New pressure adjustment - still feeling bad

[Chris8243]

Yesterday I saw my sleep doctor because the past few weeks I've not been sleeping well. I'm tired when I wake up, have a headache, and know I've been struggling with the mask. I went to see him so he could look at my stats and see what he thinks. I've just not been feeling "good."

He raised the pressure (auto-pap) from 8 to 20 since my previous high was 15 and I had several nights previously right at 15.
He also said I try to sleep more on my side. I always start out that way and usually wake up that way. I wake up too early because I hear the little leaks from the mask and try to adjust, repeatedly. My husband said I am frequently on my back but I don't know how to avoid that since I'm asleep!

Here is my graph from last night. All the activity toward morning seems to indicate to me that may be why I wake up feeling bad?

I'd be grateful for feedback. Thanks!

[Pugsy]

So what were the settings before the 8 minimum and 20 max?
Was it 8 minimum and 15 max? I suspect that is what it was and it wasn't the maximum that needed to be increased but the minimum of 8 that needs to be increased.

As to those wee hours of the morning when things are worse...is your OSA worse during REM stage sleep?
That would be my guess for why the ugly times are more in the wee hours of the morning because that's when we have more REM.
It comes on faster and lasts longer in the wee hours of the morning.
Google "sleep stages" and look at the normal hypnograms and you will see what I mean.

Now you might also have been on your back but I am betting REM is the primary culprit. It's common for our OSA to be worse and REM and need more pressure in REM.

The machine needs a better head start for preventing those events than it is getting with the 8 cm minimum...how much more I don't know but usually 1 or 2 cm will get the job done.

[Chris8243]

My previous setting was 6 to 15.

I'll look on Google for sleep stages, thanks!

[gwc2795]

Pugsy
I understand and agree with raising the min. pressure especially since the dreamstation is slower to respond to OA and increase pressure. What I don't understand is that the dreamstation is showing 8/20 but the pressure is showing at slightly above 6 not the min. of 8. Why is this?
Thanks i advance,

[Pugsy]

Pugsy
I understand and agree with raising the min. pressure increase especially since the dreamstation is slower to respond to OA and increase pressure. What I don't understand is that the dreamstation is showing 8/20 but the pressure is showing at slightly above 6 not the min. of 8. Why is this?
Thanks i advance,

You should be seeing 2 pressure lines...the minimum of 8 is the top line (inhale pressure) and the second line is the exhale pressure because Flex exhale relief is being used so there is a drop during exhale.

The minimum is 8 for inhale and you just can't see it well because of the scale involved. The little spikey saw tooth looking increases are the test pressure probes which are normal.

[gwc2795]

thanks pugsy

[Chris8243]

That was a good question, why is the pressure graph recording 6 & 8?

"6" is the lowest the pressure should go when exhaling?

[Pugsy]

With Flex exhale relief the amount of reduction is flow based and not a direct cm per setting reduction like with ResMed's exhale relief.
So the amount of drop during exhale depends on how forcefully you breathe but the most it can drop is 2 cm even at a setting of 3 and even if you are using more than 8 cm.
It's just the way Respironics does their exhale relief...the setting of 3 doesn't mean a 3 cm drop. The most a person can get is 2 cm drop and then that's going to depend on how forcefully they breathe in general.