Hi

I've just been diagnosed with sleep apnea, I've had a cpap machine for 2 weeks, the pressure is set at 17, every night I fall asleep easily as it is ramped but then I wake up after 2-2 1/2 hours after this I wake up every 1/2 hour or 3/4 hour or 1 hour even if I use the ramp. The initial effects were good but now the effects of the broken sleep are kicking in. Is this normal to waken up like this?

Help

john mcc wrote:

Hi

I've just been diagnosed with sleep apnea, I've had a cpap machine for 2 weeks, the pressure is set at 17, every night I fall asleep easily as it is ramped but then I wake up after 2-2 1/2 hours after this I wake up every 1/2 hour or 3/4 hour or 1 hour even if I use the ramp. The initial effects were good but now the effects of the broken sleep are kicking in. Is this normal to waken up like this?

Help

Hi John,

You are starting on a very high pressure, which creates problems, particularly after the ramping reaches full pressure. Your experience is not dissimilar to my own as I started on 18.

Can you post details of the type of machine you have and more importantly the type of mask (name etc). Also, details of how you were fitted out with the equipment, home call, in the clinic etc and anything the sales person said (your impression).

On the plus side, I'm using cpap for over 11 years now and very happy with it, so I hope (and think) that we can sort you out.

Kind regards,

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Thanks Daniel

I perhaps should have explained further, I live in Scotland and was refered to a sleep clinic at our local hospital. They provided me with a monitor which I took home for one night, it recorded my snoring, sleeping position, pulse etc etc. I then went back three weeks later and was given a cpap with ful nose and mouth mask this was for three nights, I don't know the type except that it varied the pressure it provided  and recorded it.  When I returned to the sleep clinic they downloaded the info. and for the first time I spoke to a senior doctor, she showed me a graph indicating the amount of time I was suffering oxygen deprivation, another graph showed that app two thirds of the time I was asleep the pressure required to keep my airway open was around the 17 - 18 that was it! She gave me a Remstar plus machine set at 17, a comfort full face mask and a nasal pillow and a return appointment in 6 weeks. The full face mask is very uncomfortable and tends to leak, I find I can cope with the nasal pillow although I do have a problem trying to breathe out against the constant high pressure.

John

I was given a Remstar pro2, which has c-flex, which automatically lowers the pressure when you exhale. You might tell them you need that feature.

john mc wrote:

Thanks Daniel

I perhaps should have explained further, I live in Scotland and was refered to a sleep clinic at our local hospital. They provided me with a monitor which I took home for one night, it recorded my snoring, sleeping position, pulse etc etc. I then went back three weeks later and was given a cpap with ful nose and mouth mask this was for three nights, I don't know the type except that it varied the pressure it provided  and recorded it.  When I returned to the sleep clinic they downloaded the info. and for the first time I spoke to a senior doctor, she showed me a graph indicating the amount of time I was suffering oxygen deprivation, another graph showed that app two thirds of the time I was asleep the pressure required to keep my airway open was around the 17 - 18 that was it! She gave me a Remstar plus machine set at 17, a comfort full face mask and a nasal pillow and a return appointment in 6 weeks. The full face mask is very uncomfortable and tends to leak, I find I can cope with the nasal pillow although I do have a problem trying to breathe out against the constant high pressure.

John

Hi John,

Sounds like you are being dealt with by the NHS ?

You had a limited home study (sometimes called domicilliary), followed by a few nights with an auto adjusting machine. Typical cut price diagnosis and titration. Sorry for harping on.

With a pressure of 17/18 you need very careful fitting for your mask, and obviously instruction. What has happened to you is further evidence why compliance rates in the UK are dropping. You are at the high end of a cpap machines ability (they only go to 20).

Are you near your hospital ? Do they have a full sleep clinic or are they a satillite unit to somewhere like the Royal Infirmary in Edinburgh ? If they are providing a full service it might be worth your while contacting them for more help (see more masks etc) and even help from the company that supplied them with the mask.

I am not very familiar with the FF mask so can offer little help, except to say that you must allow the cushion (bubble) to inflate with air from the cpap machine to make the seal, rather than tightening the straps really tight. The danger with tight straps is that the side wall of silicone collapses and creates leaks.

Nasal pillows are thought to be good with higher pressures (I think). Sometimes a problem with them can be the size of the actual pillow. It is reckoned that a large size pillow is best.

With regard to your machine and comfort......try looking for an auto adjusting machine or one with cflex. This will permit a variable air pressure, sufficient to clear apnoea events, rather than constant high pressure. In view of the high pressure level you might be able to push this with them, even for a period of 6 months or so initially. I believe possession is nine tenths of the law.

At worst, suggest that they lower your pressure to say 14 and increase it gradually over a few weeks to the 18 required to allow you a break in period, but I would leave that as a last resort. With the high pressure you need as much help from them as possible.

Post back.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Hi John,

Daniel's suggestions were smart.

Check your machine, does it already have c-flex?  Probably not.
But if it does, you might ask why a bipap wasn't required.  I really don't know the difference, except that I have a bipap and was told it is often used for people with high pressures and need a wider gap in inhale and exhale pressures.  My pressures are 18/13.  So I don't have any problem with exhale.

I don't have a full face mask either.  I am ok with a nose mask.
But the first six or more months were horrible!  I was like you, ramping and then waking to that wind tunnel after it reached it's full throttle!
I could not handle it, and I could not use it for more than a couple of hours at a time.  I went to my doctor and complained.  Now, he may be a quack, I wouldn't doubt it.  But anyway, he said it would take time for me to adjust to such a high pressure.  I never thought I could!

After awhile I did play with the mask straps a little, tightening the bottom one and loosening the top one.  That helped a little.  But I also found that gosh darn it the doctor was right.  I still need the ramp, but now I am able to tolerate it.  He told me that after awhile I will want the ramp adjusted once I got more used to it.  Sure enough, I do feel that way, although I haven't changed it yet.    

Still, it's important to get the mask working the best it can.  Daniel's right, you need better care about this.


Linda