My CPAP Treatment Journey

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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ChicagoGranny
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Re: My CPAP Treatment Journey

Post by ChicagoGranny » Sun Nov 29, 2015 4:32 pm

Heart Jumping wrote:I can post SH results of a day in question if that's needed.
It would be better because it is unclear whether you are mixing up events and AHI in these two sentences --->
Heart Jumping wrote:, total events will typically be around 3. Then I'll go back to sleep and when I get up events are much higher, between 7-10.
Heart Jumping wrote:Either way events are still higher in the second sleep cycle.

Is this common? Any theories for why?
No theories, but a guess. So, it's better to see your timeline.

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zoocrewphoto
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Re: My CPAP Treatment Journey

Post by zoocrewphoto » Sun Nov 29, 2015 5:42 pm

Heart Jumping wrote:A couple of observations/questions.

1. Lately I've been getting up at least once during the night, often after 4 - 6 hours of sleep. If I look at the Resmed display at that time, total events will typically be around 3. Then I'll go back to sleep and when I get up events are much higher, between 7-10. I assume the Resmed combines the events from the two sleep events into one, if so that means the number of events in the second sleep event are even much higher, enough so that its increasing the average for the entire sleep cycle. Either way events are still higher in the second sleep cycle.

Thanks

AHI is the average per hour, not the total number of events. That means a total of 12-18 total events in 4-6 hours.

As for higher numbers later in your sleep, it is probably due to REM sleep. A lot of people have more events during REM sleep, and it is normal to have more REM sleep later during the night.

_________________
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Resmed S9 autoset pressure range 11-17
Who would have thought it would be this challenging to sleep and breathe at the same time?

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ChicagoGranny
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Re: My CPAP Treatment Journey

Post by ChicagoGranny » Sun Nov 29, 2015 5:45 pm

zoocrewphoto wrote: it is probably due to REM sleep
The Guess

WindCpap
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Re: My CPAP Treatment Journey

Post by WindCpap » Sun Nov 29, 2015 9:04 pm

Try increasing your pressure a little more to 9 so that the changes are not so abrupt. Also, was 15 your top prescribed pressure or the top pressure you set? You may want to turn it back down for now if it is not the prescribed pressure. 9-14 is a lot smaller change than 8-15.

It sounds like the machine is getting some false asleep readings. I got a bunch of those when I first started and I still get them occasionally when I am having trouble falling asleep. Basically you get relaxed and your breathing pattern matches a sleeping breathing pattern but you are not asleep. if you turn off the full time EPR, you will know when it has ramped up prematurely, and be able to reset the ramp to prevent the pressure swings from happening. It is also possible that the pressure swing is waking you from stage 1 sleep.

If the pressure swings are giving you trouble, you could try CPAP mode. I have been doing some reading, and one method for self-titrating for CPAP when you have an apap is to take the 95th percentile pressure over a week and use that. Studies show that if you use apap, 95th percentile, spouse adjusted until you stopped snoring, or lab titration, the results pretty much end up the same, so do whatever makes you the most comfortable.

I did some recent review of my first few nights data. My AHI was 3-4, and I was actually having several obstructive events in a night. Now, my AHI is rarely above 1.5, and I might have 1-2 obstructives (usually 0), and 2-4 hypopneas in 7 hours. I don't have an explanation for it, but I think the therapy works better the longer you use it.

Above all, stay positive and proud of how far you have come. The honeymoon period (for lack of a better term) has worn off for me, and for the first time, I have had to fight the urge to sleep without the mask. I am hoping that it won't be long until I don't notice it. Fortunately, I still remember the 3+ mornings out of 7 headaches, brain fog, and exhaustion I suffered before my CPAP.

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Heart Jumping
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Re: My CPAP Treatment Journey

Post by Heart Jumping » Sun Nov 29, 2015 9:42 pm

zoocrewphoto wrote:AHI is the average per hour, not the total number of events. That means a total of 12-18 total events in 4-6 hours.
I know.
As for higher numbers later in your sleep, it is probably due to REM sleep. A lot of people have more events during REM sleep, and it is normal to have more REM sleep later during the night.
Interesting, thanks.

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Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear - Fit Pack (All Cushions Included with Medium Frame)
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zoocrewphoto
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Re: My CPAP Treatment Journey

Post by zoocrewphoto » Sun Nov 29, 2015 9:45 pm

Heart Jumping wrote:
zoocrewphoto wrote:AHI is the average per hour, not the total number of events. That means a total of 12-18 total events in 4-6 hours.
I know.
Your machine is telling you the ahi, not the total events.

_________________
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Resmed S9 autoset pressure range 11-17
Who would have thought it would be this challenging to sleep and breathe at the same time?

Heart Jumping
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Re: My CPAP Treatment Journey

Post by Heart Jumping » Sun Nov 29, 2015 10:09 pm

I know . The machine display says "total events per hour", so I was using "total events" as a shortened version of that.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear - Fit Pack (All Cushions Included with Medium Frame)
Additional Comments: AirFit F10 Full Face Mask is my backup mask for when congested.

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zoocrewphoto
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Re: My CPAP Treatment Journey

Post by zoocrewphoto » Sun Nov 29, 2015 10:17 pm

Heart Jumping wrote:I know . The machine display says "total events per hour", so I was using "total events" as a shortened version of that.
You may know what you were thinking, but we don't. When somebody says total events, we are going to believe they are talking about the whole sleep session. When i read your post saying that you got the total events off the machine, it sounded like you didn't know what it was telling you. It really helps to use the correct terminology, and ahi is shorter to type than "total events" anyway.

_________________
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Resmed S9 autoset pressure range 11-17
Who would have thought it would be this challenging to sleep and breathe at the same time?

Heart Jumping
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Joined: Wed Jul 22, 2015 3:06 pm

Re: My CPAP Treatment Journey

Post by Heart Jumping » Sun Nov 29, 2015 10:30 pm

WindCpap wrote:Try increasing your pressure a little more to 9 so that the changes are not so abrupt. Also, was 15 your top prescribed pressure or the top pressure you set? You may want to turn it back down for now if it is not the prescribed pressure. 9-14 is a lot smaller change than 8-15.

It sounds like the machine is getting some false asleep readings. I got a bunch of those when I first started and I still get them occasionally when I am having trouble falling asleep. Basically you get relaxed and your breathing pattern matches a sleeping breathing pattern but you are not asleep. if you turn off the full time EPR, you will know when it has ramped up prematurely, and be able to reset the ramp to prevent the pressure swings from happening. It is also possible that the pressure swing is waking you from stage 1 sleep.

If the pressure swings are giving you trouble, you could try CPAP mode. I have been doing some reading, and one method for self-titrating for CPAP when you have an apap is to take the 95th percentile pressure over a week and use that. Studies show that if you use apap, 95th percentile, spouse adjusted until you stopped snoring, or lab titration, the results pretty much end up the same, so do whatever makes you the most comfortable.

I did some recent review of my first few nights data. My AHI was 3-4, and I was actually having several obstructive events in a night. Now, my AHI is rarely above 1.5, and I might have 1-2 obstructives (usually 0), and 2-4 hypopneas in 7 hours. I don't have an explanation for it, but I think the therapy works better the longer you use it.

Above all, stay positive and proud of how far you have come. The honeymoon period (for lack of a better term) has worn off for me, and for the first time, I have had to fight the urge to sleep without the mask. I am hoping that it won't be long until I don't notice it. Fortunately, I still remember the 3+ mornings out of 7 headaches, brain fog, and exhaustion I suffered before my CPAP.
First off thanks for the words of encouragement and all the help. Frankly I'm very disappointed that if anything my sleep and energy has decreased since starting. But I have 0 intention of giving up. I may even order a new mask tomorrow as I enjoy experimenting and the Respironics Dream Wear mask looks very interesting, as if it might improve some of the issues I'm experiencing.

Prescription was 7 - 13. I bumped it up to 8 - 15. I had initially had ramp on, then turned it off, now have it on but only for 5 minutes as I really don't have a hard time adapting to 8 at all. I think the events where I'm feeling the pressure increase are occurring when it's shooting up to between 11 - 13. They really aren't that bad and at least they are happening before I fall asleep, they are not waking me up. I don't think I've seen any events in SH where it's ever even exceeding 13 so the top number change hasn't really done anything. I think I may change it to 9 - 13, with a 15-minute ramp starting at 7.

I'm actually not too worried about AHI right now even though I've brought it up and want to improve it. I think there's a good chance AHI will plummet when I am consistently sleeping better.

Thanks again.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear - Fit Pack (All Cushions Included with Medium Frame)
Additional Comments: AirFit F10 Full Face Mask is my backup mask for when congested.

WindCpap
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Re: My CPAP Treatment Journey

Post by WindCpap » Mon Nov 30, 2015 10:32 am

A little melatonin about 1.5 to 2 hours before bedtime may help. It does for me. It does for me. Basically it gets your circadian rhythms aligned with your chosen bedtime so that you fall asleep faster and have less time to get annoyed with the CPAP.

Do consider keeping on the autoramp as compared to a timed ramp. If wake up in the middle of the night, and go to the bathroom, and then fall asleep within 5 minutes, the machine won't respond until the 15 minutes is up. It will if you have used auto-ramp. Like I said, it is very good at detecting your sleeping state (although it does mistake extreme relaxation for sleep some of the time).

Something really cool I just noticed this morning. If you have a 5-7 hour continuous sleep period, you can actually see rem sleep as an increase in respiration rate. From there, you can figure out when all of your sleep cycles occurred. I don't know how useful this is for therapy, but it is way cool.

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Duck
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Re: My CPAP Treatment Journey

Post by Duck » Mon Nov 30, 2015 3:14 pm

WindCpap wrote:you can actually see rem sleep as an increase in respiration rate
Medical science says otherwise. Breathing is known to be irregular during REM. The respiration frequency is at times higher, at times lower, and at times the same.

WindCpap
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Re: My CPAP Treatment Journey

Post by WindCpap » Mon Nov 30, 2015 4:23 pm

Duck wrote:
WindCpap wrote:you can actually see rem sleep as an increase in respiration rate
Medical science says otherwise. Breathing is known to be irregular during REM. The respiration frequency is at times higher, at times lower, and at times the same.
Whatever you say. My data shows an overall increasing trend in respiration rate at exactly the time I would be in rem sleep. it is steady the rest of the time. I suspect what I am seeing agrees with what you are saying. It is not like it goes up a straight line, and then back down in a straight line. The variance in respiration rate goes up at the same time too.

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WindCpap
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Re: My CPAP Treatment Journey

Post by WindCpap » Mon Nov 30, 2015 4:47 pm

This is what I am talking about:

Image

Appologies to Heart Jumping for hijacking your thread.

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Duck
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Re: My CPAP Treatment Journey

Post by Duck » Mon Nov 30, 2015 5:46 pm

Look more like arousals.

Heart Jumping
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Re: My CPAP Treatment Journey

Post by Heart Jumping » Tue Dec 01, 2015 12:32 pm

Pugsy wrote:Can you turn off the mask pressure graph and instead include the Flow Limitation graph (don't need the snore graph either)?
OK, so here's a screenshot from last night. Also a link in case that's easier to view http://imgur.com/SQM36gt Don't really have any questions at this point, just posting as a record of where I am, in case you want to comment on anything you see. The 5h 39m was my total time in bed, I did not go back to bed after this. If I had have, based on recent history, my AHI would probably have shot up to 10 since it goes up during my second sleep cycle.

Last night I had a ramp time of 10 minutes and a start pressure of 5 and a range of 7 - 13. I've got a cold right now so I decided to back the pressure level down a bit to my prescription setting, and I had a fairly comfortable night all things considered. WindCpap, I know you keep telling me to use autoramp, I may try it at some point, just not yet.

I'll have a good night and then a bad one, but I continue to see strong glimmers of hope, as even with my unpleasant cold and being all stuffed up I slept OK, AHI was not bad IMO, and when I woke up I actually couldn't tell that there was any back pressure, even though I was mainly breathing through one nostril, so that was pretty incredible. I am also working hard to get back on a fixed sleep schedule of getting up at the same time every day, which was thrown off kilter by my initial battle and increased exhaustion from not sleeping soundly with CPAP, I know from experience that as soon as I do that I'm going to start to sleep even much better.

I also ordered the Philips DreamWear mask which should arrive tomorrow, which I am very intrigued by, I'm going to see how I do with that.

Thanks

Image

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear - Fit Pack (All Cushions Included with Medium Frame)
Additional Comments: AirFit F10 Full Face Mask is my backup mask for when congested.