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Still having too many events & daytime sleepiness

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KindPinkGuanaco9781 +0 points · about 7 years ago Original Poster

Hi--I have been diagnosed with OSA about 8 months ago and still struggling with CPAP but staying with it. My events range from below five to more than 20 several nights in a row. Do I need to be concerned with a few nights per week with 20+ events per hour? I can't get the daytime sleepiness to go away and I am at my wits end. I feel really scared sometimes and would appreciate any suggestions; thank you--Sophie

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BrightSpringbudSandpiper5105 +0 points · about 7 years ago

My doctors said not in the early days. I rarely see a doctor about it and only once in the last 5 years.

I have always believed that my APAP machine is dealing with the apneas whatever the numbers that happen and that if I stopped I would revert to my natural severe apnea. I stopped thinking about it for many years. If the machine is working then the impacts of the apnea itself should be being dealt with as needed. To me an APAP is doing all the monitoring and adjusting for you.

I review my stats now only every couple of years and/or if I have a really bad week to see what was happening. It seems to be more under control these days and I have been at it for 10 years. If you have daytime sleepiness after 8 months then may be worth keeping in touch with doctor. I tend to think that APAPs are better than doctors, as the machine reacts as necessary. (could be deluding myself there of course) If you are CPAP try APAP and see if it works better. Doctors seem to only echo try whatever makes you feel better.

My brother swears by CPAP but I prefer Auto PAP. If you need higher settings it does it. The fact that it runs at the lowest setting that is doing what is needed is what I like about APAP. At the moment I am good, it runs low and very quietly. But if for any reason that changes APAP ramps it up as is needed.

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StraightforwardSilverGuineaFowl6145 +0 points · about 7 years ago

BrightSpring (who gives us these names)? I'm brand new to this site. Started tonight. What is APAP? Is that the same as ASV, which I think stands for Auto-Servo Pressure? My latest sleep study showed that on ASV, I went from 92 apneic events per hour to 0 (none)! But Medicare won't pay for it because my central apnea index isn't high enough!!! What a joke!! Anyway, does APAP mean ASV?

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mrueschman +0 points · about 7 years ago Support Team

Hey SSGF, the forum names are randomly generated to make things a bit more exciting than "Member927165". You can quickly change yours on the Settings page: https://myapnea.org/account

From my understanding, APAP stands for Automatic Positive Airway Pressure, which can vary the amount of pressure given over the night to best maintain an unobstructed airway. ASV, Adaptive Servo Ventilation, on the other hand, is a more sophisticated type of PAP device that is particularly useful in cases where central apneas are present.

Here's a page that describes some of this in more depth: https://www.sleepresolutions.com/blog/difference-between-apap-bipap-cpap-and-asv

Thanks for stopping by the forum!

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wiredgeorge +0 points · about 7 years ago Sleep Enthusiast

An AHI of 20 is not good. Therapy isn't working as it should. If you have a Resmed machine and are getting AHI feedback, what is your L/Min rate? If the mask seal is good, IT IS TIME TO TALK WITH THE SLEEP DOC as your prescription isn't getting the job done. The amount of air pressure prescribed is what they found during the initial sleep study was needed to keep your airway open. So... seems to me either the mask is leaking which negates the positive effect of the air pressure or the air pressure setting is not correct for you now. How do you monitor your therapy?

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Sleep +0 points · about 7 years ago

If you AHI is ranging in the 5-20 range, I would recommend talking to your doctor. Ideally most doctors would like an AHI under 5.

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KindPinkGuanaco9781 +0 points · about 7 years ago Original Poster

I monitor my numbers through my air at resmed. The leakage varies all over the map (good seal: 18 to 20 -- to adjust seal with very low points). I don't understand why except to sleep on your side, as recommended, is pretty challenging to also keep your mask on straight and not have a leak. Honestly I haven' figured this out yet. . . still trying. Thank you for your responses--

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wiredgeorge +0 points · about 7 years ago Sleep Enthusiast

If your leak rate is acceptable, then seems to me that you should talk with the sleep doc. Only thing that remains is adjusting pressure(s). As far as sleeping on your side, I found it totally impossible with the Simplus mask but can sleep on my side using the Amara View mask. I tend to keep my hand on the mask while sleeping to stabilize the mask. They also make a side-sleeper pillow which might help. I think it is kind of U shaped. I generally sleep just on my back and don't roll around much so not much of an expert on side-sleep.

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Sleep +0 points · about 7 years ago

agreed that if you leak values are low and you are still getting a higher ahi, would recommend talking with your doctor.

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KindPinkGuanaco9781 +0 points · about 7 years ago Original Poster

Really appreciate these responses; so helpful. Helps me prepare more for my next visit.

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wiredgeorge +0 points · about 7 years ago Sleep Enthusiast

It is important you get back after chatting with your doc to give us feedback on where your course of therapy is taking you. Knowing outcome is very instructive and helps all of use learn! Good luck.

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KindPinkGuanaco9781 +0 points · about 7 years ago Original Poster

Wiredgeorge--thank you. Honestly I feel that I am not on top of this yet but I have read that some people take a year to adjust. Trying to exercise more to help short circuit the daytime sleepiness. Although, lol, I did both today: exercise and sleep during the day. I will post again after I have a better sense of where I am going with this. Really appreciate these responses.

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ModestOrangeRedFlamingo1397 +0 points · about 7 years ago

I am so glad to have a chance to hear from fellow sleep apnea folks & to be able to ask questions. I just started my apap last Thursday (2-16-17), the same day having arthroscopic surgery on my left shoulder; that said, it wasn't the best time to start. I have been sleeping in my recliner most nights due to shoulder pain (I can't sleep on my side in bed). I'm using the RestMed Airsense 10 with a F & P Eson 2 nose mask, which is what my sleep apnea doc recommended. My "events" display shows anywhere from 3- 8 per hour, where 8 events per hour was what I scored during my sleep study. I have the machine set on auto sense, but sometimes during the night when I'm trying to go to sleep it doesn't seem like I'm getting much air. I understand that it adjusts up as you go to sleep. Having said all this, are my results ok for this short period of time? Any comments/suggestion appreciated.

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DanM +0 points · about 7 years ago Sleep Enthusiast Support Team

Hi ModestOrangeRedFlamingo1397. Since you have only been on treatment for a few days and are not sleeping as well or in the same position as you normally would, I think giving it a little time is fine. If you are taking any medications after your surgery, some medications that cause relaxation (pain meds and such) can often worsen sleep apnea symptoms. I encourage you to continue using your treatment and monitor your number of events over time. Hopefully, you will continue to adjust and see some improvement as you both adjust to treatment and heal from your surgery. Please let us know how things progress!

Please be advised that these posts may contain sensitive material or unsolicited medical advice. MyApnea does not endorse the content of these posts. The information provided on this site is not intended nor recommended as a substitute for advice from a health care professional who has evaluated you.