Need some help

[lzicc]

I had a bad night last night. Not sure if it was from changing the settings or not, but at one time, early in the night, I took the mask off. I was half asleep when I was doing it, but remember taking it off. I put it back on at some point. It's all a dream to me. I got up a few times throughout the night which I usually don't. I have a slight headache this morning which I never get headache, so I am not sure what this all means. It could be that I just put a bad night in. Here are the stats though. I also remember the top straps of my mask got real loose. I tightened them up at one point.

[lzicc]

Last night I changed my pressure to 12 and below are the results. They look better except for the RERA. What would cause that?

[Pugsy]

I would just watch the RERAs for now. See what happens long term with the new pressure once your body adjusts.


RERA

Respiratory Event Related Arousal... a sequence of breaths characterized by increasing respiratory effort leading to an arousal from sleep, but which does not meet criteria for an apnea or hypopnea.”

RERA Detection in the Respironics System One data..Respiratory effort-related arousal..defined as an arousal from sleep that follows a 10 second or longer sequence of breaths that are characterized by increasing respiratory effort, but which does not meet criteria for an apenea or hypopnea. Snoring, though usually associated with this condition need not be present. The RERA algorithm monitors for a sequence of breaths that exhibit both a subtle reduction in airflow and progressive flow limitation. If this breath sequence is terminated by a sudden increase in airflow along with the absence of flow limitation, and the event does not meet the conditions for an apnea or hypopnea, a RERA is indicated.

[lzicc]

So do you think I should leave the pressure where it is at for now? I did notice between the pressure of 11 one night and then 12 the other night, the AHI went down allot.

[Pugsy]

Yes, I would leave the pressure alone for now.
Let your body get more adjusted...the AHI is great...the RERA may or may not be significant.
It's not hugely high and it could just be related to little minor arousals which might not be clinically significant.
I don't normally worry about RERAs unless I see a lot of them along with OAs and hyponeas and Flow limitations (which we can't see on fixed pressures because the machines doesn't flag FLs unless auto pressure mode is used).
Let's see what trend develops and see how your sleep in general goes.

[lzicc]

Thanks for input. I'll let it run at 12 for the next few nights and see how the data looks moving forward.

[lzicc]

One other thing I noticed that since I changed the mode to cpap, I wake up with faint headaches and the headaches last throughout the day.

[Pugsy]

since I changed the mode to cpap, I wake up with faint headaches and the headaches last throughout the day.

Coincidence.
You were using cpap in the CPAP check mode....only difference is the 30 hour evaluation and maybe a pressure change.
Otherwise..it's the same cpap fixed pressure...the way it is delivered is the same with either "mode"

Now you did increase the pressure but the mode itself is cpap whether it does the 30 hour check thing or not.

[lzicc]

So what is the difference between either mode? Does the check mode change pressure as needed or does the pressure stay the same throughout the night? I noticed in my one screen shot of the statics that it would say APAP mode with a pressure of 7.0 to 13.

[palerider]

So what is the difference between either mode? Does the check mode change pressure as needed or does the pressure stay the same throughout the night? I noticed in my one screen shot of the statics that it would say APAP mode with a pressure of 7.0 to 13.

check mode gives you a fixed pressure through the night, and 'checks' to see if it's doing ok at regular intervals of a few days, (I want to say every 30 hours, but I'm not sure about that)

[Pugsy]

I noticed in my one screen shot of the statics that it would say APAP mode with a pressure of 7.0 to 13.

SleepyHead is confused. It has the settings wrong. You aren't in APAP mode and the pressure isn't 7 to 13.
It was 10 until you changed it. Just look at the pressure graph...that's fixed cpap mode. It doesn't change the pressure throughout the night in CPAP check mode. What it does is every 30 hours it takes a look back at your AHI and decides if it needs to change something then it makes a change...and you get fixed cpap mode at whatever it may have thought it needed to change to.

[lzicc]

Here is the latest from last night. The Hynopea is high now. Should I keep running at this pressure or bump it up .5 maybe? Or could the pressure be too high?

[Sleeprider]

I don't know that I'd change things on one bad night. Those events usually respond to pressure, but your leak rate is relatively high here, and I think that has more to do with it. I'll leave you in Pugsy's capable hands, but that's what I see.

[Pugsy]

I also wouldn't change anything based on a single night's not so pretty report. I only changes things if I consistently see not so pretty reports. We all can have "off" nights every now and then...even myself now after all this time.

The pressure isn't too high though...when you see the increase in snores and hyponeas then those are signs the airway is trying to collapse either fully or partially.
Should this pattern continue then another 0.5 cm increase might be needed but unless you see this sort of thing night after night I wouldn't do anything...it isn't horribly horrible anyway.

[lzicc]

Ok, I'll let it run at 12 for now. I did tighten the mask last night to see if that helps. It's pretty tight now. I'll go a few nights then post the data.