(02-06-2016 08:25 AM)richb Wrote:
(02-05-2016 08:29 PM)bluemom51 Wrote: I read some older posts last night where some folks were advised to reduce their upper limit on their APAP's to reduce the clear airway events. The last few months my AHI's have gone from about 4-6 to 8-15 with half being clear airway events. Sleepyhead says my average pressure is 12.8 - 13.8 - that part has been pretty consistent. My settings recently were 10-18. Last night I reduced the upper number to 17 with little effect. I was just wondering with 12.8 - 13.8 average pressure, what most people would set as their range. I've always thought you had to set the upper limit high enough to cover the infrequent times the machine bumps up to 18 - maybe once or twice a night.
I had been using an Airsense 10 for Her but could never control the rainout - whether manual or climate control. That machine stated a higher average of about 13.5-14.5 and it just felt like a "softer" and nicer experience, but the constant drowning caused me to put it away. So I went back to the S9 that has no rainout but feels "rougher" and stronger, but it's average is about one point less - don't know why.
Anyway, if someone could advise on the current thinking on reducing the clear airway events - up until a few months ago, mine were about 1-2 - now they are 4-6. Also I do feel much worse and my sleep quality is pretty terrible - exhausted every day, etc. Thanks for any help.
Seems like you have 2 issues here. Rainout in one machine and CAs in both machines. Resmed has an algorithm that sends high frequency pulses through your airway to see if it is open or closed. If your airway is clear and you stop breathing the machine codes a Clear Airway event. This Clear Airway event would most likely be coded as a Central Apnea event during a PSG (sleep study). Some people are sensitive to higher pressures which "washout" CO2 and cause the CA events. Having a high number of Hypopneas is also disruptive to sleep. You need to gather more information which would help fine tune your present machines or even suggest a different machine altogether.DariaVader has asked several questions that would help provide suggestions. I have some more. What is your rate of Hypopneas? It is possible that your Hypopneas are being converted to CAs by the higher pressures and or pressure differential (EPR). Do you have any obstructive events? Have you looked at detailed sleep charts using Sleepyhead? Posting a 5 to 10 minute section of your Sleepyhead chart showing some of the CAs and other events would be helpful.
Regarding the rainouts. You might have a defective heated hose. Try working on the rainout issue some more. The newer machine being more gentle could also help reduce the CAs.
Tried just about everything for the rainouts including replacing hoses (and machines). Resmed says I will get major water spraying (more than typical rainout) with a Breeze pillows mask. The Tech at Resmed start laughing like crazy when I told him I used the Breeze, and he said it would probably never work because they had built more humidity into the Airsense 10 and the Breeze is almost impossible to use with it...... I am trying a few nasal masks, but can't seem to tolerate them.
I haven't posted any graphs because they are so very different day to day. One day AHI may be 5 and it's not too bad - last night was around 12 and woke up with terrible dry mouth gasping for breath, but SH shows virtually no leaks - very confusing. CAs were 6 averaging 13 seconds. I have such terrible sleep - sometimes bad insomnia, sometimes tossing and turning, wakeful periods.
I end up spending way too much time in bed trying to get 8 hours of sleep and thus way too much time breathing with CPAP. Many times it will be from midnight to 11:30 the next day - that just doesn't seem like a good idea at all, but the only way I can get enough sleep somewhere in there. I've tried setting the alarm, but after being up for a couple of hours, I can't stay awake and go back to bed for more hours anyway. It's a mess and every day's chart looks like a mess. I may have 2 days of 5 AHIs split between CA's and Obstructive, then several days of 12-19 AHI's - most days about half obstructive and half clear airways.
I really would like to use the Airsense 10 instead of the S9, but even with a nasal mask, and trying both manual and auto humidity, there was still strong rainout. I am going to keep trying though. I just ordered another nasal mask to try and I am going back to the Airsense 10 for a few nights. I also have a FF mask I could try, but have never been able to sleep with it.
Maybe if I can find where someone gave the instructions on how to post a graph I will post a couple of the crazy things. I'm not good at stuff like that. What are the pieces that I should post that would be helpful?
Anyway, thanks for the reply - I will keep trying for better "sleep hygiene" (even though I'm not sure how to achieve it) and keep trying masks. Starting to wonder if I need an ASV machine (have tried Bipap in the past and it was a no go) - have finally made an appt with a sleep doctor so I'm sure there will be a sleep study, etc. and maybe some answers.