frequent awakenings

[<guest>]

I have been using a Respironics Auto with cflex and heated humidifier on a rental basis for about 3 weeks. After sleeping about 1-2 hours I experience frequent awakenings (sometimes twice an hour). I generally fall back to sleep quickly. The awakenings almost always occur during a dream, which are quite detailed and realistic. I remember them when I wake up during the dream, but don’t always remember the content when I wake up in the morning.

Since I have not yet purchased the machine I don’t have the software reader. The DME will download and print it for me, but they have experienced problems with downloading the update and are waiting for their Respironics rep to provide them the update on a CD.

I am wondering if the awakenings are due to a change in my REM sleep. I would appreciate any feedback or comments. Thanks.

[Harper]

Get the VERY LATEST Version of the Software, and a USB Smartcard reader, from CPAP.COM. The newest Version, has the update already applied.

I had a LOT of trouble with the "Error 39" problem, because I didn't know the Update was already in the New Version of the Software, & installed it manually.

The Software & Reader are about $199 from CPAP.com. You need to know something about Winblows XP -Pee, before you use it, as you might have to "Tweak", to get the Software to run properly ...

Luckily, I have a "Service Contract" with Gateway, so they can "Walk Me Thru" most Problems [like "System Restore"].

I did one of those, & re - installed the Software, WITHOUT re-installing the Update to Encore Pro. Most DME's will NOT know enough about Computers, and/or the Software, to get this Program to work properly ...

Expect ABSOLUTELY NO SUPPORT from Respironics, & very little, from CPAP.com! Respironics, will hang up on you, if they find out you are a "Patient" CPAP.com will sell you the Software, but tell you that Respironics "Doesn't really want" Patients to have this Software!

I got the Software to working ... it's pretty straightforward, on how to set up "patient Information" within it, once you get it working. But it is kind of a "clunky" Interface to VIEW the Smartcard downloads in, so it's better to "Export" them to PDF. It's easier to manipulate the "Thumbnail Views there, than in Encore Pro.

I will put together an article, on what I did, to make this Software work better, for me ... a little more detailed, than what I have written here ... it WORKS, but you have to be kind of a "Computer Geek" ... it's still worth it ...

[<guest>]

Is the software for the Resmed Spirit easier to install and use? I still have not decided on which machine to purchase.

For those of you with Resmed machines -do they have better customer (patient) service?

[rested gal]

Guest, I have had two REMstar autos. The old one is only a little over a year old and works fine, but I wanted the new one with C-Flex. Love that extra comfort of less pressure for every exhalation.

I've had no trouble at all installing or using Encore Pro software with either autopap. My computer is running Win2K Pro. I have an Infineer card reader (serial, not USB.) I originally was using Encore Pro 1.3 with my previous REMstar auto. When I got the new auto with C-Flex, I upgraded my older software to Encore Pro 1.4.87 online by simply going to:

Respironics Software Update Center

and downloading only this:

______________________________________

Encore Pro v1.4i Rev 3 Upgrade Oct. 22, 2004 Download
Upgrades currently installed V1.3 or later to V1.4i Rev 3. (It does not support versions older than V1.3)
_______________________________________

No big deal. I'm not a computer geek at all. I very much like getting to see my overnight data on my own computer.

Last week I installed Encore Pro on my uncle's Win XP computer and did the same upgrade download online. No problem whatsoever.

I suppose the Encore Pro software that's available at online stores now is already the updated version and would not even require a visit to the Respironics Software Upgrade Center.

The software and card reader do not even require a prescription when purchased from an online store.

[ January 31, 2005: Message edited by: rested gal ]

[Mr Mango]

Are the dreams normal visual experiences or do they jump at you with sound, colour, repeating acts and messages.

How do you know its twice an hour? Do you have a clock at your bedside?

If you filmed yourself sleeping or recorded yourself for sounds you will get a fair idea what’s going on.

I have done this several times and seen problems I was unaware of eg: hose getting wrapped up with me, postural position changes sometimes disconnecting the hose, taking mask off and scratching around nose etc.

I am not saying what is waking you but you could be waking more then you think and it could have nothing to do with the machine or it could be.

Like you could be sticking you hand up inside the mask or anything else that could be disrupting your sleep.

Point here is your waking twice an hour and yet go back to sleep. Your not throwing the mask off but something is waking you. Postural OSA can be a problem when we are tested in one position. So you come home and lay on your back, bang you wake up and lay in a better position and go back to sleep and so this cycle of waking and going back to sleep may well be your machine set to a certain pressure.

So they turn it up because you have apnoeas on your back and then you can’t handle CPAP because it’s too high when you lay on your side when all that is needed is for you to sleep in the position that the machine is set for. Auto machines should take care of this but may not catch it before you wake up. Something so simple cannot be seen on software but yet recorded.

I believe sleep is that important and I would pay someone to record my behaviour while sleeping rather then depend on software if I had a problem I couldn’t get a handle on.

I felt I was choking on Resmeds Auto machine yet the software said it was controlling my o2 and apnoeas perfecting. Your problem is interesting because you only complain of waking up twice an hour yet you go to back to sleep without too much difficulty.

Dreaming and the body being paralyse go together and that is when apneoas could be at their worse for you.

I am sorry there is no real answer except for observing you when you sleep. Why wake up in REM sleep and what are you doing in REM. Maybe your not paralyse but active then.

These are just thoughts and guesses but you never know.

[<John>]

I have had similar experiences with C-Flex--especially if I have nasal congestion. Try turning it off. I have a theory that for some people, C-Flex encourages shallow breathing because it tricks the body into feeling like it is exhaling/inhaling more than it actually is.

I don't think Respironics has published enough data to prove that O2 sats are equivalent on C-Flex therapy, and most titration studies do not use C-Flex. My personal opinion is that it should only be used on patients who have been titrated with it. After all a doctor would never prescribe a cholesterol-lowering drug for a patient without a liver-testing protocol.

Keep in mind that unlike a Bi-Pap, a C-Flex machine does not change pressure automatically, nor does it maintain a constant lower pressure limit--rather, the timing and amplitude of the pressure drop is triggered by the patient's breathing cycle and expiratory volume. Therefore, it may be possible for the patient's breathing cycle to fall into a feedback loop with the C-Flex algorhythm where it becomes shallower and more rapid with each breath, until the body is either forced to hyperventilate or wake up--then this cycle repeats itself.

With the new REMstar Auto with C-Flex, I'd be interested to see if anyone has noticed something like this from their software downloads. . .


-John

[<pinetree>]

I have your exact same symptoms! Wake up from dreams during the night, sometimes quite frequently. I use a REMstar straight CPAP at 10 cm. Can't understand it.

Did fine on CPAP at my test, sleeping 4-5 hrs with no interrruptions.

My theory is:
1- I was tested on my side only, and not on my back, so the pressure is not high enough when I change position.
2- I gained 10-12 lbs. in the month between the test and when I got the machine at home, so again the pressure needs to be higher.

My doc has raised the pressure 3 times, from 6 to 8 to 10 to 12, to no avail. I am at 10 now and swallow lots of air some nights; 12 is too much. I have tried to get my MD to change straight CPAP to an auto with software, so I can see what is going on, but he won't budge. I am trying now to get back to my testing weight (via weight watchers) to see if that helps. MD thinks its depression waking me up, and wants to prescribe a REM supressing antidepressant, but I'm very reluctant to try that route until I know whether CPAP is actually working or not.

Love to hear any other ideas out there. it seems to me I must be waking up form apnea -- that's what it does, isn't it?

[<John>]

Seems like a lot of pressure increases for not being re-tested. Autopap would probably be a better way to go, though. I think I'd start looking for another MD for a second opinion. Just my 2 cents.


-John

[Mr Mango]

Now lets separate sleep from the breathing disorder of obstruction.

You choke at night because when you sleep you relax and get an obstruction.

You pump the body up with air to inflate to part the obstruction.

So why wouldnt someone's sleep be disturbed apart from the obstruction that no longer exist with all this happening by CPAP therapy.

Turning it up only makes the air go down their stomach, out their mouth etc.

Rather then blame pressure it may well be the therapy that is affecting our sleep.

Put your wife or husband on CPAP on a very low pressure and see how they sleep.

Too often we look at pressure rather then the stark reality that CPAP therapy is very, very difficult to sleep with.

It is invasive to sleep and in no way acheives the same quality of sleep of people experience without sleep apnea. But to have OSA and not treat it is 1000% worse.

You will never get a natural perfect sleep but you ought to look to improve your therapy. Companies have done well in the last 5 years to make it better.

You ought to see the machines and masks ten years ago. Hang in there all.

Pinetree watch out for a doctor that plays with pressures that much.

You have to get use to the therapy before messing with pressures like that.

Having a mask stuck to your face with tension for more then 4 hours has got bother anyone enough to maybe wake and re-adjust.

[<John>]

Mr. Mango makes some very good points. I've been on CPAP for 2 years now and don't think I will ever "get used to it". I just learn to tolerate it better.

Beats the alternative

[planetax]

guest,

You may be experiecing REM rebound.Vivid dreams and sleep fragmentations are signs on treatment.
It can take up to 1 year or more to feel any better.

[Mr Mango]

planetax
Explain REM rebound. You have my interest