Hi everyone,

I was dx'd with sleep apnea last this month, and I've had my Rem Star machine for a week now.  I took a home sleep test in which I wired myself to a machine that checked my breathing, pulse, and blood pressure throughout the night.  I have a mild case of APNEA, ie. I only stop breathing eleven times an hour.  They said my blood oxygen drops below 90% at night.  Before my machine, I was sleeping about four hours per night.  I was exhausted during the day, and I was relying on others to drive me places because I was suddenly falling asleep.  I also have Restless Leg Syndrome, another sleep disorder.  I take Pamapexole for that.  The person who fit me for my mask said that RLS is very common among sleep apnea patients.

Whew!  That's my history, now for the question.  Last week I began my RemStar on a setting of 7.  My partner said I was still having apneas.  I have gradually increased to a setting of 11.  My sleep has been averaging between six and seven hours since the first night (even when I was still having apneas).  I'm delighted that I'm so much more rested, but I'm not sure about my setting.  I was told that the average person uses a setting between 10 - 12.  Well, I'm in the average zone, but I would like to do more than guess.  I will have a new sleep test in a couple of months, but in the mean time I would like to be at the setting I need.  How does one find the correct setting before taking a new test?

I'm so glad this forum exists!

Drowsy Maggie

they should have given you the corect pressure from the first test, its most unusual for a person to be given a CPAP without it being set to the proper pressure, how do you know what the pressures are, are they marked on the adjuster? they usually arent

Hi Maggie and Welcome,

You need to talk to your doctor as they should know what the proper setting should be based on your sleep study.  When you get your machine, the doc. has usually called in the pressure setting along with the Rx, so normally, they are ready for you when you get it.

If your prescribed pressure was 7, you still need to call your doc. and tell them you are still having apneas.  They will probably tell you to increase it a certain amount anyway, but apnea treatment is best when viewed as a partnership between you and your doc.

Why did you have a home study?  There is a lot of information missing when corners are cut and an overnight study is not done.

Can Home Sleep Studies Replace  Polysomnography?

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

That's very interesting.  I was not given a setting.  I was told to gradually increase the settings and to talk to the rental agency where I got the machine once or twice a week.  They aren't much help.  I'm sure that the person I talked to didn't even look at my home test.  The sleep doctor that I saw told me that I was sleeping four hours per night because I 'entertained myself' too much when I awoke at 1am.  I suggested a sleep apnea test because my partner noticed I often "held my breath" during sleep.  I am going to email my sleep doctor tonight!  Thanks so much for the information.   Grrr!  I'm not very happy with the doc that I saw.

Sleep well,

Drowsy Maggie

P.S. Lynn, my machine tells the setting in the display window.

I also did a home study, my Sleep person told me to start on 8 then move up my number if I notice that I am still waking during the night.  I am to do another home study in a few weeks which is suppost to tell me if I am at a high enough setting.  From everything I have read in here you are better off doing the overnight study, if your Doctor will do it I say go for the overnight study because then they can tell you what your setting should be, and take the guess out of it.

If I were going to be using "guesstimates" by anyone as to what pressure I should be using, I'd want the machine to be an autopap (auto-titrating cpap) set for a range of pressure, not just a machine delivering a single pressure that I was supposed to move up based on how I felt.  Ideally, an autopap will sense from your breathing how much pressure is needed and adjust up and down automatically throughout the night.

A full PSG sleep study would be best, of course, but if you really have to settle for the kind of test they gave you, do push for an autopap.  I personally would also want to get the software to download and look at the data myself on my own computer each morning.  But the software is usually something you have to get for yourself...doesn't come with a machine.  Software can be purchased from online cpap supply stores without a prescription.

I'd also want the sleep doctor or "person" in charge of my case to order a couple of nights with a recording pulse oximeter while I'm using the cpap or autopap at home to see if the treatment is, indeed, keeping my oxygen levels up well all night.

If you have to go this route without a full sleep study and a prescribed pressure I'd consider an autopap and the software for it to be essential tools.  Heck, even after a full sleep study and formally prescribed pressure, I still think it's a good idea to at least have a trial using an autopap that can yield further info over a period of time about how much pressure the machine has to use throughout the night when you're sleeping in your own environment and in your usual sleep positions.

Good luck Maggie and Debbie.   They're asking you to manage figuring out a lot of things on your own.  It's doable, but only if you educate yourself as much as possible via the message boards...this board and the boards at talkaboutsleep.com and cpaptalk.com.   You can do it, but do keep digging into the message boards as if you were a med student studying for the exam of your life.  

What would I do without you guys?  Thanks so much!  I've got LOTS of reading to do, for sure!  I think that I'm experiencing the dark side of my HMO, ie. cost cutting procedures.  The bright side is that it's more affordable for me (a retiree), and I like my regular doctor.  I'm  preparing to be a 'squeaky wheel' to make them meet my needs.  Sometimes I long for 'the good old days' when the 'doctor knew best'.  Oh well, maybe I just lived in a naive cocoon.