Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Chronic Insomnia
#41
RE: Chronic Insomnia
I haven't seen signs of periodic leg movement in any of the charts so far. search the site for it if you want to see what to look for in your flow rate. I've posted examples all over the place and you'll find some in my plm thread which you can find by searching on my username.

so far what I see is a lot of flow limited breathing whose cause we don't know. the spikey flow when on auto may indicate movement. unfortunately, movement can cause those spikes and disordered breathing (like those spikes) can cause movement. which problem is yours remains to be seen. you can have someone check on you periodically to see what you do in your sleep, use a noise activated audio recorder like in a phone sleep app or you can video yourself.

the fact that your ca drops using a fixed pressure suggests your ca is pressure induced. idk why after 20 years of cpap, but there we are.

my suggestion would be to go back to a fixed pressure until your vauto arrives. the vauto will provide more of a difference between inhale and exhale pressure which may allow lower ipap which would increase comfort and reduce ca. it will help with flow limitations (if they aren't plm induced). once on vauto, you can reduce pressure activity by effectively setting constant epap and pressure support (together: ipap) which may reduce these kind of disturbances that lead to awakenings.

I think there's a good chance you're going to like the vauto. if ca still crops up, you can try high and very high trigger. but I'm hoping addressing the flow limitations will go a long way toward more restful sleep and fewer awakenings.

let's see what things look like after a night or two on vauto.
Post Reply Post Reply






Donate to Apnea Board  
#42
RE: Chronic Insomnia
        But the problem I have seen is that going to a fixed pressure might reduce my CA's but dramatically increases my OA's. What would cause that?  Thank goodness I got confirmation that my machine should be arriving by this Thursday. I am posting a chart from Dec. 25 in which my AHI was 2.12 while on Autopap with only 6 CA's, 3 OA's and 4 RERA's and tell me what you think. According to my sleep log I am keeping it shows that I felt good the next day. This was before I started weaning off the Trazodone. All the other charts I have posted were listed as bad nights on my sleep log.
Post Reply Post Reply
#43
RE: Chronic Insomnia
"But the problem I have seen is that going to a fixed pressure might reduce my CA's but dramatically increases my OA's."

unfortunately, the trade off and the challenge for many folks with apap's is finding the sweet spot between oa and ca, depending on our relative tolerance for one or the other.

you could try adjusting your fixed pressure to attempt that but it could take some time. if your vauto is on its way just stick with the settings you feel best until then.
Post Reply Post Reply
#44
RE: Chronic Insomnia
My VAuto and my wife's Airsense 10 Autoset For Her will be here in the morning. I wanted to go ahead and find out what settings you think I should start with on my machine? My doctor wrote the script but did not show pressure settings. I guess on my wife's it would be the same pressure settings she is on now which is 8-15. I don't know what the EPR should be set for her. It seems her biggest problem is Hypopneas.
Post Reply Post Reply






Donate to Apnea Board  
#45
RE: Chronic Insomnia
For your wife, Mode Autoset (can use standard, soft or for her mode) minimum pressure 8.0, maximum pressure 15.0 EPR on Full-Time, Setting 3.

You are the problem child. We need to allow the machine to operate and titrate, and work on optimization. You have found a pressure around 11.0 CPAP works best at this point. Let's start at this:
Mode Vauto
EPAP min 7.0
Max Pressure 18.0
PS 3.0

At this point it is simply a guess. Standard PS is 4.0 and I would try higher PS, but I don't want to have centrals blow up the night, so we are being cautious in case you are sensitive to pressure support. Be aware there are other settings that we are leaving at default for now, like Ti Min 0.3, Ti Max 2.0, Trigger Sensitivity Medium, and Cycle Sensitivity Medium. These can be manipulated to resolve specific problems once we see what is going on.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#46
RE: Chronic Insomnia
After finally getting my new machine, I have slept with it for 2 nights and wanted to post a couple of charts to see what changes you think I need to make. On Jan. 7 I woke up at 3:30a.m. and could not go back to sleep so any thing after that time is SWJ apneas. On Jan. 8 I woke up around 4:00a.m. and did go back to sleep and finally woke up around 5:30 and so any apneas after that is SWJ. Let me know if you need any other screenshots.


Attached Files Thumbnail(s)
       
Post Reply Post Reply
#47
RE: Chronic Insomnia
I was hoping to get someone to take a look at my charts from last night to see what changes I need to make.
Post Reply Post Reply






Donate to Apnea Board  
#48
RE: Chronic Insomnia
I think I wrote a review and failed to submit it. You indicate most CA is due to being awake. I think you should change Trigger Sensitivity to high and leave the rest alone. Leaks remain your biggest challenge. Adjusting for periods when you claim to be awake, there are nearly no events, and nothing obstructive. I'd like to see you clean up the leaks before making any other changes.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#49
RE: Chronic Insomnia
At this point mask leakage does seem to be my biggest problem and challenge. I think a lot of the problem is that I have been using a CPAP cap from Pursleep and the cap slides on my head all night long causing the mask to become loose causing leaks. I ordered a Knightsbridge cap/chinstrap to see if it does any better. My next option would be to try a pillow mask to see if that helps. My last option would be to try the Bleep mask even though it seems harder to put on every night and can get to be expensive having to buy the Dreamports to go on the nose every month.
Post Reply Post Reply
#50
RE: Chronic Insomnia
I have used the Airfit P10 since it was released. I get leaks sometimes as the headgear stretches or the pillows need cleaned or replace, but pretty good. The big question is whether you have mouth leaks, or a leak from the seal.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Complex Insomnia and Advanced PAP (ASV) Gideon 3 310 11-03-2020, 12:55 PM
Last Post: Dormeo
  Chronic Care Management for sleep disorders nydraa 2 149 10-26-2020, 08:27 PM
Last Post: SarcasticDave94
  Help Needed - Continued Insomnia with APAP IUsedToSnore 16 773 06-14-2020, 12:07 AM
Last Post: jaswilliams
  New CPAP User Having Anxiety Insomnia Fear of Sleep Apneas Achilles76 7 410 06-10-2020, 09:31 AM
Last Post: Sleeprider
  Tips for new CPAP user with insomnia? panthek 15 863 03-19-2020, 08:32 AM
Last Post: RNeil
  Developing insomnia as a new user. Normal? italyhound 3 451 09-20-2019, 02:23 PM
Last Post: Hydrangea
  Insomnia resource Dawnstar 3 710 02-14-2019, 04:20 PM
Last Post: Haley


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.