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...
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.