Resmed is better?Pugsy wrote:I don't know that your sleep quality is necessarily related to your sleep apnea totally nor if you would feel better if the AHI is lower or not.
I have been down that road myself and for some people a nice low AHI does mean they can actually feel the difference in terms of how they feel during the day but for others (like myself) a nice low AHI doesn't mean much.
I don't know which way you will go or be.
If the last couple of hours of your night is highly fragmented then those 7 to 8 hours of "sleep" may not necessarily be the "best" sleep quality.
So the overall total of good sleep hours may be less and thus impacting how you feel.
Example....7 hours of total overall sleep but 2 hours of highly fragmented sleep means about 5 hours of "good" sleep...and that's a low enough number of hours to impact how we feel during the day. If you "sleep" 10 hours but only 5 hours is "good" solid sleep...you will still feel like crap...see what I mean?
I don't know that is what is going on with you but it's possible.
It's also possible that the small evidence we see in the software reports of continued minor airway flow reductions could be impacting sleep quality.
It is also possible that you need to give these new changes a bit of time for the body and mind to adjust to. Trust me...I have seen it first hand.
When I first started bilevel therapy and was titrating to an "acceptable" AHI I had to pick something and stick with it and see where it went.
I picked something that gave me about what you are seeing from last night in terms of AHI and snores and Fls ...and stuck with it for 6 weeks with some good nights of better numbers happening occasionally and some nights which were "bad" and I really had to resist the urge to change something.
Over the 6 weeks I noticed that my AHI and the clutter (that stuff that isn't part of the AHI) slowly started to reduce and I started having many more good nights than bad nights. My overall AHI average at the end of the 6 weeks experiment for the last week was 1/2 what it was for the first week of the experiment.
My point....numbers can improve simply with time.
Give yourself a week at these settings and make special note each night (keep a diary) of how you feel and the number of awakenings, etc along with hours of total sleep vs "good" solid sleep.
See how things are going....then re-evaluate the possible need for another increase in EPAP.
Don't be afraid of more pressure...I don't see you being one of those people where Centrals are caused by pressure.
I think that the bulk of your centrals are likely centrals getting flagged while you are awake or semi awake...since most of them are happening during the last couple of hours of sleep where we know you had more awakenings. If you notice your pressure doesn't do much during that time frame anyway....because you are awake and the airway is open and the machine doesn't sense the need to do much.
Always....always... include how you feel and how you perceive your sleep quality in your evaluations of anything.
This sleep quality thing is very, very important and it isn't always something we can blame on OSA or the therapy. I wish it were that easy.
This is something I am fighting right now myself. My numbers are to die for good but I don't always feel those good numbers because I know that some nights my sleep quality or hours of good sleep is simply in the toilet.
Getting "good" numbers is the easy part...feeling them is a totally different story.
At the end of a week if the numbers hold pretty much the same and you are feeling pretty much the same then try another increase in the minimum EPAP and try it for a week and seen how you do.
We don't sleep the same each night so basing changes on what we see last night is really pretty much chasing our tails. Unless the results are horrible...give things a chance to settle in and let your body and mind get used to the changes.
Remember....the overall picture and not just numbers is hugely important. So how you slept and how you feel is very important.
At some point if you ever get in a position to get another machine....try to get a ResMed auto adjusting something (either apap or bilevel) because I really think that you might do a bit better with the ResMed algorithm.
OK thank you so so much, I sure hope things go ok
If my IPap max was 14, and my epap was lower than 14...does this mean inhaling no apnea and exhaling apnea?