Newbro/Intro Post #7589467469878378

Morning folks! Holy **** it's morning! And I'm awake and productive!

I just finished my first night on a Dreamstation auto and I'm floored, I feel GREAT this morning, no slapping the alarm multiple times, no grogginess, just being alert and productive in my classes!

I don't really have any questions since you folks all are so helpdful and kind to share the info you've gleaned. My prescription for CPAP was for an initial start at 4-15, but I bumped the minimum up to 6 and the maximum to 20 based on multiple recommendations I've read here and elsewhere. It looks like I settled in about 13-14 overnight.

I'm using a quattro FX mask, other than a short nap in the afternoon, I went to bed at 9pm last night, slept for 90mins, had a mask leak, awoke, adjusted/refit, slept for another 90mins, woke up for about 45mins, then fell asleep for almost 7 hours straight! (sleepyhead data here: http://imgur.com/a/s8wSe)

I've been twice as productive today as normal, the processing and memory errors I've been prone to for years are noticeably reduced, and in general I just FEEL better!

I imagine that I'll continue feeling better and better as I catch up on my sleep debt over time!

Based on just this one night, I think you need to increase your minimum pressure to 10...maybe a little higher.
Start with the 10 and see if your events drop.

LSAT wrote:Based on just this one night, I think you need to increase your minimum pressure to 10...maybe a little higher.
Start with the 10 and see if your events drop.

I'll give this a go! When you see my data, what makes you say I need a minimum of 10? I assume that I climbed above there and didn't drop below all night? (just trying to learn here )

your med. ipap was 11.4
so why not set min. to something close to that ... for max therapy
less changes might mean better sleep

TaxNerd wrote:I'll give this a go! When you see my data, what makes you say I need a minimum of 10? I assume that I climbed above there and didn't drop below all night? (just trying to learn here )

If you look at your pressure graph it moves up quickly from your minimum and doesn't return back to the minimum. It stays most of the time around 10 to 11.5cm. Your minimum pressure is most important in preventing the snores and hypopneas that you are seeing. By setting it close to what you need it helps the machine have a jump start on treating the events. So, I agree with LSAT try minimum 10 cm tonight. And then evaluate that for a few days to see how that effects your events.

Thanks for your help folks! I'm back

The first week on the CPAP was AWESOME, I've gotten more done in the past week than in the past month, it's honestly amazing.

The last two nights however have been pretty rough, MUCH better than without CPAP, but still dragged out and tired in the morning.

I upped the minimum pressure to 9cm as was suggested on my 2nd or 3rd night but otherwise haven't messed with things I've been running 9-20 auto mode for a week now.

The last two nights I've had the "wake up, roll over, go back to sleep" I used to do a lot before CPAP, yet looking at my data (linked below) I didn't have a lot of CAs or OAs. I'm running a humidifier level of 3 in adaptive mode, and preheating the humidifier as I start to get ready for bed.

Data for Jan 17 (two nights ago), http://imgur.com/bv7ytlx
Data for Jan 18 (Last night) http://imgur.com/8BI10Mt

Your pressure still isn't high enough - look at the settings on the graph - 95% of the time the pressure hit around 17. I'm not suggesting you raise the min. to that, but try it instead at e.g. 11 and see how things go.

Your AHI is well within acceptable range but your snores and flow limitations (which aren't part of the AHI) are present in higher numbers than I would want to see. Snores and flow limitations are warning signs that the airway is trying to collapse. In your case they don't seem to be growing up to earn a full apnea flag of some sort. Perhaps they are causing some arousals which could be messing with your sleep quality which then of course messes with how you feel.
Why the change? Don't know but it happens sometimes. These last 2 nights could just be flukes or they could be part of a longer pattern.
How do your snores and FLs look on the other nights? If they weren't so numerous on the other nights then maybe they are related to sleeping position....like have you maybe been on your back more where it is quite common for our OSA to get worse and need more pressure?

If it were me I would up that minimum pressure again in an effort to better hold the airway open and ward off those snores and FLs.
Usually snores and FLs will respond fairly easily to relatively small increases in minimum pressure. I think a minimum of 10 (as previously suggested) would be a good place to start.

These machines work best by preventing the airway collapse in the first place instead of trying to fix things after they happen.
To better prevent we just have to use a little more pressure all night as the baseline pressure.
Your reports from the last 2 nights look like reports from simply crappy sleep quality at least to me and I have personal experience with reports that look like this. Mine were very similar when in apap mode with similar settings and cleaned up quite nicely with a change from my 9 cm minimum to a 10 cm minimum. Worth trying.

Now these 2 nights could just be flukes and 2 nights don't make a trend but if you look back at your prior nights and the snores and FLs were still a bit ugly then I wouldn't wait and I would just increase the minimum if it were me.

The minimum pressure is the most critical setting. Once it is set a bit more optimally you might find that the machine doesn't go as high as often.
I would start with 10 cm minimum and see how things go. Sometimes just a little change can make a huge improvement.

Julie wrote:look at the settings on the graph - 95% of the time the pressure hit around 17.

Just wanted to clarify the 95% category. This means that your pressure was at OR BELOW this number. It doesn't tell us how long you spent at that pressure. That's where the graphs are helpful to see what pressure you were at most of the night.
This was his previous screen shot with a minimum of 6cm. The increase to minimum 9cm has helped the FL's and snores so heres to hoping for an even better night at 10cm. http://imgur.com/a/s8wSe

Thanks for correction Oky!

Julie wrote:Your pressure still isn't high enough - look at the settings on the graph - 95% of the time the pressure hit around 17.

that's not what the 95% number means.

http://adventures-in-hosehead-land.blog ... de-to.html

ah, I see oky beat me to it.