. that being said, there ARE crossovers. sleep position and diet and such do effect us all across the board. but still, we each react in our own way.

one of the places that this becomes obvious is within AHI. this is made up of many separate "events" which come together to make up AHI. so, the experts here (and believe me, I AIN'T ONE!) need to see the charts that the sleepyhead software generates. once they see all of the facts presented there, they can make helpful suggestions to make your therapy better suited for you.

and, all told, this may take a while for you to get used to. don't worry about that. i'd say ninety five percent of the people who come here don't adapt to it right away.

not to worry. you can get through this. and before long, you'll wonder what the fuss was all about!

[chunkyfrog]

. . . I am a mouth breather. . . . Tammye

Do you ALWAYS (24/7) breathe through your mouth? (Deviated septum, etc.?)
Or did someone at the sleep study TELL you? (no reason given)
It can/does happen--even when mouth breathing is only a temporary habit
that can diminish with effective treatment.

[palerider]

Most of us disable the ramp altogether within a very short time after starting out...

Really? I hadn't realized that I am in a minority.

Now you know.

[HoseCrusher]

On the other hand...

Some of us realize that ramp can provide some extra comfort and extra comfort makes this therapy more manageable.

BUT

If you are going to use ramp you need to use it thoughtfully.

Setting your minimum pressure to 4 and ramping to your normal pressure of 12 over a period of an hour or so is not a good way to use ramp. If your normal pressure is 12 and you set the start at 8 and ramp up over 10 - 15 minutes is a much better way to use ramp.

I use a ramp of 10 minutes and find it a very comfortable way to transition to sleep. I like my comforts. I may be in the minority, but I am comfortable...

[Goofproof]

The purpose of training wheels on a two wheel bicycle, is a backup plan for those that lack balance, they aren't meant for lifetime use, that's the reason they also sell wagons.

Also training wheels aren't sold on all bikes, because many kids are taught to take life as it is and meet it head on. After many generations, Americans could no longer do that, and we started selling coconut hulls to put on our kids heads to teach them not to pay attention to their surroundings and be safe.

Be safe out there, ride on the sidewalk, avoid trees, and people texting. Jim

Welcome to the minority. That's one you won't find me in, now or ever. Give me Air, or Give me Death!

[HoseCrusher]

I think of it in terms of a different analogy...

Strong people don't really need air conditioning. It is just more comfortable if you have it when temperatures get hot.

[Goofproof]

I think of it in terms of a different analogy...

Strong people don't really need air conditioning. It is just more comfortable if you have it when temperatures get hot.

Or move North, I've had my year at 130 degrees, it broke my cooling system, so I moved North. Jim

[Okie bipap]

I've lived in the north (Alaska, Montana), I moved south for the milder winters.