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AHI moderate - sleep too short - feel tired - Printable Version

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RE: AHI moderate - sleep too short - feel tired - perler242 - 11-17-2019

I found the valve here. But I don't know if it fits to my 15 mm hose. Corr-A-Flex hose is only available for 22 mm. Do I still need an adapter?

Today I had finally again AHI of 2. I hope that it was because of the beer.


RE: AHI moderate - sleep too short - feel tired - Sleeprider - 11-17-2019

Even though you use a 15 mm tube, the ends have 22 mm standard adapters.


RE: AHI moderate - sleep too short - feel tired - perler242 - 11-18-2019

Okay, thanks Sleeprider.

I didn't understand which silicone to use to close the openings?


RE: AHI moderate - sleep too short - feel tired - Sleeprider - 11-18-2019

If you want to make a temporary seal, use tape. For a permanent seal, use any silicone sealant. Any silicoe sealant should work fine, and the vinegar smell will go away when cured. If you want, you could try a "food grade silicone" or one from an aquarium supply.


RE: AHI moderate - sleep too short - feel tired - Steve Zoller - 11-18-2019

Sleeprider, I know you know a LOT more about the practical application of sleep apnea treatment than I do but I have two comments.

1) Thanks so much for the link to the EERS. I had not seen the previous posts about this idea. It makes so much sense. I spent a couple of years trying to optimize my pressure settings and the best I’ve been able to do is get my AHI down to about five with one of the five as obstructive and four as centrals. (I’m an R&D engineer so while frustrating this process was kind of fun too.) With an AHI of five I don’t believe I need to mess around with EERS but it’s fabulous to know about it in case things change.

2) Having spent so much time optimizing my pressure settings I am convinced that certainly daily, and really even weekly results, are not worth using for settings changes. There are things that affect AHI that are so variable, AHI results bounce around a lot, at least for me the centrals do. Over the course of a month my obstructives remain fairly stable but the centrals can go from one to ten. As I was reading through this post and saw perler242 was concerned about an AHI of eight for one night I was going to comment to leave it alone. One night is meaningless. I see he soon posted an AHI of two which would be consistent with my experience as well. So net, learning about EERS is fantastic but I believe perler242 is over-reacting to short-term changes and should wait at least a couple of weeks, and probably a month, before making any adjustments to see if there really is a trend beginning to form.


RE: AHI moderate - sleep too short - feel tired - Sleeprider - 11-18-2019

Steve, I'm not very concerned about AHI and particularly CAI generally less than 2-3 unless there is a complaint about comfort or sleep quality. Most of the people experimenting with EERS are using it with AHI greater than 5, and as a means of avoiding ASV. It seems to work best for treatment emergent central apnea, rather than a complex or central apnea present prior to using positive pressure therapy. One of the unexpected benefits of the therapy is that it appears to produce a real benefit in tidal volume and minute vent.

This thread started with Perler using a Philips Auto CPAP with AHI generally above 5 and as high as 19 with a lot of hypopnea, flow limitation, and a fairly low tidal volume in the 380 range. Higher pressure resulted in greater sleep fragmentation and poorer quality of sleep. About Post #42 Perler switched to a Resmed Airsense 10 Autoset, and saw a reduction in hypopnea, and large swings in pressure in response to flow limitation. As we increased EPR, the flow limits dropped, but CA became more prevalent and tidal volume remained unimpressive http://www.apneaboard.com/forums/attachment.php?aid=16324 . The first discussion of EERS was not until post #69 when this chart was posted with a CAI of 8 http://www.apneaboard.com/forums/attachment.php?aid=17112 . That was just the day before yesterday, and we are in the early stages of experimenting to see if this might be a solution, however, the most conservative approach is to ignore the bad session and mark it up to the cold, continuing on course with what appears to be working.

So, I agree with you Steve, that aside for the night when Perler complained of a cold, his efficacy and comfort were both improving. I think EERS may help to stabilize the transient CA events, and for the most part the AHI is not a driving consideration, but if he wants to give it a try, I'm always curious to see if it produces a benefit. So I think that is where we are. This is a completely optional modification, and one that can be reversed easily, especially if the exhaust vent is taped for a temporary trial. I don't want to push EERS in this case, but I don't mind facilitating it.


RE: AHI moderate - sleep too short - feel tired - perler242 - 11-20-2019

Oh, I'm scared because I didn't get a message about new answers.

So thanks for the new answers.  I gave up CPAP for one day today because I feel that sleep is not really pleasant anymore. It feels artificial somehow.

I think I should test EERS. I could also wait 2-3 months for the adjustment.

I would like to test EERS. But I have some problems with the hoses. I got the vent valve or I'm on my way. I can do without the safety valve because I have a P10.

I'm a little skeptical if the hoses just fit, even with extension. I can only get the Corr-A-Flex from the USA with high shipping costs. I didn't see anything similar in Germany. Maybe I need other adapters after all. I would very much like to test it, but that just frightens me off a bit.

Does anyone have an idea how I can get 1-2 segments of the Corr-A-Flex in Germany? Are there other similar hoses? I still have 2 CPAP hoses left, I could also shorten them in the middle and then connect them again - at least for testing.


RE: AHI moderate - sleep too short - feel tired - Gideon - 11-20-2019

The numbers are saying that you do not need EERS, that your centrals are more than handled. Changes from here should be based on issues or symptoms, not just chasing numbers.


RE: AHI moderate - sleep too short - feel tired - Steve Zoller - 11-20-2019

Your AHI scores are great.  There’s no reason to do anything.  I’m involved in investing groups and a lot of beginner traders look at their accounts and trades so often they over-trade.  I think the same thing is happening to you.  You’re looking too much and over-adjusting.  You really can stop worrying and just sleep for a couple of months.  In fact I suggest to quit looking every day and just look at weekly summaries.  Don’t worry about daily variations, they’re normal.


RE: AHI moderate - sleep too short - feel tired - perler242 - 11-20-2019

Okay, thank you so much for your answers. I will be a little more relaxed.

I've had a lot of stress in the last two weeks. I am also confident that everything will get better.

Thanks

Sleep-well