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Could you please review ? - Printable Version

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Could you please review ? - sleepyzzz - 02-01-2019

I've been getting very low AHIs, usually less than 1. but i can not stay asleep at night, i'm attaching the zoomed out graph, then zoomed in on airflow.
Each time i wake up, i mark it , i can not see anything weird right before the arousals. This has been going on for a while now and i can not figure out why, it's affecting my daily activities badly.
Please let me know if you see something :

second day


RE: Could you please review ? - Gideon - 02-01-2019

I see nothing of cause, some minor Flow Limitations, but nothing that I feel is worthy of a wakeup.  The closest I see is the DeSAT around 850

Fred


RE: Could you please review ? - sleepyzzz - 02-01-2019

(02-01-2019, 08:17 PM)bonjour Wrote: I see nothing of cause, some minor Flow Limitations, but nothing that I feel is worthy of a wakeup.  The closest I see is the DeSAT around 850

Fred
if SPO2 is normal before arousals , so why i keep waking up ? i think i wake up after each sleep cycle, it's so tiring..

btw, you have to scroll the image all the way to the right to see the end of the screenshot, it opens zoomed in in chrome for some reason..


RE: Could you please review ? - Gideon - 02-01-2019

You had a fairly quick drop to 90 at that time, I don't see signs of arousal there


RE: Could you please review ? - sleepyzzz - 02-01-2019

(02-01-2019, 08:25 PM)bonjour Wrote: You had a fairly quick drop to 90 at that time, I don't see signs of arousal there

my doctor does not seem to know either, this happens every single night.. should i do a titrating sleep study? is changing the machine or pressure can resolve this ? 
Please advise.


I also tried it as straight CPAP and lowest AHI was at 8:


RE: Could you please review ? - Gideon - 02-01-2019

A pure experiment.  I do not see where this will help but stranger things have happened.  Maybe 2 phases and this assumes that you are very sensitive to pressure changes which is something we do not know.

Set your Min and Max to 7.6 and keep your EPR at 3.

The second phase would be to eliminate your EPR.


RE: Could you please review ? - sleepyzzz - 02-01-2019

(02-01-2019, 08:38 PM)bonjour Wrote: A pure experiment.  I do not see where this will help but stranger things have happened.  Maybe 2 phases and this assumes that you are very sensitive to pressure changes which is something we do not know.

Set your Min and Max to 7.6 and keep your EPR at 3.

The second phase would be to eliminate your EPR.

i tried cpap at 7.6(attached)
tried apr off, and i was waking up at higher pressures not able to breath.
yes i am sensitive to pressure change, that's why ended up having pressure difference with 2cm

Any aother suggestions? Could it be UARS? RERAs?
My sleep study did not show UARS though, it showd mild apnea/hypopnia and RERA's.
My apneas/hr in REM were lot higher than apnea/hr in total.


RE: Could you please review ? - Sleeprider - 02-01-2019

I also don't see anything that should trigger an arousal. Sometimes it is just spontaneous disruption of sleep. We will keep looking, but the sleep disruption does not appear to be related to therapy so far. Your pressure is low with 3-cm EPR. None of the graphs seem to track the IPAP pressure, and I don't know why that is. Give your consistently low pressure requirement, I think you should change to fixed pressure, either by using CPAP mode or by setting minimum and maximum pressure to the same value. You may be sensitive to pressure changes, but it appears you benefit from EPR.


RE: Could you please review ? - sleepyzzz - 02-01-2019

(02-01-2019, 08:46 PM)Sleeprider Wrote: I also don't see anything that should trigger an arousal.  Sometimes it is just spontaneous disruption of sleep. We will keep looking, but the sleep disruption does not appear to be related to therapy so far.  Your pressure is low with 3-cm EPR. None of the graphs seem to track the IPAP pressure, and I don't know why that is.  Give your consistently low pressure requirement, I think you should change to fixed pressure, either by using CPAP mode or by setting minimum and maximum pressure to the same value. You may be sensitive to pressure changes, but it appears you benefit from EPR.

Thank you Sleeprider, please see my last post


RE: Could you please review ? - Gideon - 02-01-2019

You say that you are sensitive to pressure so try CPAP (7.6) without EPR.  If that doesn't do it I think you may need training to not wake up.  That means professional help.