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Lingering fatigue: trust Resmed sleep report?
#71
RE: Lingering fatigue: trust Resmed sleep report?
It’s maddening when everything looks good on paper but the sleep is lousy. Your air problems might clear up on their own with time, but I wonder whether it’d be any help if you set a constant pressure (still with EPR of 3). Conceivably that would make it easier for your sleeping body to adjust as you need it to.

The other thought I have is counterintuitive, and that is to get up consistently 8 or 8.5 hours after you go to bed. Sometimes the longer times abed actually can contribute to a groggy feeling the next day.

But with luck the new collar will do the trick—I hope so!
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#72
RE: Lingering fatigue: trust Resmed sleep report?
(08-20-2019, 10:43 AM)Dormeo Wrote: It’s maddening when everything looks good on paper but the sleep is lousy. Your air problems might clear up on their own with time, but I wonder whether it’d be any help if you set a constant pressure (still with EPR of 3). Conceivably that would make it easier for your sleeping body to adjust as you need it to.

The other thought I have is counterintuitive, and that is to get up consistently 8 or 8.5 hours after you go to bed. Sometimes the longer times abed actually can contribute to a groggy feeling the next day.

But with luck the new collar will do the trick—I hope so!

Thanks Dormeo. I'm open to trying both of your ideas - constant pressure and set sleep/wake time. 

I think I'm still blaming the frequent wakeups for my fatigue, because I'm so aware of them happening all night. Seems like I'm constantly saying to myself - "something just woke me up, wonder what that was" etc. Is that still the Flow limitations?

Are you saying that (including flow limits) the charts I posted look like everything is optimal and under control as far as you can see?

Thanks again
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#73
RE: Lingering fatigue: trust Resmed sleep report?
Take the time you need to recover and feel better, but you might want look elsewhere for the root cause of fatigue. As far as therapy results, I don't see much else that can be improved.
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#74
RE: Lingering fatigue: trust Resmed sleep report?
(08-20-2019, 11:12 AM)Sleeprider Wrote: Take the time you need to recover and feel better, but you might want look elsewhere for the root cause of fatigue.  As far as therapy results, I don't see much else that can be improved.

Thanks Sleeprider - this is the first definitive comment I've received that it appears that my therapy (at least on paper with machine settings) is as optimized as can be. That's encouraging. Thanks!

I know Mper had some strong ideas/suspicions about the Flow Limitations being responsible for my awakenings, and his sense that they can be further treated and eliminated - I'm anxiously waiting to see what he thinks, and if there are further things to try based on his own experience with that issue.
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#75
RE: Lingering fatigue: trust Resmed sleep report?
Hi, Gchritely, well come back!
What a quite disrupted low-efficiency sleep, friend!
For now, please, could you plot some 10min and 2  minute windows from appears has  been your best night, augst 18th!
Some preliminary questions:
1- just rule out somethings:  have PSG? anything there suggesting PLMD?
2- have you ever tried FFM resmed airfit f20?
3- In ten-minute windows do you have similar to mine's, as attached? suddensly out of nothing?
 GL
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#76
RE: Lingering fatigue: trust Resmed sleep report?
(08-20-2019, 12:05 PM)mper6794 Wrote: Hi, Gchritely, well come back!
What a quite disrupted low-efficiency sleep, friend!
For now, please, could you plot some 10min and 2  minute windows from appears has  been your best night, augst 18th!
Some preliminary questions:
1- just rule out somethings:  have PSG? anything there suggesting PLMD?
2- have you ever tried FFM resmed airfit f20?
3- In ten-minute windows do you have similar to mine's, as attached? suddensly out of nothing?
 GL
Hi!! - thanks for being there.

to answer: 

1) I did have a sleep study in lab - my sleep doctor didn't mention any movement issues, and I didn't know how to find that. I will post a screenshot
2) I have right now the F10 and F20 in a box. I didn't like them, but that was a year ago. I also tried the F30, and sent it back. Are they all different?
3) I don't see any issues on your graphs - they look quiet and perfect

I will post 10 and 2 min windows for you from August 18 - what specific graphs do you want to see? - all of the same graphs, or would it be helpful to eliminate something for you? Also, do you want to see where it is quiet up to some sort of change?
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#77
RE: Lingering fatigue: trust Resmed sleep report?
I don't see a flow limitation issue in any of the 4 charts in #68 above.  you do have some gaps in flow; look at the last minute or two of each sleep session in a 2 minute window to see if flow limitation (or anything else) is evident just before waking.

to help confirm or rule it out, I've attached another example of what periodic limb movement looks like (in my flow).  there are variations - for example, there may be fewer flow limitations or more breaths between sharp inhales - but it's always a string of some more or less uniform number of relatively flow limited breaths, preceded (and followed) by a sharp inhale, often with a moan/groan/grunt that looks like a snore in the flow.  I suspect many if not all of these sharp inhale/groans are arousals, most of which I am unaware.

you also have a few residual ca.  usually those few are not enough to sweat but I believe ca do contribute to lingering sick-and-tiredness for some of us.  I didn't reread this whole thread but I assume you've already titrated yourself to best balance between oa and ca?
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#78
RE: Lingering fatigue: trust Resmed sleep report?
(08-20-2019, 01:15 PM)sheepless Wrote: I don't see a flow limitation issue in any of the 4 charts in #68 above.  you do have some gaps in flow; look at the last minute or two of each sleep session in a 2 minute window to see if flow limitation (or anything else) is evident just before waking.

to help confirm or rule it out, I've attached another example of what periodic limb movement looks like (in my flow).  there are variations - for example, there may be fewer flow limitations or more breaths between sharp inhales - but it's always a string of some more or less uniform number of relatively flow limited breaths, preceded (and followed) by a sharp inhale, often with a moan/groan/grunt that looks like a snore in the flow.  I suspect many if not all of these sharp inhale/groans are arousals, most of which I am unaware.

you also have a few residual ca.  usually those few are not enough to sweat but I believe ca do contribute to lingering sick-and-tiredness for some of us.  I didn't reread this whole thread but I assume you've already titrated yourself to best balance between oa and ca?

Thanks - when you say "You do have some gaps in flow" - do you mean Flow Rate? if yes, that's me usually getting up to pee, OR, in the case of one night, I powered off the machine every time I woke up so I could track what was waking me - that proved to be too much effort to do every night, because it would wake me up even more to do so, and it's hard enough to sleep without the self talk of "I'm not sleeping" going on. But yes, there are usually flow limitations preceding the gaps in flow rate - perhaps suggesting that they wake me
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#79
RE: Lingering fatigue: trust Resmed sleep report?
yes, gaps in the flow rate graph, when machine is turned off. a useful strategy to help figure out why you're awakening.

the flow limitation graphs and stats shown in charts in post #68 are quite mild. however, if your 'normal' flow is flow limited, they may not be identified / flagged / graphed (as I understand it, the algorithm compares now to the last x minutes of flow to identify flow limitations). if you see flow limitations in your flow rate graph leading to when you turned the machine off or otherwise know you awakened, and you are still feeling lousy, it's probably worth trying to address them.

I'm sure you know there is a long long list of things that can cause awakening. I believe it's plm in my case, which I've done little about. even so, after about 2.5 years on apap and asv and just over a year on asv, even if my sleep is still fraught with awakenings, I'm getting more and more 3 - 6 hour sessions; something to be said for the "it'll improve in time" theory.

the key is to pay attention to what you do and consume before going to bed and again each time you wake up. is waking gradual or abrupt? feel like a slow climb out of a deep sleep? heart pounding, gasping, sweating? dreaming? thrashing? full bladder? thirsty? whatever, use a voice recorder or notepad if it helps until you can identify patterns. someone to look in on you occasionally can help as might a video camera. a phone app that features noise activated (snore) recordings can help too.
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#80
RE: Lingering fatigue: trust Resmed sleep report?
Hi, Gcrithley,
sorry, but I only can handle this very discontinuosly; ...English not native;
The charts we would need would be, from top do down preferentialy:
Pressures
FL
Tidal volume (please amplify this decreasing maximum to 1.000)
Leak
..don't need events chart
We could start ploting only 10min-windows, then later on 2.0 minute ones...
I would welcome images from around 0;15 (FR peak); 1;00, 2:00, 3;00 up wake-up; from the noisy strectche 5:00 to 7:30, trying to capturate contrasts (up down on the TV curve) and your breaks. First approach is try to calibrate your curves, concerning arousals/wake-ups, which you have been going through a lot.

"3) I don't see any issues on your graphs - they look quiet and perfect": you would be surprised by what I have been audio-recording (low cost high sensivity device) during these arousals/wake-up events, coming from a deep sleep to awkeness!
GL
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