Frequent Awakenings

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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OkyDoky
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Re: Frequent Awakenings

Post by OkyDoky » Wed Jan 28, 2015 4:40 pm

Java, I commend your persistance and do believe you can find a much better setting. Whatever setting you choose, give it a couple of days then post a daily screen shot for help here until you find your best pressure. Den uses and likes straight Cpap, and it does eliminate the swings of auto. If you find it difficult to exhale at that pressure it can be set bilevel with a higher Ipap and lower epap. Sleeprider was able to tune his in with auto settings and I started with fixed bipap and like my settings of 15/11. So with your machine you do have several options and with monitoring you can see the effects of your changes and keep working until you find your best settings. Keep us informed of your progress both in how you feel and how your reports look.
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Java
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Re: Frequent Awakenings

Post by Java » Wed Jan 28, 2015 6:19 pm

OkyDoky wrote:Java, I commend your persistance and do believe you can find a much better setting. Whatever setting you choose, give it a couple of days then post a daily screen shot for help here until you find your best pressure. Den uses and likes straight Cpap, and it does eliminate the swings of auto. If you find it difficult to exhale at that pressure it can be set bilevel with a higher Ipap and lower epap. Sleeprider was able to tune his in with auto settings and I started with fixed bipap and like my settings of 15/11. So with your machine you do have several options and with monitoring you can see the effects of your changes and keep working until you find your best settings. Keep us informed of your progress both in how you feel and how your reports look.
I was testing some settings, and I cannot exhale at 12. I had to tinker with some settings and I am comfortable trying 13/10. I know its not 12/12 but it's where I feel comfortable. I guess I will just wait and see how I sleep tonight and go from there.
Wulfman... wrote:I couldn't see in that report whether your Bi-PAP was set to use BiFlex or what setting. If you don't "need" a Flex setting with the APAP, so much the better. Otherwise, either an A-Flex or C-Flex setting of "1" or "2" would probably be OK.
I tried to turn the flex off and had trouble exhaling. I have the flex on 2 right now.

Thanks again everyone and I hope I see some changes in my sleep tonight. I know it won't happen right away, but maybe I'm at least headed in the right direction with all your help!
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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Wed Jan 28, 2015 6:31 pm

That's all you can do at this point......."tinker"........because your other settings weren't doing you any good.
I'm actually surprised you've made it this far that way. Stick with your determination.


Den

.
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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Wed Jan 28, 2015 6:34 pm

Java wrote:
OkyDoky wrote:Java, I commend your persistance and do believe you can find a much better setting. Whatever setting you choose, give it a couple of days then post a daily screen shot for help here until you find your best pressure. Den uses and likes straight Cpap, and it does eliminate the swings of auto. If you find it difficult to exhale at that pressure it can be set bilevel with a higher Ipap and lower epap. Sleeprider was able to tune his in with auto settings and I started with fixed bipap and like my settings of 15/11. So with your machine you do have several options and with monitoring you can see the effects of your changes and keep working until you find your best settings. Keep us informed of your progress both in how you feel and how your reports look.
I was testing some settings, and I cannot exhale at 12. I had to tinker with some settings and I am comfortable trying 13/10. I know its not 12/12 but it's where I feel comfortable. I guess I will just wait and see how I sleep tonight and go from there.
Wulfman... wrote:I couldn't see in that report whether your Bi-PAP was set to use BiFlex or what setting. If you don't "need" a Flex setting with the APAP, so much the better. Otherwise, either an A-Flex or C-Flex setting of "1" or "2" would probably be OK.
I tried to turn the flex off and had trouble exhaling. I have the flex on 2 right now.

Thanks again everyone and I hope I see some changes in my sleep tonight. I know it won't happen right away, but maybe I'm at least headed in the right direction with all your help!
Just so we're straight on this......... Are you configuring/using your Bi-PAP or your APAP?


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
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Java
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Re: Frequent Awakenings

Post by Java » Wed Jan 28, 2015 8:04 pm

This is the BiPAP. I didn't think it mattered since I am manually putting in the settings. Or am I wrong?
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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Wed Jan 28, 2015 8:41 pm

Java wrote:This is the BiPAP. I didn't think it mattered since I am manually putting in the settings. Or am I wrong?
Don't know yet. Go for it and see how things work out. Never know till ya try. Between the two machines, there's a multitude of settings that could be tried.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
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Pugsy
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Re: Frequent Awakenings

Post by Pugsy » Thu Jan 29, 2015 12:21 pm

The 760 has a multitude of setting options to make it even work like apap with a little or a lot PS if a person wants to do that.
There should be a PS minimum and maximum setting available. Looks like it is wide open but even though wide open is available it isn't running wide open and in fact most of the time PS is minimal.

You have had insomnia issues for 12 years and I don't think that the machine settings is the primary problem but the settings sure aren't doing you any favors the way they are right now.

I had trouble following your current experimental settings. Can you state them again please?
Mode...either auto or fixed bilevel (there is also cpap mode available)
EPAP
IPAP max (if using auto mode)
PS...if in auto mode there will be a PS minimum and PS maximum

Can you get me a copy of last night's report with your current experimental settings please? I have some ideas to maybe help you use bilevel (for comfort) and also limit pressure changes which might be a factor in sleep disturbances (but I doubt it is the primary problem) so won't hurt to at least try that avenue.
Turn off the AHI graph as it is unneeded. All I want to see in terms of graphs on the right side are these
Events
Flow rate
Pressure
Leak
and on the left side...include the AHI bar graphs and statistics as you have already shown.

Also...are you taking any meds and if so, what? I probably have asked you this question in the past but I have forgotten.

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Java
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Re: Frequent Awakenings

Post by Java » Thu Jan 29, 2015 3:22 pm

Pugsy wrote:The 760 has a multitude of setting options to make it even work like apap with a little or a lot PS if a person wants to do that.
There should be a PS minimum and maximum setting available. Looks like it is wide open but even though wide open is available it isn't running wide open and in fact most of the time PS is minimal.

You have had insomnia issues for 12 years and I don't think that the machine settings is the primary problem but the settings sure aren't doing you any favors the way they are right now.

I had trouble following your current experimental settings. Can you state them again please?
Mode...either auto or fixed bilevel (there is also cpap mode available)
EPAP
IPAP max (if using auto mode)
PS...if in auto mode there will be a PS minimum and PS maximum

Can you get me a copy of last night's report with your current experimental settings please? I have some ideas to maybe help you use bilevel (for comfort) and also limit pressure changes which might be a factor in sleep disturbances (but I doubt it is the primary problem) so won't hurt to at least try that avenue.
Turn off the AHI graph as it is unneeded. All I want to see in terms of graphs on the right side are these
Events
Flow rate
Pressure
Leak
and on the left side...include the AHI bar graphs and statistics as you have already shown.

Also...are you taking any meds and if so, what? I probably have asked you this question in the past but I have forgotten.
Here is last night. The new settings didn't help. I need to try something else.

During the day I take 2mg Valium (twice a day for a vestibular disorder). At night I take up to 1.5mg Klonopin for RLS as needed. Other than that, I don't take anything besides vitamins and supplements. D3, Fish oil, CoQ10, B12 Vit C, Turmeric, Magnesium.

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Pugsy
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Re: Frequent Awakenings

Post by Pugsy » Thu Jan 29, 2015 3:37 pm

Do you wish to stay with fixed bilevel mode as it was last night or try auto bilevel mode with a small range.
Last night's settings allowed too many snores...not quite enough pressure but AHI is acceptable.

One more question...do you have any other health issues? Fibromyalgia or Chronic Fatigue Syndrome? Anything like that?

It's odd but SleepyHead says in one area your PS was 3 but in another area 0...and your pressure graph doesn't look like PS was even on.

Are you using the ramp feature with each wake up?

If you wish to try auto bilevel mode...these settings might be a good starting point.

Minimum EPAP 12
Maximum IPAP 20
PS...minimum PS of 3 and maximum PS of 5 (note you may have to change the maximum first before it will let you change minimum)

If you wish to try fixed bilevel mode.
EPAP 12 and IPAP 15 and make sure that PS shows 3.
You should have 2 pressure lines when bilevel and PS is something other than 0.

So that the pressure graphs show 2 distinct lines...like this one. This is auto bilevel mode...if it were fixed bilevel mode it would show 2 pressure lines that were straight.
Image

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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Thu Jan 29, 2015 4:03 pm

Yeah, your EPAP pressure is a bit low, which is allowing too many snores and other stuff.
That's kind of why I was thinking about a pressure of about 12 cm., which might keep some of those at a minimum.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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Java
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Re: Frequent Awakenings

Post by Java » Thu Jan 29, 2015 4:10 pm

Pugsy wrote:Do you wish to stay with fixed bilevel mode as it was last night or try auto bilevel mode with a small range.
Last night's settings allowed too many snores...not quite enough pressure but AHI is acceptable.

One more question...do you have any other health issues? Fibromyalgia or Chronic Fatigue Syndrome? Anything like that?

It's odd but SleepyHead says in one area your PS was 3 but in another area 0...and your pressure graph doesn't look like PS was even on.

Are you using the ramp feature with each wake up?

If you wish to try auto bilevel mode...these settings might be a good starting point.

Minimum EPAP 12
Maximum IPAP 20
PS...minimum PS of 3 and maximum PS of 5 (note you may have to change the maximum first before it will let you change minimum)

If you wish to try fixed bilevel mode.
EPAP 12 and IPAP 15 and make sure that PS shows 3.
You should have 2 pressure lines when bilevel and PS is something other than 0.

So that the pressure graphs show 2 distinct lines...like this one. This is auto bilevel mode...if it were fixed bilevel mode it would show 2 pressure lines that were straight.
I honestly don't care if it is fixed or auto. I just want whatever is going to help me sleep. I suppose I will try auto Bilevel mode tonight with the settings you suggested. I never use ramp. I do have Fibromyalgia, Chronic Fatigue, and Restless Legs, and to be honest if it matters, I am overweight (very).
Thank you!
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Java
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Re: Frequent Awakenings

Post by Java » Thu Jan 29, 2015 4:12 pm

Wulfman... wrote:Yeah, your EPAP pressure is a bit low, which is allowing too many snores and other stuff.
That's kind of why I was thinking about a pressure of about 12 cm., which might keep some of those at a minimum.


Den

.

I will try the 12 like you suggested. Pugys suggested it too, so you guys must know what you are talking about. I will change my settings and update again tomorrow. Thank You!!!!!
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Re: Frequent Awakenings

Post by Java » Thu Jan 29, 2015 4:35 pm

Pugsy wrote: If you wish to try auto bilevel mode...these settings might be a good starting point.

Minimum EPAP 12
Maximum IPAP 20
PS...minimum PS of 3 and maximum PS of 5
Pugsy, does this look right?
I just set it up and laid down a bit and it sure feels like it's blowing hard!!

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Pugsy
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Re: Frequent Awakenings

Post by Pugsy » Thu Jan 29, 2015 4:43 pm

I will be honest...I don't know if the solution to your sleep issues can be found within the machine settings. If it is the pressure itself that is the problem then maybe but if your sleep problems are related more to your other health issues (which are known sleep disruptive) then it's going to be a big uphill battle but doesn't hurt to try machine settings.

Those settings you just showed.
You should be seeing 12 exhale and 15 inhale while awake...is that horrible to you?
In auto mode these would be the same settings if you used fixed bilevel mode with 12/15 and PS of 3...because in auto mode it won't change from those setting until you go to sleep and apnea events drive the pressure changes.

Do you have BiFlex turned off? If you do....try turning BiFlex on and play with the settings to see if it helps or not.

If you can't get comfortable with starting EPAP of 12...we can move it slowly up from 10 EPAP if we have to...maybe try 10.5 EPAP with PS of 3 to 5...so start small and work up.
Only change you would need to try right now would be change the EPAP min from 12 to 10.5. I think you will need more EPAP but if you can't get comfortable with it...then we just start lower and work up gradually as you get used to it.

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Wulfman...
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Re: Frequent Awakenings

Post by Wulfman... » Thu Jan 29, 2015 4:44 pm

I think Auto Bi-level is part of the problem, but go ahead and try it and see. That's the only way you're going to find out.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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