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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Rob K
 
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Re: New to the forum. Looking for answers.

Postby Rob K on Tue Feb 07, 2017 9:56 pm

Woke around 8 times through last night. Pretty typical night for me. Morning headache and felt pretty bad and tired today. A little less sleep than normal with only about 6 hours or so. I was up way too late. Got exited studying all my data, reading the forum, learning what changes I can try to make.

Here's one night of data at a minimum pressure of 6 and max of 12. I'm changing it to minimum of 8 and max of 12 starting now. How much time should I give it before I post my results?

Obviously I need to learn how to interpret my own data and know how to make adjustments. Where's a good place to read about how to do this?

Click on thumbnail for large image.
Image

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Sleepyhead software

Rob K
 
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Re: New to the forum. Looking for answers.

Postby Rob K on Mon Feb 13, 2017 1:40 pm

I'm starting to feel a little better after several days and starting to feel more alert during the day. I think we are headed in the right direction.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Sleepyhead software

Rob K
 
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Re: New to the forum. Looking for answers.

Postby Rob K on Mon Feb 13, 2017 1:47 pm

I posted a comment on another thread that raised the question of whether or not my cpap was working correctly. I described my S1 Auto as giving me a blast of air when I stop breathing. Everyone was saying this is not possible, because these machines increase pressure slowly. I just tested it and it seems to work the same as it always has. The pressure increase is not a lot, but it takes only a second to increase and it is startling to me. To me is certainly seems like a blast of air. Could the machine be malfunctioning? Is it the change in pressure that wakes me up many times during the night?

Changing the pressure range to 8-12 seems to have helped a little with the way I feel, but it has not changed how many times I wake up. Still about 6-8 times per night on average. Mabye it's the blast of air from the machine that wakes me. The awakenings seem to correlate with my breathing events.

I guess the next step is to determine if the machine is working correctly.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Sleepyhead software

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Pugsy
 
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Re: New to the forum. Looking for answers.

Postby Pugsy on Mon Feb 13, 2017 1:56 pm

We would need to zoom in real close on the pressure line right at the time you are awakened from what you think feels like a blast of air.
Need to see for sure what the pressure is and what it is responding to.
It wouldn't be impossible for the reason for the wake up to be something else and any slight pressure increase was a response to the whatever. Maybe it's the apnea events disturbing the sleep and causing the wake ups and not the pressure but you notice the pressure more for some reason.

Your machine can't deliver a real blast of air but if you wake up suddenly it could be that the increase (whatever it might be) is perceived by your brain as a "blast".

It is also possible that you are just super sensitive to pressures above a certain line in the sand...essentially that the changing pressures that apaps do could be a factor in the wake ups. You might do better with a more limited range of apap pressure or even a fixed pressure.

I am betting if you zoom in on the pressure graphs..and look at the minute by minute second by second increase or decrease you will see a very gradual going up and down of the pressure line. Gotta zoom in real close to see it though...can't be seen from the initial overview graphs.

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Machine: AirCurve™ 10 S BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Actually using the AirCurve 10 ST but using it in S mode...have the S9 Adapt for backup right now.

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Pugsy
 
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Re: New to the forum. Looking for answers.

Postby Pugsy on Mon Feb 13, 2017 2:02 pm

Next time you sleep...try this for an experiment if you can.
With each wake up reach over and turn the machine off and then right back on...then you will have a definite known wake up so you can evaluate what was going on immediately prior to that wake up. Turning it off and right back on will "mark" the therapy line in such a manner that you will know for sure where to look on the reports and where to zoom in to see what the pressure was doing.

Those little spikey pointy pressure things you are seeing on your pressure graph...those changes actually take place over a period of several minutes but you have to zoom in real close to see the gradual change. They look abrupt and fast and high on the initial detailed graphs but that's simply a byproduct of the scale used. To see the real change you have to change the scale so it's more along the lines of second by second or the entire graph just showing 3 or 4 minutes instead of hours.

_________________
Machine: AirCurve™ 10 S BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Actually using the AirCurve 10 ST but using it in S mode...have the S9 Adapt for backup right now.

Rob K
 
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Re: New to the forum. Looking for answers.

Postby Rob K on Mon Feb 13, 2017 2:26 pm

Excellent idea. I see what you mean about the the slow increase in pressure from zooming in and looking at my graphs. I just did a test with my machine by holding my breath. The pressure increase does seem instantaneous and significant. It's definitely startling when in a semi-conscious state right before drifting off. I don't understand. The graph is telling me something different than what I am experiencing.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
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Pugsy
 
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Re: New to the forum. Looking for answers.

Postby Pugsy on Mon Feb 13, 2017 2:50 pm

Rob K wrote:The graph is telling me something different than what I am experiencing.


:lol: :lol: The graph is showing you what really happened and your brain is trying to tell you it was something different.
The brain is powerful...but not always correct.

I wonder if you are sensing the pressure pulses since you mention noticing it while awake and trying to fool the machine which I assume means you held your breath to see what happens.

The usual procedure when the Respironics machine is confronted with a cessation of breathing and it can't immediately tell what is causing it...like a central (that's what you are doing when you hold your breath on purpose...no air is moving but the airway is open) or the cessation or reduction in air flow is caused by airway tissues collapsing which is obstructive in nature...
Is to do a little pressure pulse to help it identify if the airway is open or closed...I am not sure how strong that pressure pulse is but maybe that is what you are experiencing. I know some people say they can feel pressure pulses (they are extremely brief and won't show up on the pressure line graph itself but instead are shown in a different area on the flow rate graph).

So maybe that's what you are experiencing...It's a little hash mark slice thing on the graphs...they are very small.
When you do your experimenting...look for little hash marks on the very top of the flow rate graph.
I see some on the recent report you just posted. They appear to be red hash marks to my eye. First one appearing to be right below the period in the 2.11 AHI number...can you see them?

_________________
Machine: AirCurve™ 10 S BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Actually using the AirCurve 10 ST but using it in S mode...have the S9 Adapt for backup right now.

D.H.
 
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Re: New to the forum. Looking for answers.

Postby D.H. on Mon Feb 13, 2017 6:58 pm

It could be that even a small change in pressure seems like a dramatic one to you. Just an individual thing.

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D.H.
 
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Re: New to the forum. Looking for answers.

Postby D.H. on Mon Feb 13, 2017 7:02 pm

You report you name is "Rob," but you don't state you're gender (could be Robert or Roberta). Most cases of fibromyalgia are diagnosed in women, it seems to be fairly uncommon in men.

Have you tried using a humidifier (your SleepyHead report said you're not using one)?

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Pugsy
 
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Re: New to the forum. Looking for answers.

Postby Pugsy on Mon Feb 13, 2017 7:08 pm

D.H. wrote:(your SleepyHead report said you're not using one)


There's a known bug in SH where SH says the humidifier isn't attached but it is and it's working just fine.

_________________
Machine: AirCurve™ 10 S BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Actually using the AirCurve 10 ST but using it in S mode...have the S9 Adapt for backup right now.

Rob K
 
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Re: New to the forum. Looking for answers.

Postby Rob K on Mon Feb 13, 2017 7:21 pm

First, thank you so much for taking the time to help me understand the details.

I see what you are saying about the pulses. I did hold my breath for a test. I can feel the very small pulses and very slight pressure changes, but after a little bit the pressure does increase a fair amount. I don't know how much it is, but it feels like a "blast of air" to me. It is instant and very noticeable and much louder through my mask which startles me when I'm drifting off. It only takes a second or two to ramp up. This only happens when I'm going to sleep that I know of. Not sure if this is waking me up during sleep or not. Hopefully I can figure that out. I always have the ramp mode on when I start the machine so maybe that is part of what's happening.

Holding my breath is a legitimate test since it is exactly what I am doing when I'm in that state between awake and sleep. My airway is not obstructed, but I stop breathing or hold my breath without knowing it. Or my breathing is so very shallow at that time that the machine springs into action. When I'm laying there starting to drift off to sleep I don't notice the pulses, but when the pressure and sound kicks in I'm startled awake by it. It snaps me back to an awake state where I think to myself, wow the machine blasted me with some air right there so I must have been holding my breath again. Like I said the pressure difference doesn't seem to be extreme, but it is startling. The sound definitely becomes much louder and that may be due to the Airfit N10 mask I am using and small leakage.

My machine does seem to ramp up the pressure instantly after going through a number of pulses and slight pressure changes. Maybe this doesn't happen for most people, but it is for me. Wish I could see in real time what the pressure is doing. I'm starting to think the pressure is not extreme, but the sound is. That is probably startling me more than the pressure.

I have the Remstar S1Auto 560P with software version 3.04

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Sleepyhead software

Rob K
 
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Gender: Male

Re: New to the forum. Looking for answers.

Postby Rob K on Mon Feb 13, 2017 7:25 pm

I didn't report gender since I didn't think anyone needed to know. I do have a humidifier and I range from 0-3 through the year. I never use the heat.

And yes I'm starting to think a small change in pressure is dramatic to me.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: PR System One 60 Series Heated Tube Humidifier with Heated Tube
Additional Comments: Sleepyhead software
Last edited by Rob K on Mon Feb 13, 2017 7:27 pm, edited 1 time in total.

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palerider
 
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Re: New to the forum. Looking for answers.

Postby palerider on Mon Feb 13, 2017 7:27 pm

Pugsy wrote:Your machine can't deliver a real blast of air but if you wake up suddenly it could be that the increase (whatever it might be) is perceived by your brain as a "blast".

It is also possible that you are just super sensitive to pressures above a certain line in the sand...essentially that the changing pressures that apaps do could be a factor in the wake ups. You might do better with a more limited range of apap pressure or even a fixed pressure.

I bet he's talking about that 1cm pressure pulse... first time I've ever heard anybody describe that tiny thing as "a blast of air".

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Rob K
 
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Re: New to the forum. Looking for answers.

Postby Rob K on Mon Feb 13, 2017 7:30 pm

You people are fast. Several posts pop up while I'm editing what I just posted so it makes more sense.lol

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Pugsy
 
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Re: New to the forum. Looking for answers.

Postby Pugsy on Mon Feb 13, 2017 7:45 pm

Rob K wrote:Maybe this doesn't happen for most people, but it is for me. Wish I could see in real time what the pressure is doing. I'm starting to think the pressure is not extreme, but the sound is. That is probably startling me more than the pressure.


You only have the graphs to look at. Can't see it in real time.

You know another possibility...your machine will respond to apnea events during the ramp period if the criteria that causes the machine to increase the pressures are present.
It's possible as you start to fall asleep that the airway is already trying to collapse and a snore of flow limitation makes the machine decide to start increasing....maybe you are just so sensitive to the change that it feels like a big change.
We know the machine can't possibly do a big change quickly but that doesn't mean that you couldn't be sensitive to some little change.

Maybe don't use ramp at all or cut the time way down so there's no chance of you still being in ramp when you start to fall asleep. See what happens.
During ramp your machine will respond (some brands won't) if it thinks the airway is trying to collapse and if you are using a sub optimal pressure it certainly would be possible for the airway to collapse or try to. When whatever it responds to has come and gone then it goes back down to where it was during the ramp progression and then continues to work up to the minimum.
So either don't use ramp...or cut the time in ramp way down..or if ramp must be used then start it out higher than 4 or 5 cm.

Snores and flow limitations are part of the criteria that will cause the machine to start increasing the pressure because for that criteria the machine will actually respond where as with an OA that happens the machine waits until it has passed before it decides if it wants to do anything or not.

Awake...fake events that you try to do by holding your breath...you can't count on the machine responding normally to those or even flagging accurately. That's why we ignore awake breathing anything.

So...to be clear...I don't doubt that you aren't feeling something that is out of the ordinary for you...but it can't be a rapid big burst of pressure because your machine won't/can't do anything fast like in a few seconds...it takes a few minutes.
But it could be a small increase that seems big to you.
Is that maybe small increase enough to wake you up...might be...also might be that whatever caused the machine to maybe increase the pressure could also be responsible for the wake up.

Also remember...some wake ups during the night are entirely normal and don't mean a thing bad...like did you know it's normal to wake up after a REM sleep cycle and we might have several REM cycles during a night.

On the off chance that you are one of those people who are simply super sensitive to the least little pressure changing...might want to consider trying fixed pressure for a while (set minimum to equal max so you don't lose FL flagging) and see if it changes the sleep quality or not.
Don't ask me what fixed pressure though...I haven't seen enough of your reports to get a good idea yet especially since your minimum pressure still isn't quite optimal.

So some homework for you to do.
1...the turn the machine off and back on again so you can better isolate known awake times on your reports for reviewing.
2...make changes to ramp either by turning it off...cutting down the time or starting the ramp higher
3...consider fixed pressure trial to see if eliminating any variations in pressure make any difference with your wake ups.

You don't have to do all of them at one time though... :lol:
Remember science 101...for experiments keep your variables to a minimum so you can better know which part of the experiment change was likely responsible for any change in something.

_________________
Machine: AirCurve™ 10 S BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Actually using the AirCurve 10 ST but using it in S mode...have the S9 Adapt for backup right now.

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