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Sanity check on next steps (still tired)
#21
RE: Sanity check on next steps (still tired)
(08-13-2020, 07:04 PM)Dormeo Wrote:
(08-13-2020, 06:51 AM)TSomm Wrote: When I was waking up, in that groggy/semi-conscious state, I found myself holding my breath for longer than I would expect, but it didn't seem to bother me...

When you think about centrals, keep in mind that awake breathing is much less regular than asleep breathing.  As you observed, when we're awake, or even just aroused to a half-awake state, we often pause between breaths.  If the pause is 10 or more seconds long, we get a CA flag.  In such a case, the problem isn't so much the CA as the fact that you were not entirely a sleep.

That's good to know! Thank you!

I attached last night's report, with the pressure maxed at 9.

The trend over the past week:
  • Day 1: CA: 1.90 -- OA: 0.59 -- H: 0.59
  • Day 2: CA: 3.06 -- OA: 0.61 -- H: 0.31
  • Day 3: CA: 2.85 -- OA: 0.90 -- H: 0.00
  • Day 4: CA: 3.29  -- OA: 0.99 -- H:0.16
The last couple of days I increased my incline, and OA went up. I wonder if that's the cause.

CAs seem to be bouncing around, no trend.

Still waiting for my sleep report. I had to mail a request (sigh), so it'll be a bit.


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#22
RE: Sanity check on next steps (still tired)
Yes, CAs indexes tend to bounce around. I also suspect the increased incline is responsible for the increase in OAs. It's not much of an increase, but if you can do without the additional incline, you might try going back to your earlier arrangement.

You might find it helpful to think about how many of your CAs are SWJ (sleep-wake junk). For example, if you know you were awake during a particular part of the night, you can discount the CAs that occurred during that period.
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#23
RE: Sanity check on next steps (still tired)
(08-14-2020, 10:39 AM)Dormeo Wrote: Yes, CAs indexes tend to bounce around.  I also suspect the increased incline is responsible for the increase in OAs.  It's not much of an increase, but if you can do without the additional incline, you might try going back to your earlier arrangement.

You might find it helpful to think about how many of your CAs  are SWJ (sleep-wake junk).  For example, if you know you were awake during a particular part of the night, you can discount the CAs that occurred during that period.

Thanks!

I'll go back to less of an incline, see how that goes. Problem is that I experience aerophagia if I'm laying down too flat; but I'll see what I can do about that.

Most of the time I have no recollection of waking. Last night I woke up once that I can recall (I vaguely recall noise from the mask, I may have opened my mouth, as I use a nasal mask).

I did a quick look through the forum, but I want to be certain. If I'm using a nasal mask and my mouth opens, causing the pressure to escape through my mouth, is this registered as a leak? I have a headband that I use (actually, 2 but it works), however it's not perfect...
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#24
RE: Sanity check on next steps (still tired)
(08-14-2020, 10:39 AM)Dormeo Wrote: Yes, CAs indexes tend to bounce around.  I also suspect the increased incline is responsible for the increase in OAs.  It's not much of an increase, but if you can do without the additional incline, you might try going back to your earlier arrangement.

You might find it helpful to think about how many of your CAs  are SWJ (sleep-wake junk).  For example, if you know you were awake during a particular part of the night, you can discount the CAs that occurred during that period.

Good morning!

Thanks again for this response. Quick question - I presume that CAs caused when I'm awake are still a result of my holding my breath for a few seconds, is this correct? I just want to be clear on how to interpret some technical aspects of the machine.

Could someone please clarify how the machine reads a nasal mask not working because someone has their mouth open? I just want to be certain that this would be counted as a leak and not something else...

I'm posting the latest report. 
  • The bunch around 03:45 (which is really 04:45. I think my machine didn't adjust to the time shift) is when I woke up. I had my mouth partly open, which woke me up.
  • I was far less elevated this time around. Doesn't seem to have made a difference, unfortunately.
Should I push my max pressure down again? My OAs haven't increased...

Thanks again for all the help from everyone hear. It makes a big difference knowing that I'm trying new things and that there are people willing to help!
  • Going from a min of 6 to 7 and disabling EPR really reduced my OAs. Looking over OSCAR it was around 2 per night (left bar, so 2 added to the AHI) and now it's less than 1!


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#25
RE: Sanity check on next steps (still tired)
(08-15-2020, 08:44 AM)TSomm Wrote:
(08-14-2020, 10:39 AM)Dormeo Wrote: Yes, CAs indexes tend to bounce around.  I also suspect the increased incline is responsible for the increase in OAs.  It's not much of an increase, but if you can do without the additional incline, you might try going back to your earlier arrangement.

You might find it helpful to think about how many of your CAs  are SWJ (sleep-wake junk).  For example, if you know you were awake during a particular part of the night, you can discount the CAs that occurred during that period.

Good morning!

Thanks again for this response. Quick question - I presume that CAs caused when I'm awake are still a result of my holding my breath for a few seconds, is this correct? I just want to be clear on how to interpret some technical aspects of the machine.

Yes, when your airway is clear but you haven't breathed for 10 seconds or more, you'll get a CA flag, whether you're asleep or awake.

Could someone please clarify how the machine reads a nasal mask not working because someone has their mouth open? I just want to be certain that this would be counted as a leak and not something else...

Yes, it would show up as a leak.  The machine doesn't distinguish between mouth leaks and mask leaks.

I'm posting the latest report. 
  • The bunch around 03:45 (which is really 04:45. I think my machine didn't adjust to the time shift) is when I woke up. I had my mouth partly open, which woke me up.
  • You need to reset the clock when the time shifts; it doesn't do it automatically.
  • I was far less elevated this time around. Doesn't seem to have made a difference, unfortunately.
If the lack of elevation increased your aerophagia, then by all means re-elevate.

Should I push my max pressure down again? My OAs haven't increased...

Yes, I think that would be worth a try.  The pressure seems to be responding primarily to your flow limitations.  If the quality of your sleep is still not good, and you're not feeling rested during the day, then reducing the CAs is worthwhile, especially if it doesn't increase the OAs.

Thanks again for all the help from everyone hear. It makes a big difference knowing that I'm trying new things and that there are people willing to help!

You're doing a great job of learning and experimenting.  This will serve you well!  Keep us posted.
  • Going from a min of 6 to 7 and disabling EPR really reduced my OAs. Looking over OSCAR it was around 2 per night (left bar, so 2 added to the AHI) and now it's less than 1!
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#26
RE: Sanity check on next steps (still tired)
Hello again,

I've made a few changes:
  1. Picked up a soft cervical collar
  2. Added mouth tape (I'm hoping to transition to not having to wear chin straps)
  3. Lowered the max pressure
Attached are my results.

Some things are looking better (yea!), but I'm still having lots of centrals and I feel like crap (no change in how I feel day to day).

I'm still waiting for a copy of my latest sleep study (had to mail the request and have the study mailed back, so it'll be a bit).


I spent some time looking through the forum for people with CA issues and it looks like they have two options: 1) play with pressure; (2) try to get another type of machine. I'm in Canada and it seems like CAs will have to be over 5 for me to qualify for any other machine...

Is my only course of action to wait for the sleep study (in hope it shows something on which I can focus) and continue to ramp down my pressure to see what happens with the various apneas? If so, I think I'm just going to set the thing to min/max at 7 for a few days (unless the first night goes horribly). Any reason I shouldn't do that?

Thanks again Smile


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#27
RE: Sanity check on next steps (still tired)
Your AHI is under 3! Granted it is mostly Central Apnea. But focus on how you feel.!
Your AHI is acceptable by the numbers. Without even looking at OSCAR, ho do you feel? This is what we focus on at this point.

If it really bothers you post a couple of 15 min screenshots of your centrals so we can see there character. EERS may be a possibility. But don't chase numbers. How do you feel?
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#28
RE: Sanity check on next steps (still tired)
(08-20-2020, 04:01 PM)bonjour Wrote: Your AHI is under 3!  Granted it is mostly Central Apnea.  But focus on how you feel.!
Your AHI is acceptable by the numbers.  Without even looking at OSCAR, ho do you feel?   This is what we focus on at this point.

If it really bothers you post a couple of 15 min screenshots of your centrals so we can see there character.  EERS may be a possibility.  But don't chase numbers.  How do you feel?

Thanks again for all your help and advice. It has truly been helpful in lowering some of the stats.

I feel the same as I have for years, unfortunately. I agree that I shouldn't really chase numbers, but at this point it's all I've got, given that I'm not feeling any different.

I've attached a couple of the centrals. Please let me know if you need anything else shown.

**Hit my attachment size cap, will delete some stuff and post a couple more**


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#29
RE: Sanity check on next steps (still tired)
Based on those charts I do not believe that EERS will help you .

I honestly do not know how to address a feeling the same as before. Before Apnea?
What do we need to improve your comfort? Or do you need to chase something non-apnea down?
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#30
RE: Sanity check on next steps (still tired)
(08-20-2020, 04:32 PM)bonjour Wrote: Based on those charts I do not believe that EERS will help you .

I honestly do not know how to address a feeling the same as before.  Before Apnea?  
What do we need to improve your comfort? Or do you need to chase something non-apnea down?

Poop.

Before meaning with earlier settings. When my AHI was a bit higher.

If I don't use a machine I feel worse, so it is helping.

I don't recall waking up in the night, so I'm not sure it's an issue of comfort... I'm not aware of anything that would cause chronic fatigue, other than apnea (no depression, other than from the frustration of not sleeping well - generally life is good).

For now, I'll chase numbers Smile Otherwise I'll end up disconnecting the machine and not using it.

Thank you again for your help. I am truly grateful. I'm just frustrated with the overall situation and my level of fatigue. When I get the sleep study I'll be sure to post it... maybe it'll reveal the secret key to a good night sleep for me Smile
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