Newly diagnosed - on a DreamStation - need review of data

[ajack]

I'd be interested to see how 8 turns out. It looked like it would be close earlier.

[matsarge]

Ajack- your answer is up next! 

[matsarge]

So last tonight was a new setting, the min was bumped up to 8 so now the Dreamstation is set to 8-20 with Flex at 2. I've been using a Philips DreamWear nasal mask the last 3 nights. The results were very promising. My AHI was 2.33, which is the lowest it's been in over 3 weeks. It was the 3rd lowest AHI (I got 1.35 and 2.3 back in April) since I started using the CPAP almost two months ago. Another thing I noticed was the lack of events during the period I was falling asleep, that's been common lately. I guess having the higher pressure right off the bat helped. 

I'll stick here at least 3 days and see if the results hold and if so, I think I may have found a sweet spot. 

Side note- there were a bunch of storms here last night and I woke up at 5 am and couldn't fall back asleep. You'll see a bunch of RERA events between 5am and 6:20am when I was awake.

[ajack]

You were awake that ran the pressure up. You set nicely around 8-10 all night. I'd keep 8 and max 13 for a while. See if 9 would be needed later.

[matsarge]

Agreed - that period of being awake ran up the pressure and skewed the overall numbers. I disconnected it to go the bathroom and when I put back on, I could tell the pressure was way up there, I clicked the button and it was at 13.5. That was too high and I didn't like how it felt. With that in mind, I agree with you about turning the max down to 13.

[Gideon]

I too would hold for a few days. I would also look at that bit of PB, not that I am concerned about it but to be aware of that and it's particular pattern

[matsarge]

Thanks Bonjour. I looked at the PB over the length of my CPAP use (51 nights) and it appears on 13 of the nights with no discernable pattern to it. It just appears randomly some nights, comes and goes. The worst of any of the night was 2.1%. For example, it happened at different parts of the evening the last two nights but didn't appear in the previous 6 nights. 2 weeks ago, it appears 4 out of 7 nights, but before that, it didn't appear the previous 2 weeks. I added a report from Oscar. Let me know if you see anything out of the ordinary.

As a side note - with the events leading up to my sleep study (in the last 90 days), I had a number of tests run on my head/neck/chest including mutliple EKG's, Stress Echo test, X-rays, CT Scans, carotid ultrasound, etc...which were all reviewed by my primary, an ENT doctor, and well-regarded Cardiologist, and got a clean bill of health from a head and cardiovascular perspective. 

All that said, it is something I'll keep an eye on and make my doctors aware if it pops up too much.

[Gideon]

By pattern I meant the breath waveform of it.  5-10 minute view

[matsarge]

Ok, that makes sense. Here's the 2 min view of the event and the roughly 10 mins around the event. Do you see anything out of the ordinary? It looks like I was snoring during most of the period. Most nights with a PB that I focus on, resp. rate seems to stay pretty stable during that time.

[Gideon]

Yes, Heavy Expiratory mouth breathing.
On the left title of Flow Rate right click then on dotted lines click zero. Everything above that line is inhale, below is exhale. Think about it, on average, everything you inhale must be exhaled. Look at the area being inhaled and then exhaled. While different shapes and timing the volumes should be close. You are inhaling from your mask and exhaling, mostly, through your mouth. does your mouth get dry at night? This is why. Look at the Mouth Breathing section of the Mask Primer. This is not impacting your therapy as long as your inhales are via your mask.