New User - High AHI

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: New User - High AHI

Post by Pugsy » Tue Oct 07, 2014 9:49 am

The general rule is if you think you are maybe going back to sleep...put the mask back on.

30 minutes of apneas untreated is a heckuva bad way to start the day. I guarantee that your body will feel those bad 30 minutes before it feels the previous 7 hours of good treated apnea sleep.

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badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Tue Oct 07, 2014 11:20 am

I've done that alot in the past thinking it was no big deal. Also when hitting the snooze a couple times. Overall would it be better to just wake up?

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Pugsy
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Re: New User - High AHI

Post by Pugsy » Tue Oct 07, 2014 11:38 am

I usually feel better if I wake up and get up if I have slept to maybe 30 minutes before I have to get up.
I think (and I might be all wet) that when we wake up and try to go back to sleep that starts the sleep cycle thing all over again and 30 to 45 minutes or even an hour usually ends up with us in the middle of a sleep stage. I think waking up in the middle of a sleep stage has the potential to be a problem. The body doesn't get to cycle like it should.
So I think that getting that last 30 minutes has the potential to make us feel worse than if we didn't have it...but again I could be all wet.

You might play around with it a bit and keep a log...see if you notice any difference...but do wear the mask even if for a short period of time. You can't fairly compare treated sleep with untreated sleep.
And it's a bad habit to get into...that
"oh....I can sleep for 45 minutes more and it really won't hurt me that much to be without the mask for such a short period of time....so I will take my mask off for only 45 minutes and get some REAL sleep"
...that's what we tell ourselves but we are lying to ourselves.
I know...been there and done that too. It's real easy to make bad habits but bad habits are always really hard to break. The best thing is to never make them.

I am retired so unless I am doing some special that day I can just wake up to my own internal alarm. I don't have a clock in the bedroom at all. My situation is of course different from someone who still works and has to get up at a set time every day no matter what.

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badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Thu Oct 09, 2014 9:20 am

Here's my data for the last 3 nights. I only woke up 1x the 6th and 7th. Last night (8th) I woke up several times (1x for pee break, others ??) and had trouble going back to sleep after waking up. Let me know what you think.

6th
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7th
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8th
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Pugsy
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Re: New User - High AHI

Post by Pugsy » Thu Oct 09, 2014 9:47 am

Geez, you woke up more with the better of the 3 nights.
Still not the prettiest of reports even on last night.
Makes me wonder what was going on with the old cpap pressure of 13 cm.

Still looks like you probably need more pressure.
How was the sleep quality at 13 cm? Did you wake as often with it?
Is there a possibility that the variations in pressure in apap mode are a contributing factor here?
It would not be impossible...but then again the numerous evidence of either impending airway collapse or those events that the machine didn't prevent could be a factor.

How are you feeling in general compared to what you felt at 13 cm cpap?
Are you having any difficulties exhaling at these higher pressures.

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badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Thu Oct 09, 2014 10:26 am

I've never felt refreshed in the morning since having either machine, but I think it's getting better in the last week. After coming to this site I threatened to give the old machine back altogether if they didn't give me a newer one, so they did. The pressure isn't a problem at all so upping the min shouldn't be a big deal. What should I up the min to in your opinion? Once again ... thanks for your help!

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Re: New User - High AHI

Post by Pugsy » Thu Oct 09, 2014 10:35 am

At this stage I would go slow with the changes
0.5 cm changes and we need at least 3 nights with each change.
This is the fine tuning stage and it takes longer because you need to not only allow the body to adjust to the changes and watch more for trends and patterns than focusing solely on the AHI number and sleep quality and how you feel has to play an important role in things.

Also remember that not all of our unwanted daytime symptoms are related to sleep apnea and sometimes crap just happens.
I wish we could fix all our problems with a nice low AHI and pretty report but it just doesn't work out that way for a lot of us...and that includes me. I almost always have the most boring of reports in terms of OSA but some days I feel better than others for reasons unrelated to OSA.

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badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Thu Oct 09, 2014 11:39 am

Thanks again! I'm still fresh with all the terminology but what am I looking for in the reports and what does it mean. I'm sure I overlooked that information elsewhere since I'm doing this all from work.

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Pugsy
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Re: New User - High AHI

Post by Pugsy » Thu Oct 09, 2014 12:09 pm

I have the Sleepyhead tutorial thread that might help you understand some of the terminology. If you haven't read it you might take a stroll through it and come back with any questions about what you are seeing that need clarification.
Link to it in my signature line.


Snores/Flow limitations and RERAs are usually an indication that sleep quality might not be optimal and airway patency might need a little more work.
Snores and Flow limitations are the early warning signs that the airway is trying to collapse. So when we see more of these (especially in clusters) we take notice. Those are a couple of the things that drive the apap algorithm to increase to try to prevent them. When the machine can't respond quickly enough to prevent that little start of an impending airway collapse because it simply can't work that fast then that's why we increase that baseline minimum pressure to give the machine a better head start for holding the airway open better in the first place and to get to where it needs to go quickly enough when the airway starts to collapse.
They aren't part of the AHI though. So it's technically possible to have a really good AHI and crappy sleep just from the snores and flow limitations. That's why I watch them.

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badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Wed Oct 15, 2014 12:56 pm

Here's my data for the last 3 nights with min 14.5. No issues with the pressure at all so going higher won't be a problem. Only been waking 1x per night since I cut back on the water before bedtime.

10/12/14
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10/13/14
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10/14/14
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Pugsy
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Re: New User - High AHI

Post by Pugsy » Wed Oct 15, 2014 1:04 pm

Wow...can't you try to get closer to the 5.0 cut off line.
Everything is still primarily obstructive in nature and still a little bit higher than I would want to see if it was me along with the "clutter".
I would do another 0.5 to minimum if it was me.

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badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Wed Oct 15, 2014 1:52 pm

Will do. Thanks!

badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Sun Oct 19, 2014 10:30 am

Here's my data for the 15th, 17th and 18th. Was out of town on the 16th and didn't get chance to use the machine. The only thing I've noticed about the higher pressure is I've breathing out of my mouth way more. Please advise when you get a chance.

11/15/14
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11/17/14
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11/18/14
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Pugsy
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Re: New User - High AHI

Post by Pugsy » Sun Oct 19, 2014 11:07 am

Your leaks even at their worst (possible mouth breathing) aren't horrible and are still within the machine's ability to compensate.
Your reports are looking a little better.
If you are reporting waking up with the mouth breathing at these higher pressures the leak graphs don't really show it so it much so if you are...it is brief and not a lot. So from a therapy effectiveness stand point not a big deal but from a wake up stand point....it could be a big deal. Anything that wakes us up is unwanted even if it doesn't directly affect the therapy side of things.

Your pressures really aren't moving around much so again if things are still not quite optimal the only alternative is maybe a little more minimum but if more pressure is disturbing sleep then we have to decide which is worse....a little less pretty on the reports or the wake ups from the pressure causing mouth opening issues when you didn't have them before.

How is the sleep quality in general?
If you couldn't see your reports...how would you rate your sleep and how you feel?

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

badgerwooz
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Re: New User - High AHI

Post by badgerwooz » Sun Oct 19, 2014 12:19 pm

The sleep seems to be better. The mouth breathing isn't causing me to wake up at all. I've noticed it after waking up for bathroom break or when alarm goes off in the morning.