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Chronic Insomnia
#71
RE: Chronic Insomnia
Okay thanks. I will give that a try and hope that it helps.
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#72
RE: Chronic Insomnia
I hope it helps but if not we may still learn something. there's a lot of trial & error involved and beyond a crappy night's sleep there's no harm I'm aware of these machines can do.

even when we finally get settings dialed in, things tend to change in time, potentially requiring additional adjustments. so, not a set it & forget it proposition for many of us, one of the reasons the sleep medicine/dme/rt/insurance system we're saddled with is so ineffective.

otoh, thank goodness, the principals & members for this website! if my suggestions are off, someone else will provide alternate ideas.
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#73
RE: Chronic Insomnia
[attachment=29436]Last night my AHI was the highest it has been since Sept. 9, 2020. I have started double taping my mouth using medical tape over Somnifix strips and my leaks are a lot better. Last night was awful though. I guess apnea events kept waking me up throughout the night. It shows I had 51 CA's and 11 OA's. Please take a look and see what ya'll think.
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#74
RE: Chronic Insomnia
sorry you aren't feeling well but on paper it looks better in some ways to me. if you think you might have been awake during the clusters of ca near the beginning and end of the second session, you can discount them, bringing your ahi down considerably. oa, h, flow limitations, snores and leaks are lower. respiration stayed the same but mv and tv are higher. search the internet for a tidal volume calculator to see which is closer to expected to determine if higher is better or over ventilation. more experienced members may have better ideas but I'd stick with these settings for a couple days to see if you adapt. have you tried very high trigger for the ca? besides that, if the ca doesn't come down and you continue to feel poorly, it might help to continue to decrease the difference between epap and ipap. pressure is bumping up against max mostly against oa, h & fl but I would try raising epap before max ipap. that will help decrease the difference between epap and ipap as well. I haven't re-read this thread so apologies if already addressed: did you have ca in your sleep study? if not, treatment emergent pressure induced ca usually diminishes in 30 to 90 days. otherwise, you may have to pursue getting an asv. but give it a few more days and let's see if anyone else has suggestions.
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#75
RE: Chronic Insomnia
Those events when I first went to bed at 10:00 and anything after 5:00a.m I figured was SWJ apneas. But I would like to stop the events that are apparently waking me throughout the night. Something woke me up around 4 to 5 times. It's been so long since my last sleep study I can not remember how many CA's I had. I have not tried changing to Very High Trigger yet.
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#76
RE: Chronic Insomnia
I'd give a lot for only one mask off all night so I assume you're talking about roll-over type awakenings which are common. you can scroll through your flow rate at say a 5 minute view scale looking for what precedes the flow spikes, known awakenings and especially at the last 2 minutes of each sleep session. leaks, flow limitations, apnea and movement are frequent causes of waking. diet, stress, pain, environmental things like noise or movement in bed or the room too. it might help if you can manage to somehow note what you're feeling upon awakening. panting, fast heartbeat, sweating, hungry, gotta pee, etc., etc. you can mask off or spike a large inhale or leak to indicate waking. an audio and/or video recorder may also help you understand what's waking you.
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#77
RE: Chronic Insomnia
[attachment=29459]I zoomed into a 5 minute segment like you mentioned to see what might had waken me up on one occasion. It looks like a leak preceded a snore that led to a wakening. Does that slight leak look like a mask or mouth leak. Was wondering because of the fact that my leak rate has come down since double taping my mouth but my Dreamwear mask has been bothering the underneath part of my nose because I can remember having to adjust the mask because it was hurting me. If so, I might try one of my other mask like the Airfit P10 pillow mask.
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#78
RE: Chronic Insomnia
idk, that looks like you're breathing peacefully until you had a snort/snore causing a negligible leak followed by rolling over maybe, some recovery breathing (typically up and down for bit until evening out) and a ca followed by some ragged marginally flow limited breaths. I seriously doubt the leak woke you but the snort probably did. are you aware of having a floppy palate perhaps? on it's own, if my assumptions are close, nothing in this screenshot to worry much about unless you see it a lot. if you've been papping for longer than since December when you joined AB, your ca probably isn't treatment emergent but may still be pressure induced (hence the suggestion to cap max ipap) or you may just have developed ca. mine is idiopathic, yours may be too, but some underlying conditions, some meds, even stress could be at work here. keep looking at your flow rate, even going back in time, looking for additional anomalous flow rate waveforms. looking for clues. also, no reason not to try very high trigger (I do when I use my vauto).

I feel for you. my sleep has been severely fragmented and still is to a greater extent than most people. unfortunately, it's taken me years to build up to 2 - 3 and sometimes longer continuous hours without masking off. I don't want to discourage you though, even if not ideal, my sleep and ability to function is vastly improved. persevere and you'll figure this out, even if you have to finagle an asv.
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#79
RE: Chronic Insomnia
I was doing great on a ResMed S9 Cpap with 12cm of pressure using my Dreamwear mask until May 2020. My AHI stayed under 2.0 with most nights under 1.0. My leak rate stayed under 20L at all times with most nights in single digits. That’s when I think I caught Covid and only had gastro intestinal symptoms. I ended up losing 30 pounds of weight and developed this sleep problem. It started out with not being able to get to sleep with several nights with no sleep at all. That’s when my doctor put me on 100 mg of Trazodone. Then after a few months I was also having to use Ambien on a as needed basis. I finally have gotten off the Trazodone after 7 months of use. The reason I am telling this is that somehow either Covid or Trazodone and Ambien has changed my sleep causing me to have a sleep disorder.
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#80
RE: Chronic Insomnia
[attachment=29534][attachment=29535]Here are a few screenshots of last night. On one of them I zoomed into a period of time right after midnight where I had a bunch of OA's and H's while I was sleeping. But I did not have any CA's which is better. The leaks I had was probably because I had to switch to the pillow attachment on my Dreamwear mask because the nasal cushion was bothering the part between my naires and I had some leaks with the pillows. I wondering what might have caused those events.
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