Trying to set ResMed Autoset ??

[grumpygirl]

Thanks robysue for the detailed answer. Yes, I usually begin to feel some stomach pressure from the minute I "strap on" my mask and turn on my machine. Most nights I can feel my stomach fill up after about 10 minutes or before if I do not fall asleep right away.

On straight cpap I had problems with aerophagia even when I set the machine at the 10.2 setting and my stats were always good/excellent every day but as I said I still felt crappy. So, let me see if I understand your post- the aerophagia that I experience is causing awakenings and the the awakenings are contributing to more aerophagia, and round and round and round.....is that correct?? So, maybe some Pepcid later in the day might help "break up" that cycle maybe a little bit. It seems from what I am reading that is no real solution to this problem. I realize that my AHI is not the problem but what I was trying to illustrate was the fact that on apap my stats seem to be much higher than I normally have and I feel crappy nonetheless. It seems like a no win thing.

When I took my data to my DME earlier this week I did notice that the highest my pressure got during the night when the machine was set at 8.4-11.0 was 10.8, so you are suggesting that I maybe try a more narrow range that might give me better results at zapping the events while not leading to too much "GAS".? It sounds logical to me and so tonight I will try the narrow range to 8.6-10.6 maybe. My machine does not have the capability to set a number at say 8.5 or 10.5 only 8.4 or 10.4 or the next step of 8.6 or 10.6. I really have not had a pleasant experience with using EPR fulltime-many times if I use an EPR above 1 I feel like I cannot catch my breathe or something similar to that feeling, so for now I think I will just not attempt to use the EPR fulltime.

I am hopeful that your information will prove to be a benefit since I really need some restful nights, I am having a very stressful upcoming week with some anxious moments concerning my oldest daughter and some biopsy results and taking care of her two precious boys (7 years old and 2 years old). I have been very good about putting it on a back burner for the last few days but we should get the results early this week and I will need all my stamina to take care of two energetic boys !! Thank you so much for all your help, I really don't know what I would do without the caring and detailed posts I receive on this site. It truly does give me some hope in finally getting the rest I deserve. Thanks to all again-GG

[Pugsy]

To help maybe control aerophagia and not sacrifice AHI...there needs to be a balance of pressures high enough to deal with events (prevent them) and low enough not to trigger the aerophagia. It is tough when you start feeling the build up when you first mask up and are already at the minimum pressure. Events haven't even started doing anything yet to the auto adjusting pressures.

[grumpygirl]

Happy 4th to you ALL!!!

I've been experiementing for the last few weeks with my machine set on auto in order to try and find a pressure that would give me better sleep results without so much aerophagia. I have such varied results that I am once again TOTALLY confused as to what to do now.

Initially when set on apap I did a little better with my pressure set at 8.4-11.0 cm, my 95% pressure usually hovered around 9.6 or 9.8 one night I did hit 10 but usually it stayed around the 9.6 level. I did not find that this pressure helped much with the fatique even after 10 days. When I took my data card to my DME the highest pressure recorded was 10.8 so I changed my setting to 8.4-11.2 to see if it would climb as high as 11 and maybe make me feel more rested and less foggy . It didn't change much of the results they were still all over the place with AHI of 2.3 one night and 1.2 the next and 2.1 the next night. Anyway, to make this story shorter as the days went on I began to feel more and more tired and more and more depressed. Today, I feel like a zombie and so depressed that I have that crying response to everything. I KNOW it is related to my sleep because on the "glorious" days that I have actually slept well I feel so much better with more energy and a much better outlook.

SO now I am stumped again. Should I go back to straight cpap and if so WHAT pressure should I use now??? I had been on a pressure of 10.2 to avoid the horrible "gas" I always feel but I still did not feel rested (the whole reason for this apap experiement in the first place)and many days I still had some aerophagia and still felt tired. My original titrated pressure was 12cm but there is NO way I can get even close to that and not have HORRIBLE stomach issues. The last few nights I have changed my pressure range to 8.6-10.8 since being at the range of 8.4-11.2 seemed to increase the "gas".

On apap I do notice that I seem to not be waking up as often during the night as I was on cpap but something is keeping me from feeling rested. Last night I slept a good 8 hrs. with only 1 waking but my numbers were as follows:

95% pressure--9.2, Leak--.00, AHI--2.3, AI--0.2,HI--2.1 the night before my results were: 95% pressure--9.6,Leak--.04,AHI--0.6,AI--0.0,HI--0.6 but I still felt so tired,foggy(the same old thing)my aerophagia is not as bad the last two nights however.

So what now?? I don't think I can stand feeling this tired and the depression is really not something I want to keep experiencing. Yes, I have tried anti-depressants but find that they keep me awake at night and therefore the fatique is still a problem. I guess I am just one of those people who will never feel rested for whatever reason, there just seems to be so many variables involved and I just cannot find the real solution. I have had my thyroid checked my Vit. D levels etc, etc. and everything comes back in the normal ranges. I am post menopausal and know that some of the fatique is probably normal but not to this extent- I KNOW it is somehow related to my sleep, I just cannot find the answer. Confused, tired and irritable-GG

[Pugsy]

It very well could be related to something in your sleep but it may not be the AHI part of things.
We tend to zero in on the AHI and leak numbers and pressure numbers because that is all we have that is tangible to easily see and hopefully modify so that we feel better.
Unfortunately good sleep and feeling well rested is not solely dependent on those numbers. If it was this then therapy would have a much higher success rate.

[grumpygirl]

Pugsy- Any suggestions as to what to do with machine settings-go back to cpap and change to higher pressure or stay with apap and change settings?? I am totally stumped now and NEED some relief!! Thanks-GG

[Pugsy]

I am sorry but I have no ideas as to where to go based on the data...the data points to acceptable therapy and you yourself can't seem to pin point which mode or pressure offers any consistent relief. You yourself say you have good and bad nights (days) but I am supposing more bad than good or we wouldn't be having this discussion.
Nothing stands out on the data that is presented. Since it is the LCD screen data we don't have the access to the deeper data that the software graphs would show...and even if we did have access to it we don't know that it would even point to anything. Sometimes the answer just doesn't show up in the data.

I wonder if you aren't having an underlying UARS component here that is messing with things.
The aerophagia also complicates things a bit. If there is an underlying UARS thing going on and those Hyponeas are part of it, even though they technically are at acceptable levels...maybe a little more pressure would deal with them but your aerophagia limits that option.
And of course we come back to the standard speech that one gets when the reports show that we should be feeling better but we aren't and the standard questions again pop up.
Hours of sleep? Fragmented sleep? Pain? Meds? and all those other usual questions.
I don't remember...are you taking any meds at all, even OTC?