Do I need to raise my Maximum Pressure (Clusters)

fdw wrote:

Wulfman... wrote:

fdw wrote:Not panicing...I've had OS's lasting from 10 seconds to 49 seconds in the past I just really never looked at length of OA's and NO one has ever ask until you. BTW I have Jesus as my God, archangel.

Symptoms.......would be heart skipped beats (PVC's), tired. I do have a Pacemaker/Defibulator.

Last night's results were a lot better 3 OA lasting no longer than 11 seconds, BUT I did have 2 back to back CA's lasting 20 and 16 seconds.

Here's last night results.......any suggestions?

Ooooooooooh......WOW! 0.57 AHI. Goot yob!

Yeah, I reread your first post last night and remembered what you had mentioned:

I now have a Pacemaker/Defibrillator implanted back in mid October 2014

Which may be another advantage of not using a range of pressures.


Den

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Den,

I thought I'd read once upon a time that varying pressures were found to potentially cause issues with the cardiovascular system.
Is that what your referring to, or something different? Does that include EPR?

How do I know if I need to increase or decrease my pressure now that I'm on straight CPAP especially if I see OA's that are longer than just the traditional time frame?

Sorry for so many questions......just trying to get better

Yes, that is what I was thinking about. I don't believe that would include EPR unless (maybe) it drops the level below were it needs to be IF the user has or is prone to have apneas at the point where the exhale and inhale cycle coincide. And, not all users are susceptible to that condition.

But, to be honest, it seems like I've read an opposing view that advocates ranges of pressures where the user has lower pressures during the night and only higher ones when need be.
Now, I believe "logic" would dictate that not all people would benefit by the changing pressures or especially if the user had the type of breathing that would drive the machine crazy changing pressures all night long. In my opinion, that would not be beneficial.

I know it's still a little early to make judgements, but, so far, I see your reports getting better. And, not the clusters like you posted initially.


Den

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Yes, that is what I was thinking about. I don't believe that would include EPR unless (maybe) it drops the level below were it needs to be IF the user has or is prone to have apneas at the point where the exhale and inhale cycle coincide. And, not all users are susceptible to that condition.

But, to be honest, it seems like I've read an opposing view that advocates ranges of pressures where the user has lower pressures during the night and only higher ones when need be.
Now, I believe "logic" would dictate that not all people would benefit by the changing pressures or especially if the user had the type of breathing that would drive the machine crazy changing pressures all night long. In my opinion, that would not be beneficial.

I know it's still a little early to make judgements, but, so far, I see your reports getting better. And, not the clusters like you posted initially.


Den

Well......last night was not that impressive number wise or encouraging. I had a mini cluster of H 17 seconds, and 2 OA's that lasted 13 and 28 seconds. Below are graphs. Any recommendations???????

BTW, that CA cluster over a 40 minutes time frame toward the end of the night is a weird looking. I woke up in between those 2 CA and went to the bathroom, back to bed and had a no luck at falling back asleep

https://lh5.googleusercontent.com/-WIT8 ... 85838.jpeg
https://lh6.googleusercontent.com/-e0L- ... 84710.jpeg

FDW, those ca's before and after your bathroom break were probably not "real" in that you were probably awake, or nearly so, and the ca's are a result of holding your breath while moving around, like rolling over. The machine doesn't know if you are awake or asleep so it scores a CA whenever you don't breathe. In a lab, if you are awake, they wouldn't count.
Zoom in on those events and see if the amplitude of your flow wave doesn't increase just prior, an indication you might be awake.
I haven't followed this discussion, but these results with an ahi of 1.36 look pretty good to me, and I'm not sure only two events (OA) close together would be properly called a "cluster" as normally referenced. I wouldn't change anything for a while.

Jay Aitchsee wrote:FDW, those ca's before and after your bathroom break were probably not "real" in that you were probably awake, or nearly so, and the ca's are a result of holding your breath while moving around, like rolling over. The machine doesn't know if you are awake or asleep so it scores a CA whenever you don't breathe. In a lab, if you are awake, they wouldn't count.
Zoom in on those events and see if the amplitude of your flow wave doesn't increase just prior, an indication you might be awake.
I haven't followed this discussion, but these results with an ahi of 1.36 look pretty good to me, and I'm not sure only two events (OA) close together would be properly called a "cluster" as normally referenced. I wouldn't change anything for a while.

Not sure where to look in SH but I thought those CA's were suspicious of not asleep.

Yeah, I agree with Jay. If you were laying there (awake) thinking about something or tossing and turning.......and not consciously breathing, it could very easily show up as some type of apnea.
I'd still leave these settings for a week without changes. A night or two by themselves does not a trend make.

Heck, I had two apneas last night at various times. Unusual for me to even have one, but I'm not making any changes in my settings. So far, that's four of them this month.

Don't sweat it.


Den

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Wulfman... wrote:Yeah, I agree with Jay. If you were laying there (awake) thinking about something or tossing and turning.......and not consciously breathing, it could very easily show up as some type of apnea.
I'd still leave these settings for a week without changes. A night or two by themselves does not a trend make.

Heck, I had two apneas last night at various times. Unusual for me to even have one, but I'm not making any changes in my settings. So far, that's four of them this month.

Don't sweat it.


Den

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Den,

I agree 100%.......after all my last offical titration 7 years ago they set my pressure at 13.0, but NO mention of EPR.

BTW, for what it's worth I do NOT use a humidifier but I do use OCEAN nose spray several times a day to keep my nasal passages open and clear.....Any Thoughts?

fdw wrote:\Not sure where to look in SH but I thought those CA's were suspicious of not asleep.

if you're awake, it doesn't count, but, the machine doesn't know you're awake.

there's also 'swj' that happens when you're drifting in and out of sleep, meaning 'sleep/wake junk', your body is switching over from awake breathing to asleep breathing, and that often causes fluctuations in the breathing pattern that the machine will flag. but it doesn't count, and if you had wires hooked up to your head, those things would be ignored.

I decided to raise my pressure to 13.4 straight CPAP, last night (EPR 1.0 NO change).....I will leave here for at least 2-3 weeks and see how things workout. Then I will report back for some advice, unless things go completely hay-wire.

Last nights report.....looking good Lucy!
https://lh5.googleusercontent.com/-HwUU ... 73301.jpeg

fdw wrote:I will leave here for at least 2-3 weeks and see how things workout. Then I will report back for some advice, unless things go completely hay-wire.

Promise?
Seriously, those data look good. You should leave the settings as they are for some time to see the long term results. I know it's a great temptation to change settings after a night that doesn't look so good, but changing often makes things worse.
I suggest you don't even download your data for a week. Don't be tempted. Keep a log of how you think you slept and then, after a week, compare it to the data. I think the S9 will hold the detailed data for 10 days, I know it'll keep it a week.
Good luck

fdw wrote:I decided to raise my pressure to 13.4 straight CPAP, last night (EPR 1.0 NO change).....I will leave here for at least 2-3 weeks and see how things workout. Then I will report back for some advice, unless things go completely hay-wire.

Last nights report.....looking good Lucy!

OoooooooK. Yes, last night looked good.


Den

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Well it's been nearly 2 weeks since my last post on this question as promised. But I have to add some more information about my health.

Next week I will be having Arterial Fibrillation ablation for the second time next Friday. First time was in July 2014. ICD implanted October 2014.

I really want to have my pressure optional as possible......Since switching to straight CPAP from APAP I have been feeling a little better (not as many skipped heart beats).

As I've stated in the past my last official titration was in 2007 at 13.0 CPAP.

Here is last nights results and was actually in A-Fib part of the night, went to bed in A-Fib.

Any suggestions or recommendations..........BTW would EPR set at 1 be a causing any issues

Thanks

fdw wrote:I really want to have my pressure optional as possible......Since switching to straight CPAP from APAP I have been feeling a little better (not as many skipped heart beats).

FDW, those results look pretty good to me. How you feel, apart from absolute AHI, is an important consideration. You just have a few respiratory events, an EPR of 0 might eliminate those, but if it's less comfortable, your quality (how you feel) of sleep might suffer. You could turn it off for a couple of nights and see.

I think you should be taking these charts to your heart guy and your sleep guy and get their opinion! Best would be to get them working together to optimize your treatment. BTW, they might prefer to see the ResScan reports rather than SleepyHead. Some providers tend to dismiss SleepyHead.

I think you should be taking these charts to your heart guy and your sleep guy and get their opinion! Best would be to get them working together to optimize your treatment. BTW, they might prefer to see the ResScan reports rather than SleepyHead. Some providers tend to dismiss SleepyHead.

I don't have a sleep guy......and Im sure my cardiologist and electrophysiologist would say "nice graphs". They deal with the heart and not OSA, however they have said that OSA is a major factor with a person with AF. I've always said I need a doctor like Dr. House (from the TV show).

fdw wrote:Well it's been nearly 2 weeks since my last post on this question as promised. But I have to add some more information about my health.

Next week I will be having Arterial Fibrillation ablation for the second time next Friday. First time was in July 2014. ICD implanted October 2014.

I really want to have my pressure optional as possible......Since switching to straight CPAP from APAP I have been feeling a little better (not as many skipped heart beats).

As I've stated in the past my last official titration was in 2007 at 13.0 CPAP.

Here is last nights results and was actually in A-Fib part of the night, went to bed in A-Fib.

Any suggestions or recommendations..........BTW would EPR set at 1 be a causing any issues

Thanks

That report looks REALLY GOOD!
And, if you're feeling and sleeping better, that's what it's all about.

I'd say you're "good to go" unless you having other issues down the road. You may find (as I did) that as time goes by, the events become fewer and the numbers get better. It's a game of averages.

Good luck with your procedure next week.


Den

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fdw wrote:

I think you should be taking these charts to your heart guy and your sleep guy and get their opinion! Best would be to get them working together to optimize your treatment. BTW, they might prefer to see the ResScan reports rather than SleepyHead. Some providers tend to dismiss SleepyHead.

I don't have a sleep guy......and Im sure my cardiologist and electrophysiologist would say "nice graphs". They deal with the heart and not OSA, however they have said that OSA is a major factor with a person with AF. I've always said I need a doctor like Dr. House (from the TV show).

Yes, I've read that OSA is associated with Afib, here's one article: http://www.medscape.com/viewarticle/776107. Maybe you should ask your cardiologist to recommend a good sleep certified pulmonologist. Although your cardiologist might surprise you, he might very well be able to discern things in your flow rate chart related to cardio function.