This is so frustrating....

[jen61]

I knew I didn't have what would be considered a "good" night last night because it seemed I had trouble getting my mask to feel right, and several times I woke breathing through my mouth, and just seemed to have a non restful night. So I figured my leak rate would be off the charts since I've had trouble with it anyway.
So I load my data and of course my event flags and flow rate is sprinkled with events/colors as expected. My AHI is not the greatest, which was expected as well. But my leak data says No major leaks..? How odd, I sure expected it after the night I had. I did wake up tired at 8 o'clock or so and went back to sleep, and I notice those last 3 hours of sleep were the worst.
Okay so I'm wondering, if my leaks were under control, why am I still having all these "events"?
I know some of you have suggested a higher starting pressure, which my tech obviously reset because my machine now turns on at 10, but I ramp it down to 6 to allow myself to get used to it. So what I'm wondering is, if my leaks are under control and my pressure is average to high ...why am I still having trouble? I would love to know what it feels like to have a night with a "good" AHI. I was diagnosed at 52 or 53, so maybe 8 to 10 is the best I can hope for?

[chill]

Okay so I'm wondering, if my leaks were under control, why am I still having all these "events"?

See post #2: SMB Effect

Don't discount this factor. It takes a while for your mind and body to acclimate to sleeping with CPAP.

Here is how my past months look:


I made some pressure adjustments, but very few. Notice how the AHI trends down over time, but also spikes at time. Notice how it is low and even at the end (right).

It could also be that your starting pressure is still too low and that the ramp would not be helping that. Or it could just be that you had a bad night's sleep and thus you were awake more often and these machines will score awake sleep as bad events which skews the results. The machine does not know if you are asleep, only how you are breathing.

[PoolQ]

Welcome to CPAP, it is not impossible, but it is not automatic despite what the machines are named.

You cannot tune your machine with large leaks going on, but that does not mean that you machine is tuned just because you got your leaks under control.

You are now at the tuning, tweaking, and getting used to it stage.

1. therapy settings so the machine can control apneas
2. comfort settings so you will tolerate the machine and sleep (you must be comfortable). You can sleep without getting deep, restful sleep.
3. once all the settings are the best you can get them, be patient and breathe, get used to all this new stuff.

[green wings]

Hi, Jen.

1. Hm, weird. I see what you mean about your machine going to 10 when you turned it on at the beginning of the night and again when you turned it off then back on around 8:30 am. (I think the red graph line is your machine's nominal pressure, and the green line is the detected pressure?)

But later on during the night, the pressure frequently drops below 10, so it doesn't seem as though 10 is your min. pressure setting. Maybe someone else who has the same type machine as you do will know what's going on there.

If you hit "F11" (for a Windows machine) to go to full screen display before you take the screenshot, I think it will include more of the machine settings in the snapshot.

2. I agree with the people who said that your minimum pressure is too low. The pressure frequently drops down to around 7 cm. I think you'd do better with a minimum pressure of 9-10. Then the pressure wouldn't have so far to go when you start having clusters of apneas.

3. Ramp - I think it's fine to use it, but if you fall asleep while the machine is ramping up and start having apneas, the machine can't respond. I think that's what happened around 9:45 am.

If you want to avoid that, you can try not hitting the ramp button if you get up in the middle of the night and stop then restart the machine. Try it and see how the pressure feels. It probably will feel okay and not like it does when you turn the machine on for the first time at bedtime.

If you decide that you do need to use ramp in the middle of the night, then you can try using a shorter time setting for the ramp so that it will be finished ramping before you get too deeply asleep (like a 10 minute time).

But, the ramp is there for your comfort, so I'd primarily go with what lets you use the machine comfortably for now. Just know that if you fall asleep before the ramp is done, the machine can't respond to them. You can work towards decreasing your ramp time gradually.

I think that your AHI will definitely come down with time. I know the frustration of wanting the see the Events graph with mostly white space like some people get. Mine doesn't look like that either.

For now, though, I'd just suggest a shorter ramp time and a minimum pressure of 9-10 as far as tweaking settings goes. Otherwise, just keep working to keep leaks down and to sleep as comfortably and soundly as possibly and let your body adjust to using the CPAP therapy.

[chill]

But later on during the night, the pressure frequently drops below 10, so it doesn't seem as though 10 is your min. pressure setting. Maybe someone else who has the same type machine as you do will know what's going on there.

Jen, were you pressing the ramp button again when you woke up at a night (without stopping and starting the machine again)? That is what it looks like. Also the top left part of the image says the machine is still running at 4 - 20, which I assume is a SH bug because it does not match the Pressure graph.

[jen61]

I only hit the ramp button when I went to bed at night, then when I woke up at around 8:09 I turned the machine off, decided I was going to go back to sleep for awhile, so I turned it back on and it was at 10, so I ramped it at that time too.

[chill]

Looking again, the waveform does not match the sudden drop of ramp. The only other thing I can think of is that it was dropping the pressure trying to fix leaks, but the leaks don't look that bad, but I can't see all of the graph.

[green wings]

'Morning, Jen. Got another graph for us to look at? Still wondering what's going on with your machine re the pressure starting at 10.

Thanks.

[jen61]

Here is a screenshot from last night. It seems better than the previous night. No major leaks. My machine started at 9.5 I believe and I decided to tough it out and not hit ramp. I was hard at first but really didn't take too long to get used to the pressure. I see the pressure dropped down to around 5 shortly I went to sleep though.

[AlanE]

According to your image, your machine is set to a min of 4 (the machines absolute minimum setting) and a max of 20, (i will assume that is the machine's max settings). This is typically the default values for a machine that was not set up properly. What was your prescribed setting?