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11-04-2019, 10:42 AM (This post was last modified: 11-04-2019, 10:44 AM by Mpadgett714.)
RE: Clear airway events after waking and going back to sleep
[attachment=16749 Wrote:Sleeprider pid='317987' dateline='1572878495'][attachment=16750]I agree with bonjour's previous recommendation for a higher minimum pressure of 8.0, and would not be reluctant to set it as high as 9.0 contingent on comfort. There is sufficient evidence of obstruction and flow limitation in these charts, that higher pressure seems to be indicated, and the Philips is not particularly good at getting there without setting the minimum high enough. This is particularly true when an individual does not snore as we see here. Resmed's Autoset will quickly raise pressure on flow limitation, but Philips will just sit there at minimum pressure.
What Flex setting are you using? Please consider posting a close-up of the chart (2-minute segments) in areas where you are concerned about events. We can actually interpret whether the events are arising from flow restriction or other causes. Also, you mentioned that you may be using a pillow that is too tall causing your neck to flex forward and closing off the airway. This is very common, and you should read the wikis under my signature for Soft Cervical Collar and Optimizing Therapy, with a focus on the section for Positional Apnea.
See charts. One is focused on the CA event and other focused on RERA.
I am using a flex of 3.
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
11-04-2019, 11:17 AM (This post was last modified: 11-04-2019, 11:21 AM by SarcasticDave94.
Edit Reason: Add Image
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RE: Clear airway events after waking and going back to sleep
You're probably going to need to zoom in even closer to see something like this:
[attachment=16755]
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Clear airway events after waking and going back to sleep
We see some flow limits in those results, especially in the closeup from 03:50, and that is a pretty severe FL at 03:51:40 with a snore. The increased flow rate following that suggests an arousal, and is why the RERA is flagged. The first thing I think I'd like to try is to just back the Flex setting off to 2. I never had a lot of luck with Flex at 3. It doesn't really give any more pressure relief in exhale, but a setting of 3 seems to have poor timing for the pressure relief. These latest charts really show a need for minimum pressure at 8.0-8.5.
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.
RE: Clear airway events after waking and going back to sleep
Good morning. First, I appreciate all your help and input. My Dr. only looks at averages and not the time stamped event data, so I haven't got much help. My followup is next week and I'm sure he'll be surprised when I walk in with my laptop and OSCAR running.
Please take a look at last nights data. Good night on average. But the one thing I cannot figure out is why do the CA's occur after I wake to go to bathroom and trying to fall asleep. If you go through all of my charts, the majority of CA's will occur near the time I go back to bed. One other oddity,,,if I wake up early in the evening,,,say 2:00-3:00, I fall back to deep sleep and don't seen the have many CA events. But if I wake up at 4:00 or so, then I have lots of CA's and can't get back into a good sleep.
RE: Clear airway events after waking and going back to sleep
Your breathing in your shortened segments are abnormal as they show nearly equal inhale and exhale instead of an extended exhale. This would promote a more efficient washing out of CO2 from your blood thus causing the Central Apneas. This is not typical of your night as evidenced by the nightly averages in the statistics section. Your breathing is very regular which is unusual for awake, but it may be your awake tell.
Comments.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter
RE: Clear airway events after waking and going back to sleep
THanks for the reply. You are right that it wasn’t typical, but better than average. Don’t know why. No difference in consumption of food or alcohol, similar schedule of eating and bedtime,,,,don’t know. But, even though I had less events, they are still similar in that the CA’s occur after returning to bed and trying to fall back asleep.
I’m not conscious of my breathing, so not sure about inhale/exhale durations.
RE: Clear airway events after waking and going back to sleep
(11-05-2019, 07:42 AM)Mpadgett714 Wrote: Good morning. First, I appreciate all your help and input. My Dr. only looks at averages and not the time stamped event data, so I haven't got much help. My followup is next week and I'm sure he'll be surprised when I walk in with my laptop and OSCAR running.
Please take a look at last nights data. Good night on average. But the one thing I cannot figure out is why do the CA's occur after I wake to go to bathroom and trying to fall asleep. If you go through all of my charts, the majority of CA's will occur near the time I go back to bed. One other oddity,,,if I wake up early in the evening,,,say 2:00-3:00, I fall back to deep sleep and don't seen the have many CA events. But if I wake up at 4:00 or so, then I have lots of CA's and can't get back into a good sleep.
Is this normal.
Also, I agree on raising P to 8.
Thanks again.
It is very normal to have events when awake or just going asleep this is skeep wake junk and if you are aware you are awake then ignore these numbers your machine has no idea if you are awake or not it just records events. The level of CA's are not enough to worry about
RE: Clear airway events after waking and going back to sleep
It also normal to get more CA events in the last 2 to 3 hours of the night. As the night progress, the amount of REM sleep you experience increases and REM sleep breathing can be quite irregular compare to NREM sleep especially if you are dreaming. The machine can flag these events as central apneas even though they are not real apneas.