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Waking up with interrupted sleep for weeks now..
#1
Waking up with interrupted sleep for weeks now..
I have been on cpap for the past few weeks and I started to wake up in the middle of the night at around 3-4 am everyday. my AHI is low, but I do have lots of user flagged event which is set to 50% restriction for 5 seconds. Currently on full face mask with a pressure of 10 with c-flex of 2. One thing to note is that my uvula touches my tongue when I sleep and I wonder if that is the cause of my disturbances. Is there anything i can do with my cpap settings to better my treatment? Check out my last week days of sleep charts. I have an appointment with my sleep technician tomorrow and I will print out these charts and show him. I had an appointment with my ENT and he did not even bother looking at my sleepyhead charts and was rude to me, told him I may had UARS and he just told me "its just a simple stuffy nose" which I believe it is not. I waited for 4 months to get an appointment with an ENT just to wait again for months because he booked a polysomnography. I need help optimizing my CPAP while I wait out to take polysomnography lab test. on my last 3 charts. I put a tape over my mouth to see if using only my nose would help, it did not.

   
   
   
   
   
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#2
RE: Waking up with interrupted sleep for weeks now..
more close up sleep charts continued.

   
   
   
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#3
RE: Waking up with interrupted sleep for weeks now..
One thing that stands out for me is that you are fighting to breath out. You are taking like 3 seconds to breath in and about 1 second to breath out. That is not fun. The Resmed machines would fix that I do believe. I had a phillips CPAP and I had the same issue with breathing on it and the Resmed machines completely fixed that on day one. this is just my 2 cents worth.
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#4
RE: Waking up with interrupted sleep for weeks now..
The Philips dreamstation does not handle flow limitation well, in fact it doesn't even flag it in CPAP mode, and the only solution ends up being to increase pressure.  The Aflex algorithm tries to predict inspiration and expiration and makes complete mess of the timing.  Do you really have a 3-second inspiratory time and 0.8 second expiration?  No, it is machine error.  In the image below, we see flow limited inhale with flat or downward sloping peaks, followed by a strong exhale with a brief positive pressure followed by zero flow ahead of the next inhale. That peak following exhale is your machine returning to IPAP pressure (actually ending CPAP pressure relief) prematurely and cutting off exhale.  

That's the problem, so what to do about it.  First, you should be in auto pressure mode, and, would start at 9-14 pressure range.  I think you will end up at the upper range of that pressure.  Second, set flex at 1 or off.  It's doing you no good because the machine is not properly detecting inhale/exhale anyway.  Third, try to get a Resmed Autoset, or BiPAP.  This will get you a true IPAP/EPAP that follows your respiration, rather than trying to predict trigger and cycle for pressure relief.  Finally, if you can tolerate nasal therapy rather than a full face, it might help to cut your sense of congestion.  You are the best judge of whether that is feasible.

[Image: attachment.php?aid=9244]

[Image: attachment.php?aid=9242]
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#5
RE: Waking up with interrupted sleep for weeks now..
I can't believe the results just from changing the settings. Even though my sleep is interrupted and short, I felt like I slept way better. I do believe I know where my sleep interruption is coming from (heartburn/acid-reflux/gerd most likely). Take a look at my result and sleep chart for today. Thanks for replying, my user-flagged events are significantly lower, and my some flow limitations are finally showing. It seems like the machine never went up higher in pressure for some reason.

   
   
   

normal breathing to an event leading to snoring?
   

I will take a guess that this should be my normal breathing?
   
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#6
RE: Waking up with interrupted sleep for weeks now..
(11-30-2018, 07:45 AM)Jiggy Wrote: I can't believe the results just from changing the settings. Even though my sleep is interrupted and short, I felt like I slept way better. I do believe I know where my sleep interruption is coming from (heartburn/acid-reflux/gerd most likely). Take a look at my result and sleep chart for today. Thanks for replying





normal breathing to an event leading to snoring?


I will take a guess that this should be my normal breathing?

Sleep chart continued...


Snoring?
   
   

I have a question about resmend/bipap, which model should I buy? and is buying from craigslist safe? I saw some significantly cheap prices on craigslist, my current machine is being rented to me for $170 a month and it cost around $2,000+ in total if I buy it out from my DME.
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#7
RE: Waking up with interrupted sleep for weeks now..
I'd recommend the Resmed Air Curve 10 VAUTO. I own both the Resmed and the Dreamstation and the Resmed is much better. I would avoid craigslist and would probably recommend buying from the supplier's list. http://www.apneaboard.com/forums/Thread-...plier-List

The problem with craigslist is you don't really know the condition of the machine and you get no warrenty.
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#8
RE: Waking up with interrupted sleep for weeks now..
(11-30-2018, 08:27 AM)Walla Walla Wrote: I'd recommend the Resmed Air Curve 10 VAUTO. I own both the Resmed and the Dreamstation and the Resmed is much better. I would avoid craigslist and would probably recommend buying from the supplier's list.   http://www.apneaboard.com/forums/Thread-...plier-List

The problem with craigslist is you don't really know the condition of the machine and you get no warrenty.

I'll offer a Ditto of Walla Walla's suggestion. I'm not saying Craigslist cannot be a good backup choice, but I'd try say Supplier #2 before CL.
Dave

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

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#9
RE: Waking up with interrupted sleep for weeks now..
I mentioned the Resmed Autoset or bilevel before.  Both are capable of treating your obstruction and can be adjusted to target flow limits, while at the same time avoiding aggravation of your GERD.  Last night was a nice step in  the right direction.  Since there is no OA you can lower minimum pressure to 8.0.

This chart shows inspiratory flow-limited breathing with flattened peaks that leads to what may be an arousal with recovery breathing and possible shift in body position. Snoring appears as a jagged line on top of those inspiration peaks, and you can see some in this example.  I have included an image from the Beginner's Guide to SleepyHead that shows some exaggerated examples of flow anomalies you will hear us talk about.

[Image: attachment.php?aid=9256]

[Image: Flow_limitation_images_zpsdb148d1f.jpg]

I can't really explain this pattern, but have seen it before.  It would respond to pressure support ant timing in a Vauto machine, but it's going to be hard to persuade your doctor to prescribe based on a bunch of squiggly lines.  It appears to be mostly a form of flow limitation where inhale effort is not sustained, and that is where inspiratory pressure support could smooth things out and enable a more normal full, smooth breath.

[Image: attachment.php?aid=9258]
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#10
RE: Waking up with interrupted sleep for weeks now..
quick question, I am going to buy the resmed autoset v10, what settings should I use for this machine? the same as my dreamstation machine at 8.0 with 1 A-flex?
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