(04-21-2015, 12:23 PM)Terry Wrote: The biggest thing I noticed is that your machine is set for an upper limit of 10cm, and it seems to spend a lot of time there, and is unable to fix all your hypopneas. These will make you feel like crap.
You might want to see about raising your upper limit a couple of CM and see if that makes you feel better. If it does, you could also bump up the lower limit a little so the pressure doesn't spend all night flying up and down, which can also disturb your sleep.
I agree. And I consider this good advice.
But no APAP can "fix hypopneas"; hypops are, once again, flagged by comparison to surrounding breaths, meaning that by the time the determination is made that a shallow breath qualifies as shallow enough to be flagged a hypop, that event happened two or three breaths ago. Without a time machine, nothing can go back and "fix" that hypopnea, or any other successive hypopnea. The APAP will not even recognize a hypop until after it has passed. All it can do is report that it happened; reporting that it happened does not imply that the APAP could do anything about it or "fix" it.
An APAP can raise pressure in the face of OA or FL or snores, and this can help prevent successive OA events, but a hypop typically happens with an open airway, and is completely dependent on how deep your respiration is, and is not dependent on how "open" the airway is. A hypop is a different sort of problem; the APAP is a specific tool designed only to keep the airway open and therefore is not really effective against hypops. It can not force a breath on you.
Pressure increases do not effectively stimulate respiration response, so an APAP can't prevent successive hypops either, although higher pressure may have a minor secondary positive effect on 02 desat. But generally speaking, the only thing that an APAP can do is splint the airway open to prevent a greater percentage of OA events, and then raise pressure to prevent successive OA events once a predictive event occurs.
One would probably need a different type of machine such as a ventilator if their AHI makeup had a lot of (actual and not false positive) CAs and/or hypops. APAP is just not that effective on much other than OA events, although keeping the airway splinted open (which is all an APAP does) may have a secondary positive effect of minimizing other types of events simply by lowering the occurrence of OA events.
Furthermore, whether your APAP prevents or even fixes events has no direct correlation to how you feel, because you can have severe apnea for decades and feel just fine, and then get 100%-effective xPAP treatment and not feel any "finer". "These will make you feel like crap" is an over-generalized assumption that may or may not be accurate, depending.
There is indeed a direct correlation between a lower AHI and how healthy your sleep is, which is the exact point of xPAP therapy in the first place. But this may or may not have anything at all to do with how you feel. This is why SA is such a sinister malady; you may, again, for decades, have no symptoms or clues that tell you that you have it, until you start digging and see a doctor who will also start digging. Unfortunately, no one starts digging until they have a reason to, which may be too late, and is why 11 million SA sufferers in the US alone don't seek treatment.