In another thread I mentioned that I'm awaiting a new sleep study, where I'll do 1/2 night BiPap and 1/2 night ASV in an effort to try get rid of my centrals. In the meantime I continue to try and tweak my current APAP setup. Since I've started staying off my back I've gotten my AHI down to the 3 range most nights, which is really good for me. One thing that's a little confusing though is that while my obstructive events are almost totally gone, I still have a large number of hypopneas (and the centrals). If the pressure is high enough to keep the airway from collapsing and eliminating the obstructives, how can hypopneas keep sneaking though? Is there anything I can do to try and lessen them?

On the other hand, since I have the new study coming up sometime in the next couple weeks, maybe I should just leave things as they are.

I might look at sleep position now if I were you - you could have 'positional' apnea, which could possibly even let you get off Cpap altogether, though isn't that common. Here's a link that might help -

viewtopic.php?f=1&t=70205&st=0&sk=t&sd=a&start=15#p650175

One thing that's a little confusing though is that while my obstructive events are almost totally gone, I still have a large number of hypopneas

No one here knows, but they will probably speculate about it.

Now when you say "large number", how many are you talking about?

TheUglyTruth wrote:
No one here knows, but they will probably speculate about it.

Now when you say "large number", how many are you talking about?

Last night I had 31 hypopneas, 6 obstructives and 17 clear airway events, AHI was 8.4 The night before, my AHI was 3.1, with 8 H's, 6 OA's and 9 CA's. Basically, I guess I'm all over the place.

Before I started sleeping on my side only, the H's and OA's were much higher. So, staying off my back has made a significant difference in the number of OA's, a smaller difference in the H's, and off course no real change in the CA's.

The more I think about it I might just leave things as they are since I have another study coming up, I'm pretty sure I'm going to end up with either a BiPap or ASV. After 2 months of fiddling the only thing that's made any significant difference was staying off my back and that's only really addressed the OA's.

Tomma, no matter how much I tweaked my settings I had an average AHI of 18.6 until I had a sleep study with ASV and passed. I think an ASV with the proper settings would be an improvement for anyone. The cost is prohibitive unless you need an ASV and insurance is picking up the tab. My AHI on ASV is at 4-8, quite a significant improvement. I would relax and stop tweaking until the sleep study. Good luck and please keep us posted.
Mary

Mary Z wrote:Tomma, no matter how much I tweaked my settings I had an average AHI of 18.6 until I had a sleep study with ASV and passed. I think an ASV with the proper settings would be an improvement for anyone. The cost is prohibitive unless you need an ASV and insurance is picking up the tab. My AHI on ASV is at 4-8, quite a significant improvement. I would relax and stop tweaking until the sleep study. Good luck and please keep us posted.
Mary

Wow, sounds like exactly the same thing I'm going through right now. No matter what I do, I'm just not really getting a good, consistent result. I think I'm going to take your advise and take off my tweakers hat for now. One more question though, did you have any trouble getting used to the ASV? Sounds like it's a different kind of experience than straight PAP.

Tomma, I didn't have any trouble getting used to the ASV, except when the pressure gets high, my mask would blow out (FitLife Total Face Mask)- I switched to another mask and use the silicone earplugs to insure a comfortable leak free fit- no more problems. I've hand no trouble
adjusting
to anything from CPAP to AUTO to ASV in five years. I've been using ASV for 10 months. I sleep like the dead usually, anyway. I would start using the entire 45 minutes ramp and gradually decrease that if I were having trouble sleeping. The first night in the lab the pressure was all over the place and that kept me in a light sleep. Once the machine and I "learned" each other it's been smooth sailing. Good luck,- mybe be aware that the first night in the lab, the pressure may vary drastically.
Mary

the manual for my resmed machine says that

"Obstructives are when the respiratory flow decreases by more than 75% for more than 10 seconds"

"Hypopnea's are when the respiratory flow decreases by 50% for more than 10 seconds"

if I understand it correctly, the difference between the two items is simply how constricted your air flow / breathing becomes.

tomma wrote:
Last night I had 31 hypopneas, 6 obstructives and 17 clear airway events, AHI was 8.4 The night before, my AHI was 3.1, with 8 H's, 6 OA's and 9 CA's. Basically, I guess I'm all over the place.

17 clear airway events is negligible. There is a good chance that you were awake for most or all of them. In which case they weren't apneas.

With only this one thread as evidence, I say you are worrying too much about data. How do you feel? Are you active, eating well, sleeping throughout the night with minimal interruption, feeling good for much of the day?

Can you maintain non-supine sleeping long term?

TheUglyTruth wrote:

tomma wrote:
Last night I had 31 hypopneas, 6 obstructives and 17 clear airway events, AHI was 8.4 The night before, my AHI was 3.1, with 8 H's, 6 OA's and 9 CA's. Basically, I guess I'm all over the place.

17 clear airway events is negligible. There is a good chance that you were awake for most or all of them. In which case they weren't apneas.

With only this one thread as evidence, I say you are worrying too much about data. How do you feel? Are you active, eating well, sleeping throughout the night with minimal interruption, feeling good for much of the day?

Can you maintain non-supine sleeping long term?

Not totally sure about long term non-supine sleeping yet, I think I can. I'm still getting used to it but it is getting easier little by little.

Overall I'm feeling pretty good. My main issue right now is fragmented sleep. Like the non-supine sleeping, it's getting better, but very slowly.

As far as the data, it's not that I'm overly concerned with the it, the doctor ordered another sleep study based on it, I was mainly just trying to understand how the OA's can be so much better, but not the H's.

My main issue right now is fragmented sleep. it's getting better, but very slowly.

- Nix on naps during the day

-Learn what excellent sleep hygiene is and practice it

- Moderate exercise

- Learn what a good diet is and eat it

- Blah, blah, blah,