Increasing Pressure + Statistics Questions

My titration # was 10 but my slep doc described this not so much as my "ideal" pressure number, but more the top of the pressure scale that I generally need. No real question with regard to that. That as about 3.5 months ago and I have been on CPAP for 2.5 months. I have gone from bone weary fatigue to just tired....much better but no way near where I want to be. I have also been released (since I had PE) to start exercising and I have gone from 240lbs to 228lbs in a couple months and expect that trend to continue....my increased exercise, improved fitness and CPAP probably all have contributed to my feeling a little better. My sleepitself is not very good and has not really improved. I fall asleep quickly every night with the help of ambien (10mg). My sleep issue is that I get up at least once a night about 2:30-3:00 AM...every single night. Not really a bathroom break - just have to get up and get out of bed. I have not sleep through the night in about 6 months. So my goal is to continue feeling better but to also try and get better sleep through the night. My numbers are pretty good, especially since I am on a Resmed....I am very appreciative of the help of the people on here and have recommended this site to many people. I average about 7 hours a night during the week and 8.5 on the weekends. I clearly feel better on the weekends...nooooo question about it. Perhaps the increased hour makes a big difference..I really don't know. I have messed around with my settings 3 times and all three times I did not have good nights of sleep and felt like crap the next day. My question is whether I just need to give it some more time - adjusting the low end of my pressure settings or is it a clear indication that it is not for me? The three instances are below. I do not have the AHI #'s for the first two "pressure adjusted nights" but I will describe my nights as best I can.

1. Approx a month ago - tried CPAP Mode at about 8.5. Woke up about 7-8 times during the night...did not sleep well, kept fidgeting with my mask and felt awful the next morning.
2. About 2 weeks ago - raised my minimum from 5 - 15, to 7.5 -13. I slept ok but woke with a headache and very bloated stomach. Finally went away mid morning but was not well rested. Woke up 3-4 times during the night.
3. Last night (3.10.10) Adjusted my pressure to 6.8 - 13. Woke up 3-4 times...not sure why. Have not felt very rested today but my AHI was 2.9

I am wondering if I just need to leave my pressue at the orginal 5-15.....?

Here are my numbers for last 5 nights:

Date 95% Median AHI AI Max

3.10 - 9.4 - 7.8 - 2.9 - .4 - 10.0
3.9 - 8.8 - 7.2 - 2.8 - .5 - 9.6
3.8 - 10.4 - 8.0 - 1.5 - 0 - 11.4 *** only slept with the mask for 6 hours -took it off at 5 AM - slept last 2 hours without it
3.7 - 9.4 - 7.0 - 4.3 - 0 - 10.0
3.6 - 9.8 - 7.4 - 3.5 - 0 - 11.4


What do these numbers tell me? I somewhat understand the 95% but would the median explain why I am not able to raise my low end settign without it affecting my sleep.

As always - thanks a ton.


Brian

Hi,

Do you have the graphs from the machine available to post? I'd like to see if you are maxing out on pressure from time to time. My first suspicion is that you have a few events that the machine is not able to go after and suppress. You might be one of those folks who are very sensitive to any events. For example, my AHI is typically under 1.0, but I have the occasional night where I have a 2.5 night. I simply feel horrible the next day when that happens.

Another possibility is that you are sensitive to how the auto machine works. I noticed you tried straight CPAP mode, but at 8.5, it doesn't seem like it will work since your 95th numbers are higher than that. You might need CPAP on a number like 12. But you need to see what the pressures are when you are having events to get an idea of where to set things.

I had the same issue with getting up for 30 to 45 minutes during the middle of the night. I used to watch music videos to pass the time. It took me about 9 months to get over it, but it still seems to happen for me about once a month.

-john-

Swim_Bike_Run wrote:...
1. Approx a month ago - tried CPAP Mode at about 8.5. Woke up about 7-8 times during the night...did not sleep well, kept fidgeting with my mask and felt awful the next morning.
2. About 2 weeks ago - raised my minimum from 5 - 15, to 7.5 -13. I slept ok but woke with a headache and very bloated stomach. Finally went away mid morning but was not well rested. Woke up 3-4 times during the night.
3. Last night (3.10.10) Adjusted my pressure to 6.8 - 13. Woke up 3-4 times...not sure why. Have not felt very rested today but my AHI was 2.9

I am wondering if I just need to leave my pressue at the orginal 5-15.....? ...

Brian, I'ld say "stay the course" for a few more days. You are sleeping better. It's not perfect. You might need to head back to your sleep doctor before it is all over. But it's really good to try to make it work as best as possible.

The low AHI value will help you feel better. But there may be something else going on that will make it worse.

Swim_Bike_Run wrote:...
Here are my numbers for last 5 nights:

Date 95% Median AHI AI Max

3.10 - 9.4 - 7.8 - 2.9 - .4 - 10.0
3.9 - 8.8 - 7.2 - 2.8 - .5 - 9.6
3.8 - 10.4 - 8.0 - 1.5 - 0 - 11.4 *** only slept with the mask for 6 hours -took it off at 5 AM - slept last 2 hours without it
3.7 - 9.4 - 7.0 - 4.3 - 0 - 10.0
3.6 - 9.8 - 7.4 - 3.5 - 0 - 11.4

What do these numbers tell me? I somewhat understand the 95% but would the median explain why I am not able to raise my low end settign without it affecting my sleep. ...

Well, not sure what the "Max" number represents. Could that be Leak rate in liters per minute?

Of course, the 95% and Median tell us about the pressure. Since they are close together it shows your pressure does not stray much from that tight range.

You may not be able to raise the lower end number because as the pressure increases it might induce some central apneas. That's just one possibility. Or it might be that you don't do well with higher pressure. As it was the lower pressure had your Apnea Index quite low.

AHI of course is the apnea and hypopneas index (number of events per hour) that your machine noted. The Apnea Index (number of apneas per hour) is outstanding. The ResMed units always over score the hypopneas. So, it's probably lower than that.

But remember, this is just an objective measurement to tell us what is happening during your sleep. It does not tell us how you feel. And if your numbers continue to look good, but you don't feel well, you may need to chat with your doctor.

Also remember that it can often take weeks or months to completely get back to normal.

Hope that helps.