Custom 68 Therapy Help Thread

[custom68]

Can anybody offer any guidance or input on these "clusters" of CA events?  I seem to be having these more and more.  
Thanks,
Dave

[jdougc]

Are you strictly a side sleeper, the best position for many who have sleep apnea?

You REM sleep breathing has always been very,very erratic, see around 22:50.  Erratic breathing during REM is ok, but yours seems to be way more so.
The REM sleep is usually when you CAs are the worst.
See if you have peaks in your Tidal Volume chart. I do, that helps me find my suspected REM sleeping period.

I still think you need a different machine to treat these issues,  the CAs, the erratic REM Sleep breathing and your flow limitations, which effect your comfort and cause arousals. 
Gasps and erratic breathing, including holding your breath, CAs, and then arousals, leading to awakenings.

Your sleep study showed CAs.
Consider a slightly used machine as a test. 
I will let the more experience people here speak to what machine is needed to treat CAs.

[custom68]

Thanks Jdoug I need to learn more about what all to look at. It appears I haven't spent enough time understanding all the differences and things to look for. Your are correct, my tidal volume does have peaks in that area.
Yes predominantly I sleep on one side or the other, I do switch sides thru the night. Before the machine my wife said I slept better and quieter on my left side so I try to do that for the most part. I believe I may sleep better (now) on my right side. It is more of a side/stomach thing.
I may need to talk to my sleep doctor but I don't know that it will be much help. I am more educated on this now than I was for sure. I dont feel that I am getting much benefit from the CPAP however my wife believe otherwise as I am not snoring and gasping that she can tell anyway.
I I have stuck at this single pressure for a while, it seems any change I make makes it worse. I had a couple of nights when I was on vacation that I was sub 1 but I cant seem to duplicate that. My settings haven't changed.
Thanks for looking
Dave

[custom68]

Here is last night, this was much better and I feel like I did sleep better however I am still concerned with some of my breathing pattern.  This is something I am learning as I go.  I was pretty trusting in the Sleep study specialist I had seen but now I question that I have good information to start with.  
Thanks,
Dave

[jdougc]

I am glad that you slept better.
Is that breathing pattern sort of repeatable at around 1:40 ish, 3:40 ish and 4:40 ish?

You might need a different machine.

[custom68]

Yes it is. It is odd (at least to me) that I do have a few good nights scattered in the mix where my sleeping looks better and the AHI numbers are lower but it remains inconsistent.
I am wondering if I do need something different. I had hopes this would work its self out as I used this. I am around 3 months in.
Dave

[custom68]

Just another post, I think for the most part I am sleeping pretty well.  This night (last night) wasn't as good going by how I felt and I know I was awake some and woke up early for some reason.
Andi I will add one from the 9th that felt better overall.

[custom68]

I will go ahead and post another one.  It is kind of a mess again.  I had lowered the pressure down in hopes it would help the CA issues.  It has not.  I will bump this a bit back up.  It is probably time to see my Dr and see what they can recommend if anything.   I have only been at this for almost 3 months so I was hopeful this would have subsided by now.

[jdougc]

I wouldn't raise your pressure, but lower EPR to 1 or turn it off if you can take it.

You rarely have sessions of gentle relaxed breathing, like you did around 2:40 and midnight.
Usually you have very big breaths during your light or your deep sleep.
Your REM sleep is when you have many of your CAs. Erratic breathing is to be expected during REM sleep, but not the consistent CAs that you have.

It is back to your CAs that you had in your sleep study not being addressed and the flow limitations also. If you zoom around in your flow rate chart, I would think you would see flattened breath tops and other issues.

You may want to look for a lightly used AirSense 10 bilevel. It can treat both the flow limitations and the CAs.

[custom68]

Thanks for that input.  I had tried lowering the EPR but didn't seem to offer much help.  That was a month or so back.  I didn't stay at that setting like I need to to see what the trend looks like.  I had read that can help, I have tried to be pretty methodical about my changes but it is certainly worth going to that for a week or so to see what changes.  
I didn't think I was having any flow limitations but that could be from the EPR settings as well.
I haven't looked for a different machine yet but that may need to happen.  
I am including a zoomed section at that 2:40 range you mentioned to see the breath tops.