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Hurting today...changed my settings
#11
I'm pretty much a newbie myself, so take it with a grain of salt, but...

Your 95% pressure is 13.3. The general recommendation on this board is to bracket that pressure by 2cm. So if you were going to tweak the settings, I'd think a good min would be 11, and that the 8.5 would just be way too low for what you're needing.
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#12
(05-10-2017, 10:04 AM)Zandor435 Wrote: I  know it must be time consuming to dig into my data and make specific suggestion as you did.  thank you very much for that. 
You are welcome.  It's my way of "paying it forward" to the extensive amounts of help I received online when I was going through my own, very difficult and very prolonged adjustment to PAP therapy.

Quote:I am going on 3-4 days of not good sleep.  when that happens, i find that things start to snowball on me and I get "loopy" and I recognize that I am not thinking as cooly as I would like.  My goal for now is, as you say, to get back into decent enough sleep that I am no longer "loopy" (thinking clearly again) I am making small tweaks and honing in on "perfect" or best possible sleep. 
Some things to keep in mind:

1) Frequent tweaking can make it harder for the body to acclimate to CPAP therapy.  I'm not saying "don't tweak." I am saying that if you are a sensitive sleeper, you've got to go slow when you start tweaking.  Changing too many things too often never lets your body sort out how to sleep with all the "stuff" you've added to your bedtime routine.

2) While we all want "perfect" or "best possible sleep", achieving it is a process.  Chances are how you feel and how well you function may improve very slowly.  Sometimes we only recognize the progress when we look back and realize how far we've come.  It can help a lot to keep a very short sleep journal to track how well you are doing on a daily basis. SleepyHead has a built-in tool for doing that under the "Notes" tab on the left sidebar of the Daily Data page.   In several weeks or in a couple of months, you can look back to compare the number of "zombie" days then to the number of "zombie" days now.  And re-read your written notes.  Sometimes the first signs of positive progress are easy to miss if you're not making some daily notes.

Quote:I will probably take your advice tonight w/ the CA's.  I will turn my C-Flex back on.  Do you know if there is a way with sleepyhead to tell when i turned C-flex off? 
While SH will tell you what the flex setting is for a night where the flex is the same all night long, I'm not sure that you can see what the flex is on any given individual session on a particular night.

However, if there is essentially only one pressure line---i.e. the red (IPAP=therapeutic pressure) curve and the green (estimated EPAP pressure) curve are usually on top of each other, that's strong evidence that Flex is turned off.   It's more difficult to tease apart whether the Flex is set to 1, 2, or 3, because SH does not show how the pressure changes for individual breaths. The reason SH doesn't show this is that PR Dreamstation does not record pressure data with that much granularity.  

Quote:I am not sure when i did that.  I am remember most of my other settings for the past 3 weeks.  I am using the previous 3 weeks as a baseline b/c i had moderately good sleep over that time span.
What were the settings during the 3 weeks you are using as baseline? How much did you change them? Did you change them after the quality of your sleep started to deteriorate? Or did you change the settings hoping to improve the "ok" sleep, but then the sleep started to deteriorate as you started to change the settings?


Quote:
Quote:Zandor435 Wrote: I feeling slightly better than the last couple of days but I am still feeling jittery. I slept with a cervical collar last night and took two of my lunesta to make sure i got to sleep.  I also took a natural supplement called Somnapure which is basically just a Vitamin mix.
Quote: Try to not let the SleepyHead data influence your answer to this question: How well did you sleep last night? In terms of getting to sleep reasonably quickly? In terms of staying asleep most of the night? And in terms of comfort when you woke up and were trying to get back to sleep?


Thanks for the levity.  My feeling through the night was better.  (likely b/c i doubled my Lunesta to 2 mg).  I only remember waking up 3-4 times.  But if yesterday was a 4 out 5 on the jitters scale, today is a 3 out of 5 on the jitters scale.  So despite the marginally better night time experience, I still feel "loopy" and jittery today.   There could easily by some confirmation bias happening here.  But i only feel marginally better than yesterday after 7.5 hours
How far apart were the wakes you remember?  Even people with perfectly normal high quality sleep often wake up after every REM cycle.  The thing is, however, they only wake up long enough to establish that everything is ok in their sleep environment, and then they turn over and go right back to sleep.  When they get up the next morning, they don't even remember these normal post-REM wakes because their normal post-REM wakes lasted only a minute or two; studies have shown that most people only remember waking up in the middle of the night if they are awake for at least 5 minutes.

Quote:
Quote:Clearly something woke you up around 4:50, when you hit the reset button.  Whether it was the increase in pressure between 4:30 and 4:50 or the cluster of events themselves that triggered the pressure increase is not clear.

I had the same thought.  I moved from 8 to 8.5 as min pressure on Sunday (maybe Monday).  10 feels uncomfortable as a starting place.  So I understand you correctly.  You are saying that your body will slowly adapt to these higher pressures and then I will get likely prevent some of those OA's?  right?
Yes.  Most people's bodies will adapt to increased pressure if they make the increases slow enough to NOT trigger a lot of discomfort.

If 8.5 is comfortable enough to sleep with, but 10 is uncomfortable right now, you may very be able to train your body to tolerate a starting pressure of 10 by slowly increasing the pressure.

First, spend a week using 8.5 as your starting pressure. If you have no serious trouble getting to sleep and getting back to sleep after a wake while using a starting pressure of 8.5, then bump the min pressure up to 9cm and leave it there for a week. And if by the end of the week you are having no serious problems getting to sleep or getting back to sleep after a wake at 9 cm, then bump the min pressure to 9.5 and leave it there for a week.  And if by t he end of the week you are having no serious problems getting to sleep or getting back to sleep after a wake at 9.5 cm, then bump the pressure up to 10 and see how you do.

But if at any point in the process, you start to have real problems with comfort and with getting to sleep or back to sleep at the current (new) pressure level, don't make further increases until you either start sleeping ok with the current pressure. Or---if you really just hit a wall---consider using the SmartRamp feature on your machine.  But if you decide to use the SmartRamp, then you need to carefully think about how to use it intelligently.

I'll offer my recent experiences as an example: Last fall and winter I put on about 5 pounds, and that was just enough to bump my usual AHI of 1.5-3.0 up to the 4.0-6.0 range AND some of my pre-CPAP symptoms started to come back.  My sleep doc suggested that I bump up my min EPAP to 6cm. Now understand: I am a real wimp when it comes to pressure because I've had more than one really awful battle with aerophagia issues.  I tried to just bump the EPAP from 4 to 6, and I could feel the air bubble starting to grow in my stomach within 10 minutes and I knew that I was never going to be able to get to sleep that night.  So I decided to do two things:

1) I bumped the EPAP only up to 5cm since I knew that my 90% EPAP was always at or above 5cm and when the EPAP hangs out at 5cm for 50% or more each night, I don't have aerophagia problems.

2) I turned the SmartRamp on so that I could continue starting out with EPAP = 4 and not have to deal with trying to get to sleep with an EPAP higher than I was used to.

I made the conscious decision that I would NOT get worried about the AHI.  As I expected, the AHI didn't improve much with these new settings.  But after a week of using min EPAP = 5, I was able to comfortably increase the min EPAP up to 5.5 and continue using the ramp  so that I can get to sleep comfortably.  And viola: The AHIs almost immediately went back down to my more normal 1.5-3.0 range.  And the pre-CPAP symptoms that had returned have once again disappeared.  Had they NOT disappeared with a min EPAP = 5.5, I would have increased my min EPAP up to 6 about two weeks ago.  But I'm a strong believer in If it ain't broke, don't fix it.


Quote:If that is the case, then the question becomes one of how fast to try and "adapt."  I have seen the suggestions of only upping .5 per week.  Are there any other indicators to use other than my basic comfort for how fast i might be able to "adapt" or up the pressure?
If you think you are sensitive to pressure increases, then slow and steady is going to work much better than a one time larger increase.

Your machine can only increase the pressure settings in 0.5 increments.  Given your history, I think increasing the min pressure by 0.5cm/week is a good idea.  You'll have a week's worth of data to figure out whether the new setting is still lower than it needs to be. You'll also have a week's worth of sleeping at the new pressure to figure out if the slightly higher pressure is triggering any comfort problems.  

But the critical idea is that you need to leave all the other settings and things that you do at bedtime alone: You need to make one change at a time, gather a week of data for that one change, and then make a decision about what to do next.

Right now, the thing that screams out in your data is that the min pressure is not high enough to prevent the worst of your clusters from getting started, and the machine does not increase the pressure fast enough or far enough to effectively bust up the clusters.  So if it takes you a few weeks to slowly increase the min pressure from 8.5 to 10cm, you've got to be patient.  And expect that on some nights (possibly many nights) the data won't look as good as you'd like it to look.

And to come full circle: at the start of your post, you write:
Quote:I am going on 3-4 days of not good sleep.  when that happens, i find that things start to snowball on me and I get "loopy" and I recognize that I am not thinking as cooly as I would like. 
One of the things about going slow is that your body will hopefully be able to adjust to each new, individual tweak without triggering a period of 3-4 days of really bad sleep.

However, you may still find that right after a reasonable tweak, you wind up having 3-4 bad days.  The "fix" then may be to go backwards: Go back to the last setting and see if the subjective quality of the sleep improves. Then reevaluate just how bad the data actually is at the older setting.

The goal is to find your sweet spot: A pressure setting that allows you to sleep comfortably  on most nights, wake up feeling decent most mornings, have enough energy to get through the day on most days, and keep the AHI to below 5.0.  It may be that you will find that you function better with settings that give you an AHI in the 2.5-3.5 range than you do with settings that give you an AHI in the 0.5-1.5 range. And in that case, go with how you feel rather than what makes the data look best.
Questions about SleepyHead?
See my Guide to SleepyHead
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#13
(05-10-2017, 11:28 AM)Zandor Said - I put my comments at the bottom of this thread.  Robysue, Wrote: robysueZandor435I  know it must be time consuming to dig into my data and make specific suggestion as you did.  thank you very much for that. 
You are welcome.  It's my way of "paying it forward" to the extensive amounts of help I received online when I was going through my own, very difficult and very prolonged adjustment to PAP therapy.

Quote:I am going on 3-4 days of not good sleep.  when that happens, i find that things start to snowball on me and I get "loopy" and I recognize that I am not thinking as cooly as I would like.  My goal for now is, as you say, to get back into decent enough sleep that I am no longer "loopy" (thinking clearly again) I am making small tweaks and honing in on "perfect" or best possible sleep. 
Some things to keep in mind:

1) Frequent tweaking can make it harder for the body to acclimate to CPAP therapy.  I'm not saying "don't tweak." I am saying that if you are a sensitive sleeper, you've got to go slow when you start tweaking.  Changing too many things too often never lets your body sort out how to sleep with all the "stuff" you've added to your bedtime routine.

2) While we all want "perfect" or "best possible sleep", achieving it is a process.  Chances are how you feel and how well you function may improve very slowly.  Sometimes we only recognize the progress when we look back and realize how far we've come.  It can help a lot to keep a very short sleep journal to track how well you are doing on a daily basis. SleepyHead has a built-in tool for doing that under the "Notes" tab on the left sidebar of the Daily Data page.   In several weeks or in a couple of months, you can look back to compare the number of "zombie" days then to the number of "zombie" days now.  And re-read your written notes.  Sometimes the first signs of positive progress are easy to miss if you're not making some daily notes.

Quote:I will probably take your advice tonight w/ the CA's.  I will turn my C-Flex back on.  Do you know if there is a way with sleepyhead to tell when i turned C-flex off? 
While SH will tell you what the flex setting is for a night where the flex is the same all night long, I'm not sure that you can see what the flex is on any given individual session on a particular night.

However, if there is essentially only one pressure line---i.e. the red (IPAP=therapeutic pressure) curve and the green (estimated EPAP pressure) curve are usually on top of each other, that's strong evidence that Flex is turned off.   It's more difficult to tease apart whether the Flex is set to 1, 2, or 3, because SH does not show how the pressure changes for individual breaths. The reason SH doesn't show this is that PR Dreamstation does not record pressure data with that much granularity.  

Quote:I am not sure when i did that.  I am remember most of my other settings for the past 3 weeks.  I am using the previous 3 weeks as a baseline b/c i had moderately good sleep over that time span.
What were the settings during the 3 weeks you are using as baseline? How much did you change them? Did you change them after the quality of your sleep started to deteriorate? Or did you change the settings hoping to improve the "ok" sleep, but then the sleep started to deteriorate as you started to change the settings?


Quote:
Quote:Zandor435 Wrote: I feeling slightly better than the last couple of days but I am still feeling jittery. I slept with a cervical collar last night and took two of my lunesta to make sure i got to sleep.  I also took a natural supplement called Somnapure which is basically just a Vitamin mix.


Thanks for the levity.  My feeling through the night was better.  (likely b/c i doubled my Lunesta to 2 mg).  I only remember waking up 3-4 times.  But if yesterday was a 4 out 5 on the jitters scale, today is a 3 out of 5 on the jitters scale.  So despite the marginally better night time experience, I still feel "loopy" and jittery today.   There could easily by some confirmation bias happening here.  But i only feel marginally better than yesterday after 7.5 hours
How far apart were the wakes you remember?  Even people with perfectly normal high quality sleep often wake up after every REM cycle.  The thing is, however, they only wake up long enough to establish that everything is ok in their sleep environment, and then they turn over and go right back to sleep.  When they get up the next morning, they don't even remember these normal post-REM wakes because their normal post-REM wakes lasted only a minute or two; studies have shown that most people only remember waking up in the middle of the night if they are awake for at least 5 minutes.

Quote:
Quote:Clearly something woke you up around 4:50, when you hit the reset button.  Whether it was the increase in pressure between 4:30 and 4:50 or the cluster of events themselves that triggered the pressure increase is not clear.

I had the same thought.  I moved from 8 to 8.5 as min pressure on Sunday (maybe Monday).  10 feels uncomfortable as a starting place.  So I understand you correctly.  You are saying that your body will slowly adapt to these higher pressures and then I will get likely prevent some of those OA's?  right?
Yes.  Most people's bodies will adapt to increased pressure if they make the increases slow enough to NOT trigger a lot of discomfort.

If 8.5 is comfortable enough to sleep with, but 10 is uncomfortable right now, you may very be able to train your body to tolerate a starting pressure of 10 by slowly increasing the pressure.

First, spend a week using 8.5 as your starting pressure. If you have no serious trouble getting to sleep and getting back to sleep after a wake while using a starting pressure of 8.5, then bump the min pressure up to 9cm and leave it there for a week. And if by the end of the week you are having no serious problems getting to sleep or getting back to sleep after a wake at 9 cm, then bump the min pressure to 9.5 and leave it there for a week.  And if by t he end of the week you are having no serious problems getting to sleep or getting back to sleep after a wake at 9.5 cm, then bump the pressure up to 10 and see how you do.

But if at any point in the process, you start to have real problems with comfort and with getting to sleep or back to sleep at the current (new) pressure level, don't make further increases until you either start sleeping ok with the current pressure. Or---if you really just hit a wall---consider using the SmartRamp feature on your machine.  But if you decide to use the SmartRamp, then you need to carefully think about how to use it intelligently.

I'll offer my recent experiences as an example: Last fall and winter I put on about 5 pounds, and that was just enough to bump my usual AHI of 1.5-3.0 up to the 4.0-6.0 range AND some of my pre-CPAP symptoms started to come back.  My sleep doc suggested that I bump up my min EPAP to 6cm. Now understand: I am a real wimp when it comes to pressure because I've had more than one really awful battle with aerophagia issues.  I tried to just bump the EPAP from 4 to 6, and I could feel the air bubble starting to grow in my stomach within 10 minutes and I knew that I was never going to be able to get to sleep that night.  So I decided to do two things:

1) I bumped the EPAP only up to 5cm since I knew that my 90% EPAP was always at or above 5cm and when the EPAP hangs out at 5cm for 50% or more each night, I don't have aerophagia problems.

2) I turned the SmartRamp on so that I could continue starting out with EPAP = 4 and not have to deal with trying to get to sleep with an EPAP higher than I was used to.

I made the conscious decision that I would NOT get worried about the AHI.  As I expected, the AHI didn't improve much with these new settings.  But after a week of using min EPAP = 5, I was able to comfortably increase the min EPAP up to 5.5 and continue using the ramp  so that I can get to sleep comfortably.  And viola: The AHIs almost immediately went back down to my more normal 1.5-3.0 range.  And the pre-CPAP symptoms that had returned have once again disappeared.  Had they NOT disappeared with a min EPAP = 5.5, I would have increased my min EPAP up to 6 about two weeks ago.  But I'm a strong believer in If it ain't broke, don't fix it.


Quote:If that is the case, then the question becomes one of how fast to try and "adapt."  I have seen the suggestions of only upping .5 per week.  Are there any other indicators to use other than my basic comfort for how fast i might be able to "adapt" or up the pressure?
If you think you are sensitive to pressure increases, then slow and steady is going to work much better than a one time larger increase.

Your machine can only increase the pressure settings in 0.5 increments.  Given your history, I think increasing the min pressure by 0.5cm/week is a good idea.  You'll have a week's worth of data to figure out whether the new setting is still lower than it needs to be. You'll also have a week's worth of sleeping at the new pressure to figure out if the slightly higher pressure is triggering any comfort problems.  

But the critical idea is that you need to leave all the other settings and things that you do at bedtime alone: You need to make one change at a time, gather a week of data for that one change, and then make a decision about what to do next.

Right now, the thing that screams out in your data is that the min pressure is not high enough to prevent the worst of your clusters from getting started, and the machine does not increase the pressure fast enough or far enough to effectively bust up the clusters.  So if it takes you a few weeks to slowly increase the min pressure from 8.5 to 10cm, you've got to be patient.  And expect that on some nights (possibly many nights) the data won't look as good as you'd like it to look.

And to come full circle: at the start of your post, you write:
Quote:I am going on 3-4 days of not good sleep.  when that happens, i find that things start to snowball on me and I get "loopy" and I recognize that I am not thinking as cooly as I would like. 
One of the things about going slow is that your body will hopefully be able to adjust to each new, individual tweak without triggering a period of 3-4 days of really bad sleep.

However, you may still find that right after a reasonable tweak, you wind up having 3-4 bad days.  The "fix" then may be to go backwards: Go back to the last setting and see if the subjective quality of the sleep improves. Then reevaluate just how bad the data actually is at the older setting.

The goal is to find your sweet spot: A pressure setting that allows you to sleep comfortably  on most nights, wake up feeling decent most mornings, have enough energy to get through the day on most days, and keep the AHI to below 5.0.  It may be that you will find that you function better with settings that give you an AHI in the 2.5-3.5 range than you do with settings that give you an AHI in the 0.5-1.5 range. And in that case, go with how you feel rather than what makes the data look best.

RobySue,

I am not sure if I am writing my response at the right end of this thread.  But just want to clarify a few things

Quote:
Quote: Wrote:I will probably take your advice tonight w/ the CA's.  I will turn my C-Flex back on.  Do you know if there is a way with sleepyhead to tell when i turned C-flex off? 
While SH will tell you what the flex setting is for a night where the flex is the same all night long, I'm not sure that you can see what the flex is on any given individual session on a particular night.

However, if there is essentially only one pressure line---i.e. the red (IPAP=therapeutic pressure) curve and the green (estimated EPAP pressure) curve are usually on top of each other, that's strong evidence that Flex is turned off.   It's more difficult to tease apart whether the Flex is set to 1, 2, or 3, because SH does not show how the pressure changes for individual breaths. The reason SH doesn't show this is that PR Dreamstation does not record pressure data with that much granularity.

Sleepy Head Baseline - April 28th, 2017

That is the day I am using as a baseline.  And per you explanation, it looks like i was mistaken earlier.  C-Flex has definitely been on.  So I will turn that back on tonight.   Also, thanks for the suggestion about the notes.  I have actually already started using that a few weeks back, but I will be a little more diligent about it w/ your comments in mind.



Quote:How far apart were the wakes you remember?  Even people with perfectly normal high quality sleep often wake up after every REM cycle.  The thing is, however, they only wake up long enough to establish that everything is ok in their sleep environment, and then they turn over and go right back to sleep.  When they get up the next morning, they don't even remember these normal post-REM wakes because their normal post-REM wakes lasted only a minute or two; studies have shown that most people only remember waking up in the middle of the night if they are awake for at least 5 minutes.


I am sleeping w/ a fitbit and using that in conjunction w/ SH data.  That may or may not be a good idea.  Take last night for example. 

Night of April 9th SH Data Link

Night of April 9th Fitbit Data Link

I only remember waking up 3 times about 2-3 hours apart.  once at 2:50 am.  once at 5 am (i think) and once around 7:30 am.

Fitbit data shows i woke up 7 times last night.   So maybe I should stop using that data b/c it could be misleading me.  I assume it derives all of those sleep charts off of both my heart rate through my wrist (not sure about this) and also whether i am moving or not w/ the gyroscope.

Thanks again for your example.  It is very helpful to tie alot of the things I have been reading together. 

My game plan now is to turn C-Flex back on (i always had it on 3 the max b/c i know i didn't mess w/ the levels).  Leave my min pressure at 8.5 and then just try to grind out a few nights of sleep out of my "loopy" and jittery phase.  Once I can do that, I'll creep it up.
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#14
Zandor,

What FitBit are you using?  Mine only distinguishes "sleep", "restless", and "wake".

And does your (fancier) FitBit have a "sensitive" vs "normal" sleep setting? If so, what's it set to?

All that said,  I think the FitBit data is useful, but you have to take it with a bit of a grain of salt.

Some things that pop up in considering your memories of the night, together with your APAP data and your fit bit data:

1) The longest wake (right before 5:00) where you remembered feeling overwhelmed by the pressure and you remember hitting the reset button on your APAP to lower the pressure definitely corresponds to a long post-REM wake in the FitBit data.  My guess is that you had a normal post-REM wake, noticed the APAP blasting air down your throat, and that woke you up further and helped keep you awake long enough to remember that wake.

2) The second longest wake in the FitBit data is also most likely a normal post-REM wake around 2:45ish.  It's hard to tell exactly what is going on in the APAP data at that time, but it does look like there might be a small break in the flow rate graph, but not the pressure graph.  You may have taken the mask off momentarily to scratch your nose or something similar.  Zooming in on the APAP data between 2:30 and 3:00 may help clear up what might have been going on.

3) There's a spike in the Leak graph right around the time of the 7:30 wake.  It could be that the leak woke you up.  Or it could be that you woke up and briefly moved the mask around in an effort to scratch your nose or something similar.

3) The other 4 FitBit wakes might just be you arousing enough to turn over in bed. Or arousing enough to adjust the mask in your sleep.  Or they might be short wakes that you don't remember.  I'm not sure there are enough of them to really worry about. Nor do they look long enough to have really disrupted the overall quality of your sleep. 


It's also worth reading up on what your FitBit is using to distinguish "Wake" from "REM" from "LightSleep" from "DeepSleep".   As I recall, the only data your FitBit has to work with is pulse rate and movement.  So my best guess is that your FitBit is probably using an algorithm based on the following broad ideas:
  • Lots of movement and a pulse rate similar to or higher than your base waking pulse rate is probably labeled as Wake.
  • Some small movements and a pulse rate that is lower than your base waking pulse rate is probably labeled as Light Sleep.
  • No movement and a low pulse rate that is clearly lower than your base waking pulse rate is probably labeled as Deep Sleep.
  • No movement and a pulse rate that is similar to your base waking pulse rate is probably labeled as REM.

Quote:
Quote:How far apart were the wakes you remember?  Even people with perfectly normal high quality sleep often wake up after every REM cycle.  The thing is, however, they only wake up long enough to establish that everything is ok in their sleep environment, and then they turn over and go right back to sleep.  When they get up the next morning, they don't even remember these normal post-REM wakes because their normal post-REM wakes lasted only a minute or two; studies have shown that most people only remember waking up in the middle of the night if they are awake for at least 5 minutes.


I am sleeping w/ a fitbit and using that in conjunction w/ SH data.  That may or may not be a good idea.  Take last night for example. 

Night of April 9th SH Data Link

Night of April 9th Fitbit Data Link

I only remember waking up 3 times about 2-3 hours apart.  once at 2:50 am.  once at 5 am (i think) and once around 7:30 am.
The FitBit data clearly shows the first two wakes are normal post-REM wakes that just got prolonged to the point where you remember them.  They're nothing to worry about.  The third wake may have been due to a spike in the leak rate waking you up.  (Look at the APAP leak line to see what I'm talking about.)


Quote:Fitbit data shows i woke up 7 times last night.   So maybe I should stop using that data b/c it could be misleading me.  I assume it derives all of those sleep charts off of both my heart rate through my wrist (not sure about this) and also whether i am moving or not w/ the gyroscope.
Keep using the FitBit, but I think you should just learn to take the FitBit data on wakes with a grain of salt. Use the FitBit data as a tool to explore what might be going on rather than accepting its verdict that you were awake x number of times during the night as the gospel truth.

If you remember a wake at a time the FitBit shows some restlessness or a wake, the FitBit wake is real.

If there is evidence in the APAP data of a wake (you turn the machine off and back on, or you hit the reset or ramp button) at a time the FitBit shows some restlessness or a wake, then you know the FitBit wake is real. If there is evidence in the APAP data that something APAP-related might have woken you up (like a leak) then the FitBit wake is probably real.

But for other FitBit wakes? As you've noted, the FitBit might just be picking up on you moving around a lot in bed. And in that case, the FitBit data may just be what's called a "false positive"--it shows a wake where one didn't actually happen.

There is one more thing that may also be worth doing with your FitBit data: You could try to correlate the times the FitBit says you are awake to the events in the event table.  If there are a lot of events being scored at a time that you don't think you were awake, but the FitBit says you were, that could be explained by the FitBit being sensitive enough to pick up on the motions your body may be making in an effort to get your sleep disturbed breathing normalized.  (Remember that OAs and Hs are often followed by a lot of gasping for breath, and that gasping can trigger body movements ...)  So if you see a cluster of events during a time the FitBit says you were awake and you have no other evidence that you were awake, that could mean that the cluster of events was indeed enough to clearly disturb your sleep.  And if those events are obstructive, that would point to the need to increase your min pressure in the long run.

Quote:My game plan now is to turn C-Flex back on (i always had it on 3 the max b/c i know i didn't mess w/ the levels).  Leave my min pressure at 8.5 and then just try to grind out a few nights of sleep out of my "loopy" and jittery phase.  Once I can do that, I'll creep it up.
Sounds like a plan.  Keep us posted, and good luck in getting at least a few nights of semi-decent sleep to get out of the current "loopy" and jittery phase.
Questions about SleepyHead?
See my Guide to SleepyHead
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#15
Hi Zach,

I won't give input on your data and settings, you are getting plenty of help and suggestions on that front.

However I will mention that I have found that I seem to have a "run of nights" where I don't sleep well, or feel overly rested.

Then I have times where I have a string of good nights, and I still don't have a specific reason as to why this happens.

I was going to ask if you where getting enough hours of sleep per night, but I see you are over 9 hours at times, so that question may be a moot point.  Unsure

I have found that under 7.5 hours, and over 9 hours, I tend to feel I've not had a good night's sleep.. the 8 to 8.5 seems to be my optimal sleep time.

Maybe part of it for you will be finding the slept hours bracket that makes you feel most rested as well.

Sleep-well
Cheers,
Ock.
Coffee
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#16
(05-10-2017, 10:04 AM)Zandor435 Wrote: I  know it must be time consuming to dig into my data and make specific suggestion as you did.  thank you very much for that. 

I am going on 3-4 days of not good sleep.  when that happens, i find that things start to snowball on me and I get "loopy" and I recognize that I am not thinking as cooly as I would like.  My goal for now is, as you say, to get back into decent enough sleep that I am no longer "loopy" (thinking clearly again) I am making small tweaks and honing in on "perfect" or best possible sleep. 

I will probably take your advice tonight w/ the CA's.  I will turn my C-Flex back on.  Do you know if there is a way with sleepyhead to tell when i turned C-flex off?  I am not sure when i did that.  I am remember most of my other settings for the past 3 weeks.  I am using the previous 3 weeks as a baseline b/c i had moderately good sleep over that time span.

I will also ditch the cervical collar.  I thought it couldn't hurt.  I didn't find it terribly uncomfortable, so I thought I would try it. 



Quote:Zandor435 Wrote: I feeling slightly better than the last couple of days but I am still feeling jittery. I slept with a cervical collar last night and took two of my lunesta to make sure i got to sleep.  I also took a natural supplement called Somnapure which is basically just a Vitamin mix.
Quote: Try to not let the SleepyHead data influence your answer to this question: How well did you sleep last night? In terms of getting to sleep reasonably quickly? In terms of staying asleep most of the night? And in terms of comfort when you woke up and were trying to get back to sleep?


Thanks for the levity.  My feeling through the night was better.  (likely b/c i doubled my Lunesta to 2 mg).  I only remember waking up 3-4 times.  But if yesterday was a 4 out 5 on the jitters scale, today is a 3 out of 5 on the jitters scale.  So despite the marginally better night time experience, I still feel "loopy" and jittery today.   There could easily by some confirmation bias happening here.  But i only feel marginally better than yesterday after 7.5 hours

Quote:Clearly something woke you up around 4:50, when you hit the reset button.  Whether it was the increase in pressure between 4:30 and 4:50 or the cluster of events themselves that triggered the pressure increase is not clear.

I had the same thought.  I moved from 8 to 8.5 as min pressure on Sunday (maybe Monday).  10 feels uncomfortable as a starting place.  So I understand you correctly.  You are saying that your body will slowly adapt to these higher pressures and then I will get likely prevent some of those OA's?  right?

If that is the case, then the question becomes one of how fast to try and "adapt."  I have seen the suggestions of only upping .5 per week.  Are there any other indicators to use other than my basic comfort for how fast i might be able to "adapt" or up the pressure?

Your summary thoughts area good. I agree.  Again, I can't express how thankful I am to have a community of thoughtful and precise people such as yourself as a support group.  Knowing I can bounce ideas off of this forum helps undermine my anxiety during the "loopy" phases.

thanks so much again.


May 10th Sleepy Head Link

My AHI has climbed quite a bit.  But I actually think I felt better as I slept.  I only woke up 2-3 times that I remember.  I don't feel as much pain as the previous two nights when i had a lower AHI.  The only difference this past night was b/c I turned my C-Flex back on to 3.  It definitely is a comfort feature.  I woke up w/ the pressure on 14 this morning and can tell that my body is either adjusting to it or the C-flex is simply making it now that high of pressure

one thing I have a small issue with at the high pressure is swallowing air.  the higher pressure seems to blow my cheeks out and make it inevitable that I will swallow air.

Overall, I am going by the subjective feeling today....it is better than the last couple of days.  Thanks RobySue again.
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#17
Just curious... Are you doing the tongue technique, where you keep it to your back teeth to help seal it? That has helped me a lot.
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#18
i have read about others doing that but I am not sure if I have it down.  Did it take your some time to adopt that technique?  I am only recently getting into some pressures that this air swallowing thing is a problem.

I am going to look into the tongue technique more. Thanks for the input.
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#19
No problem. Glad to help!

I learned about it here, after about a week into CPAP, and I realized my tongue had actually already learned to do it. BUT now I'm *conscious* of it, and can ensure I'm doing it consistently.
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