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Lingering fatigue: trust Resmed sleep report?
RE: Lingering fatigue: trust Resmed sleep report?
The CA index is only 1.77, and making changes should really be based on your comfort rather than the numbers. Unlike with the Airsense 10 EPR, you can reduce PS in 0.2 cm increments, so you may find slightly lower PS between 3 and 4 is your sweet spot.
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RE: Lingering fatigue: trust Resmed sleep report?
(10-16-2019, 09:24 AM)mper6794 Wrote: ...CA's firstly appear false events associated with moves/awakenings. Let us confirm on ten-minutes windows!

Thanks Mper - here are three 10 minute windows from last night, always ending in what the machine flags as a CA.


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RE: Lingering fatigue: trust Resmed sleep report?
(10-16-2019, 09:44 AM)Sleeprider Wrote: The CA index is only 1.77, and making changes should really be based on your comfort rather than the numbers.  Unlike with the Airsense 10 EPR, you can reduce PS in 0.2 cm increments, so you may find slightly lower PS between 3 and 4 is your sweet spot.

Thanks Sleeprider - I'll try lowering/lessening PS tonight - thanks for that. Will this make it easier to exhale, or slightly more difficult (or is it not even related to exhalation)?

Also, do you know why my pressures didn't move at all last night? they were static despite any events. I thought the machine responded and fluctuated?
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RE: Lingering fatigue: trust Resmed sleep report?
"Also, do you know why my pressures didn't move at all last night? they were static despite any events. I thought the machine responded and fluctuated?"

I think a relatively even pressure is a good sign. you only had 4 events that weren't ca and as I understand it the vauto doesn't treat ca so maybe no surprise there.
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RE: Lingering fatigue: trust Resmed sleep report?
(10-16-2019, 11:38 AM)gcritchley Wrote: Also, do you know why my pressures didn't move at all last night? they were static despite any events. I thought the machine responded and fluctuated?

It looks like your maximum IPAP is set at 11 and your minimum EPAP at 7, with PS of 4.  Because 7 + 4 puts you at your maximum IPAP, you have constancy of both IPAP and EPAP all night.  Have you checked to see whether your pressures have always been static with your current settings?

At any rate, that's my understanding; I hope those with more expertise will weigh in.
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RE: Lingering fatigue: trust Resmed sleep report?
(10-16-2019, 11:38 AM)gcritchley Wrote:
(10-16-2019, 09:44 AM)Sleeprider Wrote: The CA index is only 1.77, and making changes should really be based on your comfort rather than the numbers.  Unlike with the Airsense 10 EPR, you can reduce PS in 0.2 cm increments, so you may find slightly lower PS between 3 and 4 is your sweet spot.

Thanks Sleeprider - I'll try lowering/lessening PS tonight - thanks for that. Will this make it easier to exhale, or slightly more difficult (or is it not even related to exhalation)?

Also, do you know why my pressures didn't move at all last night? they were static despite any events. I thought the machine responded and fluctuated?

gcritchley,
The VAuto or any Auto machine does not respond to Clear Airway Events. So it will not adjust or raise the pressure when those events are flagged.
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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.
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RE: Lingering fatigue: trust Resmed sleep report?
Hi, gcritchley

Yes, indeed, these centrals  you have posted appears to false events following awakenings. However, not sure about all of them.
I have plotted your data (RR, EPAPmin, and PS) thus far, but because your have experienced too little on changing EPAPmin and PS (only PS:4.0, and EPAPmin 6.4 and 7.0), still not possible to ultimately fine-tuning semi-quantitatively these two parameters for you. Considering:
1_some discomfort with pressure;
2_no significant obstructive events;
3_maybe too high difference EPAPmin-PS; you are in 3.0 now;
4_preliminary indication that your fine-tuning PS would not end up too high (maybe <4.0; bump for Sleeprider!);

I would suggest the following settings, and more “courageous” changes from day to day, so that we could quickly fine-tuning your parameters semi-quantitatively, of course taking into account How You Feel:

Day 1: EPAPmin 5.0, PS:3.2 (#1.8), Max IPAP:8.4 (in order to avoid false obstructive events bother you);
Day 2: observe, and, at first, keep on going increasing daily, proportionally, all these three parameters.

How you have been feeling? Are you still on medication? (would it be type that may eventually alter your respiratory rate?);

I would reinforce the need for a final position on PLMS (your FR and TV still look too noisy!).

Good luck
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RE: Lingering fatigue: trust Resmed sleep report?
...attaching some suggestions on building some semi-quantitative graphs, which would allow you quickly set fine-tuning numbers for your therapy. For me, it worked nicely.

good luck
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RE: Lingering fatigue: trust Resmed sleep report?
Popping in again on this thread, to share last night's graphs from my newer Vauto machine with a couple of questions. Thanks for your time.

1) is it realistic to think that my flow limitations can be/should further reduced? If yes, how would I do so?
2) Should I lower the IPAP further to continue to lower CA's?

I will say I think overall I'm sleeping better, but I know I wake up often, and at some point will have to investigate what else might be contributing, but with this new (to me) Vauto machine, I want to be in my optimal zone with CPAP before looking elsewhere. I think I'm close, but maybe a few small tweaks away.

Thanks again!


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RE: Lingering fatigue: trust Resmed sleep report?
I suppose you could edit settings fractionally. If myself, I'd focus on how I was feeling with the AHI at 1.xx.
Dave

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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.
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