Sorry for the rant DanM. You did not deserve it. Thank you for your reply. I do value your advice.
So, when I asked my sleep doctor not to give me a pressure too low, because I slept fine in the hospital with a regular cpap which only has one pressure, the doctor's reason would be .... that she is an example of a doctor that doesn't listen to her patient...? (to say it politely) From what you say, there was really no reason for her not to follow my request other than being difficult. Doctors are so childish sometimes when I question them.
Not to be too critical really, but how many years is "over the years", because from what I hear the apap is fairly new. That would mean the "low" pressure setting is also a new thing... right?
And, from what I read here (which of course is only a sample mainly, of the people trying to solve problems), many people are being starved for oxygen. And, the bad thing is that many people will stop using the device, as I mentioned that I felt like doing. Wouldn't it be better to prescribe a setting high enough that it wouldn't do this. Since we are being force to have a sleep doctor prescribe the settings and might take a month or two before they review the issue. I mean if you set it a bit high for those it makes uncomfortable, they are simply getting more air, and are not being suffocated as are the people where the pressure is too low.
And, the final part is we must not only pay for another doctor visit to get this insanity resolved, but we also must make another visit to the DME... This should be resolved on the first visit to the DME, by testing to see what pressure IS comfortable to the patient. Not simply by the doctor "guessing" at the correct low setting. At least as long as unreliable doctors have us by the short-hairs, where we are required to get a prescription for the treatment machines.
After adjusting my own apap the Airsense 10, I see the complexities and realize something must be done, but the bit about being forced to have a "prescription" to get the machine is idiotic.
Not trying to attack you DanM, just the process itself, which is far from being even close to adequate.
Wow, amazing. I am dumbfounded when I read that the cpap is KNOWN to help uncontrollable high blood pressure and yet my supposed sleep "doctor" would not prescribe the treatment for my uncontrollable high blood pressure and recently developed Afib (high). According to her, I needed to have so many periods of stopping breathing before she would give me the prescription. She simply said she would not do it for blood pressure or afib. Both my regular doctor and cardiologist were certain that cpap would help both of those. Isn't refusing treatment somewhat against the oath doctors are supposed to take?
Number one, this is a Airsense 10 (apap) and it doesn't have an 02 sensor. The initial low pressure is like slow suffocation. ie: torture from lack of oxygen. And so, having no 02 sensor, the sleep doctor cannot actually assess whether they are depriving you of oxygen or not.
Not readily obvious, it was only when I was going to throw the whole ball of wax, that I started trying to see why I was having to sleep 11 hours on the machine then 6 hours off the machine to recover. So, I put on my mask and breathed, paying attention. That's when I noticed that trying to draw air through the machine was like trying to breathe through a single straw.
When I raised the low pressure all the benefits started showing up.
My initial pressures were 5-15 EPR 3. I have reset them to 9-16 EPR 2. I am hoping that was my last adjust, so I can see how my body and the AI in the Airsense can adjust to these settings. I have been at 1.05 or lower AHI for the last 9 days. The machine doesn't put me into Afib anymore (yet?), and I am sleeping 7-8 hours instead of the 12 I used to have to sleep to feel rested.
I would like to get to that point. The last 6 years I have had to sleep 12 hours to feel rested at all. 7-8 felt comfortable when I was in my 20's. I had heard that as you get older the need to sleep so much goes away, but in my case it got worse. Now, with this therapy I'm getting along and feeling great with much less sleep. It's like I've made my days 3-5 hours longer, because I'm fine with 7-8 hours again. Usually, I can get back to sleep when something wakes me, like rolling over on my cat.
LOL! I don't know if I should answer... I slept on a cpap 1 time at the hospital, a real cpap not automatic like the ResMed Airsense 10, so the pressure was constant and the nurse turned the pressure up while I slept. I awoke after sleeping 7:20 hrs straight. Something I usually never do. I felt well rested, and my high blood pressure dropped to be exceedingly low that night.
My sleep doctor (3months later) later put me on 5-15 EPR 3 on my Airsense 10, in spite of my asking her to keep the pressure high like I'd had at the hospital. Now, it's possible "she" is comfortable on a low pressure of 5. But, because I'm about 3 times her weight the low pressure of 5 was like trying to breathe thru a single straw. The first night I slept 11 hours on the machine, and then I had to sleep another 6 hours off the machine to recover. It was the same until the 4th day, and it was simply too frustrating to not be able to breathe. I was ready to toss the Airsense and my doctor out the window and give up. But, I had uncontrollable high blood pressure and in March I ended up in the hospital where I was diagnosed with Afib (high). So, I couldn't quit. Also, I'd hurt my back picking up the machine, and being unable to take it in to the DME and having a doctor who would be unwilling to change my prescription without looking at data. The necessary data is probably the O2 readings which require extra hardware. Anyway, from my point of view, I HAD TO CHANGE IT. So, I found out how to change it myself. I found recommendations for starting pressures of 9-17 & 9-20. I tried lower than 9, but 9 is where breathing becomes easy, and I had negative experience when I tried to go below 8.8.
my pressures are now 9-16 with EPR 2. The EPR allows my exhale pressure to drop down to 7. If I let it drop down to 6 I cause myself to have Afib. However, these new pressures have caused my blood pressure to drop as it did in the hospital, and my primary Doctor was thrilled with the Sleepyhead charts that showed my progress. My AHI's have been less that 1.0 for 7 of the last 9 days, and 1.05 for 2 of the days. And, my pulse rate is dropping to pre-Afib days. And, I wake well rested. Since the original cpaps start with 1 pressure I don't understand why these doctors start people with a pressure that's too low. My feeling is that they don't really have a good reason.
I have been a technician and analyst most of my life, so I was comfortable making my changes. However, you may not feel up to trying anything yourself. In which case you should contact your sleep doctor asap, so you can sleep decently.
Also, I've never gone above the high pressure of 17. I've lowered it to 15 and 16 a few times and I think 16 may be the magic number. My guess is the AI in the machine needs the high a bit higher than your highest pressure. Like 14.96 has been a frequent high pressure for me. I'm not sure, but 15 appeared to be to close and so I've gone back to 16 and the chart looks a bit better today. Now to see if I can keep this pressure until I get an appointment with my sleep doctor.
Sobakawa pillows are made out of buckwheat husks. These pillows were advertised on TV years ago. They circulate air well, and are fairly cool. The husks move a bit, but they are firm, and you can shape the pillow to what you want. You are kind of where I am wiredgeorge, my therapy is going very well, and my leak rate is really very very good, so I want to keep on with what's working. Still, I ordered the $35 fabric (washable) mask pads last night. Which is one of your suggestions that I am following up on (Thank you very much!). Using that finger push downward from above the nose really seats my mask well. I seated it before sleeping, then twice when I woke during the night. But, no leaks woke me. I doubt it would help nose masks or pillows, but it works a treat on my F10 full face.
Congrats on the lower reading! There must be a learning AI in the machine, because you set the machine, sleep great, and then over the next couple days you see the charts have changed again. Plus, your own body is adjusting as well.
My adjustments have kept my Ahi's to: 2 readings of 1.05 and 6 readings 0.11-0.81, over the last 8 days, so I'm getting close.
I normally wake up often while sleeping. I won't wake to a fire engine, if it parked out in the driveway, but the mask buzzing on my cheek will wake me. Lately with the cpap, there have been a few times I've actually slept through the night. It's kind of funny, I didn't post the above to get help with mask leaks, just to mention my little fix that seems to help the mask adjust itself correctly and prevents leaks from occurring.
LOL! If I'd followed my own advice and pressed down from the top to seat the mask last night, I might not have woken to a leak at all. And, I know you are right, it's better not to have to wake up the adjust the mask. I am going to try your suggestion and get a mask pad to see if that will stop even the little buzzing facemask leaks.
Sleeping on your back is supposed to increase ahi, and I haven't slept that way since my 20's. I remember when I was 18, I awoke with my heart trying to beat it's way out of my chest. Also, I felt scared. I have no memory of trying to get myself breathing again. But, I felt a lot of fear (of what I don't know), and was likely breathing hard. The fear and terrific pounding of my heart was all I really focused on. When I have tried sleeping on my back during the last 40 or so years, I don't fall asleep. I can fall asleep in a recliner, but I still tend to roll to my side.
Also, I tried one of those mouthpieces that were made to stop snoring. It seemed to work for a while, but then I would wake up in the morning having spit the thing out at some point. I think I would do the same thing with any other mouthpiece.
LOL! My leak rate last night was 4 L/m, and the night before it was 2 L/m on the myAir website. I only had to push the mask down 1 time last night, and if I had done it as a last step to fitting my mask, I might not have awakened to the slight leak at all. It seems, at least with my mask, to be a very helpful adjustment.
Yes, I have tried tightening the bottom straps, but I think I may need to loosen the top straps, then tighten the bottom straps, to reposition the mask slightly.
I have a large mask, probably need an extra large, which they do not make. I worked in the shipyards, and learned to adjust facemasks so they didn't leak at all. We tested them with real gas, probably tear gas. Of course I wasn't lying half on my face at the time;D