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Most obstructive events are while Im awake
#1
Question 
Most obstructive events are while Im awake
I've been using my dreamstation auto cpap machine for about 2.5 years. It was not working for me for the first year but I switched to a Sleep doctor who does nothing but treat sleep disorders. He adjusted my settings and I had significant improvement. 
However I am a nose breather and use an under the nose cpap mask. I was unable to wear a full mask.
After the changes my new doctor made my Ahi Score was about 4-5. However last winter they climbed to10-12. I was having severe nasal congestion and was not responding well to decongestants. I had a non invasive procedure to fix my turbinates and again was doing a bit better. 
I then bought a special air purifier for my bed room and again the scores dropped again . However they gradually climbed again (I will need to change one of the 2 air purifier filters in about a month).
I evaluated my sleep using sleepy head and now Oscar. I note that the number of obstructive events according to the dream mapper software was high (sometimes 4 0 events) but according to Oscar, most of these event occur either while Im awake watching tv before I go to sleep and then again after I awaken and remain in bed with mask on either reading, trying to get back to sleep or again watching TV.
I doubt the accuracies of the AHI measurements because most of these obstructions are while Im awake, clearing my throat or swallowing.
I just dont understand why they go away for a few days and then return for weeks.
I should alson note that I have lost about 20 pounds since starting my sleep therapy but that has not changed much. I also do not snore more than one episode each night.
This is my first post so I cant upload any data.
I can tell you it is phillips dreamstation. Starting pressure 5.0 , maximum pressure 15, humidifier on. Ramp time disabled.
90% pressure 7.6. Obstructive events on one day 45. All were after I was awake for about 2 hours.
Any suggestions
 BTW not sure how to attach sleepyhead data.
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#2
RE: Most obstructive events are while Im awake
Welcome to the forum!

Others here have much more knowledge than I do.

I'm a nose mask user too; I use an under-jaw collar to prevent mouth breathing. I get claustrophobic wearing a full face mask. I've tried...

My story isn't important. Others here will help you a lot to solve your issues and improve your care.

ps: check for OSCAR instructions. It's a lot better for me than the old Sleepyhead version I used.
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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#3
RE: Most obstructive events are while Im awake
http://www.apneaboard.com/forums/Thread-...ter--25239


Link for you....OSCAR is incredible. My hat is off to all the people who work on it.
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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#4
RE: Most obstructive events are while Im awake
Hi silverdr,
You stated in your post that you were using OSCAR.
See the links in my signature line for directions to post a screenshot from the daily page.

First, follow the examples for setting up your chart. Daily page should include the following graphs: Events, flow rate, pressure, leak rate and snores. Eliminate the right side bar, but include the left sidebar.
Also, please eliminate the pie chart and calendar.

Once set up, use the Attachment Feature to post your charts here.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Most obstructive events are while Im awake
"I doubt the accuracies of the AHI measurements because most of these obstructions are while Im awake, clearing my throat or swallowing."

sleep wake junk skews recorded results. this is one of the reasons I never lie awake in bed with mask on. if I'm awake for more than a minute or so I stop the machine and take off the mask until I'm ready to try to go back to sleep.

old habits die hard but proponents of good sleep hygiene warn us away from watching television in bed, to which I would add: especially while masked up, if you want a more accurate picture of the efficacy of your treatment.
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#6
RE: Most obstructive events are while Im awake
I am an insomniac. When I go to bed, I usually put on the mask and turn on the machine. But if I lay there a while before I start feeling sleepy, I'll reach over and turn off the machine for a bit then turn it back on. When I view the data later in SH or OSCAR, I can turn off that part of the data report so it is into counted in the AHI.

AHI is apnea events (obstructive and central) plus hypopnea events divided by the time used. So that time the machine is on but you aren't sleeping is going against you. Plus the "events" being counted is going against you. Your numbers are essentially useless like that. CPAP machines get their data from the feedback the air pressure encounters. Our irregular breathing while awake probably confuses the heck out of it.

Oh, and events are not counted unless they last 10 seconds or longer. So unless you clear your throat for 10 seconds, it isn't being counted. What IS being counted is your unconscious reactions to what you are watching on tv or reading in your book or whatever. We hold our breath, we change rhythm, we yawn.

Do an experiment. Take a timer. Put on your mask, turn on the machine, then start the timer. At regular intervals, do various things and note the time of each, leaving plenty of space between each one. Yawn. Clear your throat. Cough. Hold your breath by blocking throat (tongue). Hold your breath by just stopping breathing (vs blocking). Turn off machine and go download the data into software of your choice. See what does and does not appear.
PaulaO

Take a deep breath and count to zen.




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#7
RE: Most obstructive events are while Im awake
Here is an example of what I am referring to. I lie in bed with my cpap on at about 7:30 PM. I turn off the tv at about 10-11. Then I wake up almost daily at about 230 PM.
Look at the time of the obstructive events.


Attached Files Thumbnail(s)
   
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#8
RE: Most obstructive events are while Im awake
thank you , I am going on vacation for a week and wont be able to do this testing (my travel cpap doesnt produce data I can evaluate until I connect the machine to my windows computer.) I will try this when I get back.
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#9
RE: Most obstructive events are while Im awake
You somehow have your software reporting events that are less than 10 seconds. I have no clue how to fix that. These events are not necessary to know about. If you removed all of them that have (#less than 10) after them, your AHI will be much lower and more accurate.
PaulaO

Take a deep breath and count to zen.




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#10
RE: Most obstructive events are while Im awake
The dream mapper software app on my iphone is reporting the same number so there must be a setting in the dream station that is doing this?
Anybody know?
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