Sudden Unexplainable Change

[Hydrangea]

Preach it, pholynyk!!

[Sleeprider]

Haha.   

Foolish me I didn’t change the start pressure setting that you had recommended.  I think I’d get better results with that. 

Since it’s occurring at the beginning and end of sleep is it possible that it's recording when I took the mask off and recording that as sleep apnea?  I never consciously wake up in the middle of the night, but some nights when I have a hard time falling asleep I might get up to get a drink.  I don't turn the machine off I just wait for the Airsense smart sensor to automatically turn it on and off anytime during the night and in the morning at the end of the session.  Sometimes it takes a little while before it detects that it's off but it already has leaked a lot.  Would the machine in this instance falsely record that as an apnea possibly?  Or maybe the sleep apnea event is too long?  Just thought I'd throw that out there.  Last night btw I was awake after the pressure got to 8.4 because I wanted to make sure it was correct.  That also seems to point to it recording when I was awake unless I happened to fall asleep shortly after it got to 8.4 (I dont recall how long it took me to fall asleep)

One thing I recall about waking up was that I laid in bed awake longer than usual, maybe about a half hour after I awoke, but did not fall asleep.  Can it record sleep apnea while awake or is that just central ai?  The reason I suggest that and it might be only because it's such a short time I've had times where I had the mask on sitting in bed, but never fell asleep and it shows a bunch of sleep apneas but it's only a session of a few minutes. Once I revamp the pressure however it seems to delete the data as my AHI in the morning shows fewer than it showed then.

Things are definitely much better than a week ago, I’m going to give it a couple more days to see.

I do work odd hours of 12:30 to 9, but the time is way off.  I might go to sleep between 12:30 and 1:30 - in the morning not afternoon (latest).  I also do not take naps since starting CPAP therapy.  My schedule is about to change for the better though on Monday as I got a normal 8:00 am shift now so I hope that will help get my circadian rhythm in sync.  Thanks

From what you said here, all of your apnea events occurred while you were awake...in other words, your AHI was zero and those are not valid events.  Pretty much what I was assuming as well.  As you gain experience looking at these charts, and awareness of your sleep state, will make picking out "real" events easier.

I have posted that same clinical titration article many times. The procedure for CPAP titration is straight-forward, and I use that and the bilevel titration principles when making suggestions to people that come here for some pointers.  Especially with EPR in the Resmed CPAPs, it has become more important to know how bilevel works and affects events.   I disagree that CPAP is superior to APAP, or vice-versa.  Each individual has his or her own needs, and may respond better to fixed or variable pressure.  Particularly where higher pressures are needed for individuals with apnea related to sleep position or sleep stage, an automatic pressure can be more comfortable and effective.  We also see individuals that are very sensitive to pressure changes as it disrupts their sleep or causes centrals to occur; where fixed pressure works better.  I try not to pre-judge what is going to work best, and in your case I simply accepted fixed pressure was your preference, and whatever happened to fix the extended OA clusters you started with, already represents great progress. 

Keep up the good work, you're doing fine.

[scottdooley]

Hey your a genius!  I got 1.1 last night so it worked!  Never give up! Haha

Also my S Plus reocrded only 4 interruptions (usually its 8) and 1 hr 15 min Rem with 45
Min deep sleep!

One thing I noticed last night before I went to bed was the humidier was almost empty.  I havent been filling that every night - everything plays a role like Beej said!

Maybe its time to try 9 cm!

Scott

[Marillion]

Nights will vary depending on many factors. It might be a good idea to leave it at your current setting for a couple of nights instead of changing it immediately to 9...

[Sleeprider]

Maybe its time to try 9 cm!

Scott

There's a name for that!  "Dial winging" aka dialing for apnea.   

[Sleepster]

This is what I don't understand about CPAP therapy.  Anything under 5 is considered normal and that doesn't even require CPAP treatment if you had achieved that without the CPAP machine, but that means that you've stopped breathing or had a partial obstruction 40 times a night if you sleep for 8 hours!  

The way apnea is defined you have to stop breathing for 10 seconds or more, a hypopnea is breathing below some set percentage of the maximum for 10 seconds. Do these things for 9 seconds and they don't count in the AHI. So having a AHI of 5 just means you had an average of 5 events per hour. It doesn't mean your sleep was disturbed that many times.

CPAP therapy is in its infancy, and doctors are just beginning to figure out how to use it effectively. The categories of mild, moderate, and severe are set for purposes of research. There's more to sleep disordered breathing than can be measured with the AHI. Nevertheless, that is what the industry is using right now.

Now mine has been 1.7 and last night .7 but do you think there's still room for improvement?

Certainly you can tweak things, but there are probably more important things to consider when the AHI gets that low. Mine varies from just below 1 to just below 3. Sometimes when it's higher than 2 I feel like I may have spent more time in deeper sleep and that's what made it that high. When we're sleep deprived that's the way our bodies make up the loss. We spend more time in the deeper stages of sleep.

Have you looked at your leak rate graph to make sure all is well there? This is often overlooked and is probably more important than AHI. Certainly the leak statistics can tell you if something's wrong, but you can have good leak statistics and still have leak problems that are interfering with your sleep in ways that don't show up in the AHI.

I like to see a nice smooth leak graph for the entire nights. If it's going up and down a lot, especially if it's staying up for extended periods of time, that can indicate a problem.

[scottdooley]

Ha I think of it as airway management!

[scottdooley]

Good evening,

Saturday I kept pressure at 8.4 and I had an AHI of 1.05, Sunday I raised the pressure to 9 cm and my AHI was a remarkable low at .70!  I will post the results. The only thing is that my clear airway went up to 0.35 from 0.12 the day before (showing 3 events).  Many times throughout my history I had a central airway of 0.  

Is that something to be concerned about or is it better to have a lower obstructive and a slightly higher clear airway reading?

Scott

[Sleeprider]

Not a problem. It's pretty common to see equal CA and OA as you are fully dialed in. They are short events and not necessarily a central apnea, but a change in position or arousal.

[scottdooley]

Hey I stepped out for a few days, I hope all is well. Things seemed to be going well but the last week or so my AHI has gotten higher and close to the 5 AHI limit. I'm posting last week's results along screen shots of the last few days. I was wondering if you think I should try the auto setting on my ResMed AirSense Elite? Would it hurt to try?

* Also, I just noticed that last night's data had a huge gap it it in the middle of the night. Could this be a card recording error?

AHI:

Date Level

4/5 4.60
4/4 4.68
4/2 3.20
4/1 2.31
* In contrast the week before I had an average of 1.5

https://www.dropbox.com/sh/oq67qzbofmake...gyh5a?dl=0

Thanks,

Scott