Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Two Long Weeks
#1
Imgur gallery of sleepyhead data: imgur.com\a\3iVPa

Shouldn't Have Put This Off

So, a few months ago now, my doctor had me wear an ambulatory blood pressure cuff for a day. While my blood pressure was normal, the test showed a small increase in pressure at night.

I was referred to an at-home sleep study at the local DME. They were very quick to process the results, resulting in my physician writing a script for an auto-pap without even having the chance to discuss the results.

Picking up the machine, the Sleep Tech quickly walked me through the study. There were no apneas, but for the duration of the study, I had 18 hypopneas. I'm unsure if this is per hour or throughout session, but the pulse ox doesn't lie: with hyponpeas lasting a maximum of 48 seconds, it read as low as 83%.

Perhaps this explains why I am so tired during the day and inclined to sleep upwards of 12 hours, yet feel very little relief. My sleeping schedule also rolls forward a few hours each day, give or take. For many years, I just assumed this was the result of a diagnosis of ADD (without the hyperactive component) and medicated it with a small dose of Adderall, not to mention caffeine and calories. It's been a good 12 years of that.

The Sleep Tech gave me a machine calibrated to 4-16 with a FLEX setting of 2. It was very difficult to get to sleep due to the sensation of suffocation, but somehow I managed. My AHI was only 1.52, all hyponpeas.

After another night of hyperventilating myself to sleep, I changed the pressure to 5, then to 6. Finally, I could get to sleep comfortably. After finding a helpful post here about placing your tongue lightly against the roof of one's mouth at night, I was able to eliminate any leaks related to mouth breathing.

My sleep remained fragmented, however. I'd constantly wake up every 1-3 hours. Most of the time I could get back to sleep, averaging 6 hours a night.

Sure, I'd feel more rested, but no longer being able to get a "solid" feeling sleep continues to take its toll on me.

My AHI averages about 2, so at least there's that.

DME Wins

There've been periods through this where I've been convinced I don't need this therapy and I'm just a cog in the DME's racket to sell me a machine with a 100% markup. But, after recording my sleep for a night, I'm forced to conclude that there's something going on: my breathing becomes shallow and sounds almost like it stops for a while, then it continues again.

Touche, DME. Maybe I do have a problem.

Figuring Out What's Normal

Now, something else has shown up: periodic breathing. For the last two days, the machine's flagged it. It's short, making up less than 1% of my sleep, but going back through the flow rate graphs, I notice similar patterns. Perhaps they're just not of long enough duration for the DreamStation to detect them? I have long periods of stable breathing, then it seems to undulate.

Likewise, I see gaps in my breathing. They're similar to hyponpeas, but are unflagged by the machine.

Then there's flow limitations. One every hour or so, of 6 seconds duration, yet most the time it looks like I'm breathing in Sleepyhead.

Then, the last two nights, I've noticed that when I wake up, am trying to drag myself back to sleep, and am laying on my back (normally I sleep in a positional hybrid of stomach and side), it seems like my breath just stops for a second. I have to consciously will myself to take a breath. Just a weird sensation.

Does this sound normal? Anyway, I'll talk with my doctor tomorrow, hopefully, then the Sleep Tech on the weekend. If more info is needed, just ask. Bit spaced out at the moment. Bigwink
Post Reply Post Reply
#2
You've done pretty good getting the machine to work for you, but perhaps we can get things a bit better tuned to your needs. To start, can you take a look at your average and 90% pressures? (median and 95% is fine if that's what you record)
Post Reply Post Reply
#3
Averaged (12 days):

Median: 8.0
90%: 10.0
95%: 10.5

Rounded to the nearest 0.5.
Post Reply Post Reply


#4
I'd set that min pressure at 8 and leave it for a week. see if that helps to reduce hypopneas even further! also, while your AHI is low now, I would look at the durations of the events.

What are the maximum pressures looking like?
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Post Reply Post Reply
#5
Will give it a shot once I speak the sleep tech. I'm under the impression they won't be glad I changed it to 6. Speculatively, I assume this was really meant to get a baseline at the end of the month, when they try to sell me the machine. Tongue

Sleepyhead reports 11.5 this week; 15 for the month.
Post Reply Post Reply
#6
Oh, good. SleepyHead lets you export CVS.

Length of Hyopnea: 18s avg, 57s max

Rest are rare enough that there's probably not much reason to include them, for now.
Post Reply Post Reply


#7
57s is long! 18s is not short.... your therapy should be maximized so that these don't happen if possible. an AHI of 2 when the events are 10 or 11 sec is very different from what you have described.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Post Reply Post Reply
#8
Well, it certainly wasn't intentional. Big Grin That should be 15 seconds average, not 18. Mistyped.

The second longest, at 56, might be sleep-wake junk. It's the second-to-last chart, here: http://imgur.com/a/NbXEn You can see that it's on a very, very short session.
The longest, 57, happened after a RERA.

Of 253 events, only 11 are over 40.

Apologies.
Post Reply Post Reply
#9
Hi EnigmaGrey,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy and getting it fine-tuned to better meet your needs.
Hang in there for more responses to your post.
trish6hundred
Post Reply Post Reply


#10
I'm 100% in agreement on a minimum pressure of 8.0. The Dreamstation is not fast enough to stop apnea if it is too far below the therapeutic pressure. If this was fixed CPAP, we would recommend the 90% pressure, closer to 10.0. The auto lets you enjoy somewhat lower pressures, but if you leave it at 6.0, you will continue to experience these problems.

I assume the 57 second duration is a hypopnea, not an obstructive apnea event. Hypopnea is a calculated event where flow volumes are reduced, and it's not unheard of for them to be of longer duration. Still, assuming that is an obstructive apnea, it may be completely prevented by starting at a pressure of 8, rather than far below your therapeutic pressure. The fact your machine has averaged 8.0 in spite of low starting pressure, is a message.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  First 2 weeks. Mask recommendations? Acheron2010 2 123 12-03-2017, 11:58 AM
Last Post: DKRMT
  [Pressures] 8 Weeks In. Seeing Consistent 14+'s. Up the Max? Doza 13 360 12-01-2017, 09:49 PM
Last Post: Doza
  Hosed up for 6 weeks now Swisssleeper 24 777 11-30-2017, 01:39 PM
Last Post: Marillion
  1 1/2 weeks on CPAP couple questions Randynh 7 309 11-12-2017, 03:41 PM
Last Post: ajack
  Two Weeks - Data Checkup dracus 5 163 11-10-2017, 10:37 AM
Last Post: DeepBreathing
  Another long over due newbie dsmith14469 6 208 11-09-2017, 09:54 PM
Last Post: dracus
  Long time user, new machine - need help LabDog66 2 220 10-28-2017, 03:40 PM
Last Post: LabDog66

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.