Do I need to raise my Maximum Pressure (Clusters)

[fdw]

Bear with me.......

You might even be able to try 12 min and 12 max with EPR turned off.


Den

.

So your suggesting straight CPAP

Kinda sounds that way, doesn't it. (Yes, that's my suggestion.)
The problem (as I see it) is with your Flow Limitations. They're driving unnecessary pressure increases.

I see lots of spaces in your report where your events are pretty non-existent and your pressures are at their minimum.


Den

.

Den,

Last nights's results are somewhat positive with a few exceptions, hopefully you will stay with me through this process.

Some of my observations are:

95% Flow Limitations have doubled?
Rate of breaths per minute (Breaths/min) W-Avg: 17.10 somewhat higher?
I believe I woke up every 60-90 minutes....I don't see any evidence of that in the graph though (unless Im just unaware to look), but I did wake several times. My legs feel a little heavy this morning to me that means Im tired.

Thanks

https://lh3.googleusercontent.com/-Kvff ... 73353.jpeg

[fdw]

If anyone would like to chime in on my last post please feel free too.

[Sleeprider]

It looks pretty darn good to me except you spent a little over 4 minutes in apnea on relatively few events. You are operating the unit as a fixed pressure CPAP and it seems to work pretty well. On the other hand, it's not statistically a significantly different result than you had with a pressure range of 12.8-14 using EPR, although you've driven down the OA and have replaced it with H which would seem to be an improvement.

Kinda hard to say. You might try this for a while, or plug your max pressure of 14 back in and leave off the EPR. I think that EPR is a bigger problem than a little bit of pressure drift that you might need to deal with a few OA and H events in REM sleep.

[Wulfman...]

Last nights's results are somewhat positive with a few exceptions, hopefully you will stay with me through this process.

Some of my observations are:

95% Flow Limitations have doubled?
Rate of breaths per minute (Breaths/min) W-Avg: 17.10 somewhat higher?
I believe I woke up every 60-90 minutes....I don't see any evidence of that in the graph though (unless Im just unaware to look), but I did wake several times. My legs feel a little heavy this morning to me that means Im tired.

Thanks

Looks pretty good to me, too.
I'd suggest letting these setting "ride" for about a week and see how things look at that point.
The thing about the Flow Limitations is that they're at least not affecting your pressure.
And, your obstructive events look to be fewer than they were.
Too many changes too quickly can muddle the data. It can take weeks to months sometimes to see the optimal results.


Den

.

[fdw]

Last nights's results are somewhat positive with a few exceptions, hopefully you will stay with me through this process.

Some of my observations are:

95% Flow Limitations have doubled?
Rate of breaths per minute (Breaths/min) W-Avg: 17.10 somewhat higher?
I believe I woke up every 60-90 minutes....I don't see any evidence of that in the graph though (unless Im just unaware to look), but I did wake several times. My legs feel a little heavy this morning to me that means Im tired.

Thanks

Looks pretty good to me, too.
I'd suggest letting these setting "ride" for about a week and see how things look at that point.
The thing about the Flow Limitations is that they're at least not affecting your pressure.
And, your obstructive events look to be fewer than they were.
Too many changes too quickly can muddle the data. It can take weeks to months sometimes to see the optimal results.


Den

.

Possiblly the zero EPR setting change MAY have caused my many wake-ups last night.....Just don't know.

Can you (someone) help me understand why I would have woke up every 60-90 minutes by making the change from APAP 12.8 -14.0 and EPR 1 to CPAP 12.2 and EPR 0.

Thank you

[Wulfman...]

Last nights's results are somewhat positive with a few exceptions, hopefully you will stay with me through this process.

Some of my observations are:

95% Flow Limitations have doubled?
Rate of breaths per minute (Breaths/min) W-Avg: 17.10 somewhat higher?
I believe I woke up every 60-90 minutes....I don't see any evidence of that in the graph though (unless Im just unaware to look), but I did wake several times. My legs feel a little heavy this morning to me that means Im tired.

Thanks

Looks pretty good to me, too.
I'd suggest letting these setting "ride" for about a week and see how things look at that point.
The thing about the Flow Limitations is that they're at least not affecting your pressure.
And, your obstructive events look to be fewer than they were.
Too many changes too quickly can muddle the data. It can take weeks to months sometimes to see the optimal results.


Den

.

Possiblly the zero EPR setting change MAY have caused my many wake-ups last night.....Just don't know.

Can you (someone) help me understand why I would have woke up every 60-90 minutes by making the change from APAP 12.8 -14.0 and EPR 1 to CPAP 12.2 and EPR 0.

Thank you

Not for sure. Sleep stages supposedly cycle in 90 - 120 minute periods. Don't know if there's a connection of some sort or not. Anything in your dwelling that may kick on or off around those times? Local traffic?


Den

.

[Wulfman...]

Just looked again at last night's report. There seemed to be some little leak spikes (possibly) at some of those intervals.
Maybe they contributed to or were the result of your sleep disturbances.


Den

.

[fdw]

Just looked again at last night's report. There seemed to be some little leak spikes (possibly) at some of those intervals.
Maybe they contributed to or were the result of your sleep disturbances.


Den

.

No inside or outside disturbances

I agree with the leaks assessment possibly causing the wakes. For tonight I'm staying straight CPAP 13.2 and EPR 1.0, for some reason not having EPR on has caused leaks in the past.

[archangle]

I've been doing OK for a while but recently I've noticed cluster OA's in some of the OA's they've lasted as long as 47 seconds (according to SH).

Zoom in on one of those long OA's in SleepyHead and post them. Sometimes they're not as clear cut as you might think. Have the apnea take up about half of the screen right to left.

You can go to the "event" tab and click on the event to automatically zoom in or do it manually.

[fdw]

I've been doing OK for a while but recently I've noticed cluster OA's in some of the OA's they've lasted as long as 47 seconds (according to SH).

Zoom in on one of those long OA's in SleepyHead and post them. Sometimes they're not as clear cut as you might think. Have the apnea take up about half of the screen right to left.

You can go to the "event" tab and click on the event to automatically zoom in or do it manually.

Hope this helps define.

https://lh5.googleusercontent.com/-3nfF ... 84350.jpeg

[palerider]

well, it's clear the machine would like to give you more pressure to prevent having more of those.

[archangle]

Hope this helps define.

https://lh5.googleusercontent.com/-3nfF ... 84350.jpeg

Individually those are bad. However, there aren't that many in a night. You also get about 10 seconds of good breaths between apneas. You also seem to be doing these clusters only about 3 minutes at a time.

I suspect most sleep docs would look at the AHI and not worry about it.

Don't panic, but keep an eye on it, especially if you start getting even longer apneas, longer clusters, or shorter breathing breaks between the individual apneas.

Are you having any symptoms of problems?

[fdw]

Hope this helps define.

https://lh5.googleusercontent.com/-3nfF ... 84350.jpeg

Individually those are bad. However, there aren't that many in a night. You also get about 10 seconds of good breaths between apneas. You also seem to be doing these clusters only about 3 minutes at a time.

I suspect most sleep docs would look at the AHI and not worry about it.

Don't panic, but keep an eye on it, especially if you start getting even longer apneas, longer clusters, or shorter breathing breaks between the individual apneas.

Are you having any symptoms of problems?

Not panicing...I've had OS's lasting from 10 seconds to 49 seconds in the past I just really never looked at length of OA's and NO one has ever ask until you. BTW I have Jesus as my God, archangel.

Symptoms.......would be heart skipped beats (PVC's), tired. I do have a Pacemaker/Defibulator.

Last night's results were a lot better 3 OA lasting no longer than 11 seconds, BUT I did have 2 back to back CA's lasting 20 and 16 seconds.

Here's last night results.......any suggestions? https://lh6.googleusercontent.com/-TrmC ... 80106.jpeg

[Wulfman...]

Not panicing...I've had OS's lasting from 10 seconds to 49 seconds in the past I just really never looked at length of OA's and NO one has ever ask until you. BTW I have Jesus as my God, archangel.

Symptoms.......would be heart skipped beats (PVC's), tired. I do have a Pacemaker/Defibulator.

Last night's results were a lot better 3 OA lasting no longer than 11 seconds, BUT I did have 2 back to back CA's lasting 20 and 16 seconds.

Here's last night results.......any suggestions?

Ooooooooooh......WOW! 0.57 AHI. Goot yob!

Yeah, I reread your first post last night and remembered what you had mentioned:

I now have a Pacemaker/Defibrillator implanted back in mid October 2014

Which may be another advantage of not using a range of pressures.


Den

.

[fdw]

Not panicing...I've had OS's lasting from 10 seconds to 49 seconds in the past I just really never looked at length of OA's and NO one has ever ask until you. BTW I have Jesus as my God, archangel.

Symptoms.......would be heart skipped beats (PVC's), tired. I do have a Pacemaker/Defibulator.

Last night's results were a lot better 3 OA lasting no longer than 11 seconds, BUT I did have 2 back to back CA's lasting 20 and 16 seconds.

Here's last night results.......any suggestions?

Ooooooooooh......WOW! 0.57 AHI. Goot yob!

Yeah, I reread your first post last night and remembered what you had mentioned:

I now have a Pacemaker/Defibrillator implanted back in mid October 2014

Which may be another advantage of not using a range of pressures.


Den

.

Den,

I thought I'd read once upon a time that varying pressures were found to potentially cause issues with the cardiovascular system.
Is that what your referring to, or something different? Does that include EPR?

How do I know if I need to increase or decrease my pressure now that I'm on straight CPAP especially if I see OA's that are longer than just the traditional time frame?

Sorry for so many questions......just trying to get better