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waking up multiple time
#1
So I have been using my APAP machine for about two month now. I seem to wake up multiple times per night. So last night, each time I wok up, I turned the machine off and on so it would be easy to see the wake-ups in the data and look for any patterns. last night I woke up four times. I have attached the zoomed in data for the four wake-ups. My overall AHI for the night was very low (.39) but I would rather not be waking up. I feel much better with CPAP even with the wake ups but I did not wake up this much without CPAP; maybe once a night. Two of the wake ups seem to have a significant negative spike in the flow and the other two I seem to have stopped breathing. yet the machine did not mark a event for these non-breathing periods. I don't understand that one for thing. So anyone see some explanation for why I am waking up?

The blank areas are where the machine is off. So just before the blank is where I wake up.


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#2
I am trying to digest this right now so I do not have any answers for you other than that the problem may not be sleep apnea or treatment related. I will tell you that I did not see anywhere that you stopped breathing long enough to be scored as an apnea and those times looked like they were during a time period where you were awakening.

Best Regards,

PaytonA
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#3
Until someone with more experience comes along, I'll put my 2 cents in. It looks like you're either exhaling through your mouth or you're so relaxed that your throat is closing on exhale. I have the latter problem and have to have a balanced pressure (no EPR) otherwise it will wake me up.

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#4
(03-01-2016, 01:07 PM)Crimson Nape Wrote: Until someone with more experience comes along, I'll put my 2 cents in. It looks like you're either exhaling through your mouth or you're so relaxed that your throat is closing on exhale. I have the latter problem and have to have a balanced pressure (no EPR) otherwise it will wake me up.

sorry, what is "balanced pressure"?
Do you mean constant pressure? i.e. turn off the APAP feature?
EPR sounds like the same thing as A-flex only Resmed vs PR. So are you suggesting I turn off or reduce the A-flex setting?

Just trying to understand what you are suggesting I try.

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#5
So here is my 2 cents.
Your numbers are very nice, so the therapy is working just fine.
As we cycle through the night we go between seep sleep and almost awake, if something is making us uncomfortable we can actually wake up.
We tend to do this for bathroom breaks, we get almost awake and then our mind says "hey wake up and go"
This is also when I may kick off the blankets if I am too warm, or cover back up.

I would look to the comfort settings and not the basic therapy settings.
Flex settings, temperature, humidity. My guess is that something is close to where you like it, but not quite optimized. When you get to the close to awake part of the cycle, you notice the "itch" and wake up.

What you are seeing right before you wake up might be what is waking you up or just the actual process of waking up as we may talk short breathes or actually hold our breath when waking.
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#6
(03-01-2016, 01:57 PM)rhodesengr Wrote: sorry, what is "balanced pressure"?
Do you mean constant pressure? i.e. turn off the APAP feature?
EPR sounds like the same thing as A-flex only Resmed vs PR. So are you suggesting I turn off or reduce the A-flex setting?

Just trying to understand what you are suggesting I try.

The EPR that I referred to is a Resmed name for "Exhale Pressure Relief". It is akin to your A-flex (I believe). The basic operation is to reduce the air pressure during exhale. This difference can be set anywhere from 1 to 3 cm below the inhale pressure for a CPAP and more on a B-level machine. Like I said, for me the pressure drop causes my airway to collapse thus preventing me to exhale through my nose.

Take my analysis with a grain(pound) of salt. I'm probably out in left field on this anyway.
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#7
(03-01-2016, 02:42 PM)Crimson Nape Wrote:
(03-01-2016, 01:57 PM)rhodesengr Wrote: sorry, what is "balanced pressure"?
Do you mean constant pressure? i.e. turn off the APAP feature?
EPR sounds like the same thing as A-flex only Resmed vs PR. So are you suggesting I turn off or reduce the A-flex setting?

Just trying to understand what you are suggesting I try.

The EPR that I referred to is a Resmed name for "Exhale Pressure Relief". It is akin to your A-flex (I believe). The basic operation is to reduce the air pressure during exhale. This difference can be set anywhere from 1 to 3 cm below the inhale pressure for a CPAP and more on a B-level machine. Like I said, for me the pressure drop causes my airway to collapse thus preventing me to exhale through my nose.

Take my analysis with a grain(pound) of salt. I'm probably out in left field on this anyway.

this happens to me. Anything more than a 1 flex number, and I get lots of wake ups. It drove me batty until we turned the flex completely off.
"I am not a Doctor, but I DID stay at a Holiday Inn Express last night.Coffee
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#8
well there are some good ideas here. I can easily try reducing the a-flex. I mean it is simple to do.

While I am mostly using the P10, I also have a nasal mask. Sometimes I switch over and use the nasal mask. I had a sense that I woke up less with that mask but tended to have higher AHI over the night.

No idea what would explain the nasal mask leading to few wake ups and I am not sure the data is statistically valid. Just a sense I had.
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#9
I am on BiPap AUtoSV, and when I switched to that from an APAP (where I used a setting of 3 for the A-flex) I needed to reduce the A-flex to 1. I still have a number of wake-ups during the night, for other reasons, and my doc has "forced" me to actually reduce the amount of time in bed with a set lights out and a set wake-up 6 hours later to try to train my body/mind to consolidate my sleep. We will then expand that time for sleeping once I get "trained". She might actually be on to something... I am starting to sleep through more of the night without conscious wake-ups during periods of arousals or after REM (they really need to find a better term than arousals).
This sleep stuff is hard for us old folks, how come babies do it so easy?Dielaughing
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