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AHI going higher
#11
(05-07-2017, 01:47 AM)ajack Wrote: when you wake up thinking you haven't got the mask on, but it is.... you know you are there
your senses wake up later than you do

This actually happened to me this AM. I woke too early and decided to doze for a while. I woke up again feeling a bit upset with myself for going back to sleep w/o my mask. Got up, and lo and behold I was wearing my mask! Darn all that self directed anger gone totally to waste. Whats a guy to do?
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#12
(05-07-2017, 01:47 AM)ajack Wrote: when you wake up thinking you haven't got the mask on, but it is.... you know you are there

That'll be the day. Smile
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#13
(05-07-2017, 10:46 AM)ppca Wrote:
(05-07-2017, 01:47 AM)ajack Wrote: when you wake up thinking you haven't got the mask on, but it is.... you know you are there

That'll be the day. Smile

For me every morning is with a smothering hand pressing on my face, and this is with the straps fairly loose (and leak rates way up).  I tighten mask like directions say but then I am awake more than asleep and feel lousy in the morning.  But this is just my babyish newbie whining. Rolleyes

My ideal mask and maybe other users, would be a strapless mask with Post it note type adhesive so you place it on your face, glue seals "perfectly", then peel off on morning, any adhesive washes off in shower.  I see ads for an adhesive to give a better seal, which is as good as it gets and perhaps I should invest in to combat leaks.
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#14
I dropped EPR to 1, with no other changes. Don't know why or how, but last night I hit the highest AHI ever. It was 4.06, with only 1 CA event, but 21 H events, which is about 100%-200% more than I typically see. What am I doing wrong now? Maybe back to 2 with EPR?


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#15
ppca,
The EPR will usually show up as CA's.  This is just a guess but try bumping your pressure up to 9cm and, based on your Flow Limits, I would set the EPR back to 2 or 3.  I am trying to reduce your Hypos(by increasing pressure) and Flow Limits (increasing EPR).  Another thought; This is just a one night snapshot.  You may wish to give it a few days. What are your thoughts?
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#16
Yes, I most certainly understand that one night's results cannot be used to draw any conclusions. It's just that right after I dropped the EPR to 1, I am seeing a pretty significant change. As you suggest, I should probably run at this setting for another few nights and see what happens.

In the meantime, I've gone through my SleepyHead history. By far the best results, with lowest AHI, were when I ran at 7.8 pressure and EPR of 3. I was typically seeing 2-5 Hypos and 0-2 CA's. However, that was also the time when I wasn't getting as much deep sleep, as now. At least, that was my impression, based on the more frequent awakenings.
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#17
ppca,
Was your Flow Limit lower when your EPR setting was 3?
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#18
(05-08-2017, 11:30 AM)Crimson Nape Wrote: ppca,
Was your Flow Limit lower when your EPR setting was 3?

What exactly should I be looking for? When I checked those flow limit graphs, they look very similar to the latest one, oscillating between 0 and 0.50.
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#19
For lack of a better description, mine looked like yours, or worse, without using EPR.  I referred to it as "5 weeks growth". When I used EPR it went down to a 5 o'clock shadow.  (I need to work on my vocabulary)

Look at your Clinician Menu->Options->EPR Inhale.  It has a setting of "Medium" and "Fast".  This determines how fast the S9 will return to the set pressure when inhaling while using the EPR.  I found that the "Fast" setting produced a blast of air that would cause sleep disturbances. Additionally, it made my mask pulse like a diaphragm between inhale and exhale thus becoming an annoyance.  Setting it to "Medium" produced a gentler feel. . . almost to the point that the change in pressure was undetectable and reduced my Flow Limit as well.

.
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#20
It's kind of unusual to see hypopnea increase, with a decreased EPR. I would certainly put it back to 2. You may have some issues exhaling against the pressure. You might even try the opposite experiment. Increase pressure by 1 and dial up EPR to 3. You might find this actually improves tidal volume a bit. Any asthma or restrictive pulmonary conditions?
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