Centrals and obstructive apneas in the same night — how to adjust pressure?

palerider · Post by **palerider** » Sun May 27, 2018 8:19 pm

Try 16 and see what happens.

At this point, I think all we can do is experiment and see if anything makes a difference.

nikkwong · Post by **nikkwong** » Sun May 27, 2018 9:18 pm

Looking back, all nights look like some derivation of this kind of breathing—very choppy and fragmented. Does this look like UARS? Reading about UARS is not very fun. It looks like my treatment options are pretty grim. It definitely explains a lot though. In my last sleep cycle I am sleeping very intermittently with lots of dreams/wakeups—the corresponding breathing during that period is not surprisingly very fragmented.

HoseCrusher · Post by **HoseCrusher** » Mon May 28, 2018 12:20 pm

One possible perspective...

The event on the left doesn't give enough information to comment on.

The event in the middle is almost obstructive, except it didn't last long enough to be flagged.

The event on the right has the appearance of an "arousal and turn in bed event."

Keep in mind that sleep is dynamic and until you are nearly dead your breathing tends to fluctuate during the night. I would consider some fluctuations normal and healthy.

To go into greater depth into these observations more data is needed. What was going on with your brain activity? What about oxygen levels? What about heart rate changes? and so on.

While these in isolation don't seem too bad, the problem is that you don't feel rested. The brings up the question if there are enough of these "events" to interfere with you getting restful sleep.

If fine tuning doesn't seem to help it may be worth looking at other areas of your life that may be contributing to the problem. Air flow interruptions are only one cause of not feeling rested.

nikkwong · Post by **nikkwong** » Mon May 28, 2018 3:43 pm

HoseCrusher wrote: ↑
Mon May 28, 2018 12:20 pm
One possible perspective...

The event on the left doesn't give enough information to comment on.

The event in the middle is almost obstructive, except it didn't last long enough to be flagged.

The event on the right has the appearance of an "arousal and turn in bed event."

Keep in mind that sleep is dynamic and until you are nearly dead your breathing tends to fluctuate during the night. I would consider some fluctuations normal and healthy.

To go into greater depth into these observations more data is needed. What was going on with your brain activity? What about oxygen levels? What about heart rate changes? and so on.

While these in isolation don't seem too bad, the problem is that you don't feel rested. The brings up the question if there are enough of these "events" to interfere with you getting restful sleep.

If fine tuning doesn't seem to help it may be worth looking at other areas of your life that may be contributing to the problem. Air flow interruptions are only one cause of not feeling rested.

It's really hard to say for sure.

However, I think there is a direct relationship with the shape of my breaths and how well I feel the next day. My guess would be that those RERAs, however small they may be, are disrupting my ability to sleep.

This is last night, we have very extreme uniformity. I feel good today. I was able to achieve this by using a mandibular advancement device in conjunction with a head strap (to keep the MAD in place), and ensure that my lower jaw was protruded very far forward.

One thing that is interesting to note is that the pressure seems irrelevant, almost. Any min pressure > 12 gives me a AHI of < .5, but, on its own, will leave me feeling groggy. A min pressure of 12 and a min pressure of 16 gives me the same undesirable results. Only the combo of the PAP therapy with the mad gives me the desirable breath shapes that I'm looking for.

I'll keep testing over the next few days, and see if I can continue replicating these results. Hopefully others with UARS may find this helpful.

nikkwong · Post by **nikkwong** » Thu May 31, 2018 12:53 pm

Have kept playing with it—last night reached an AHI of 0.

This is pretty amazing after 8 tumultuous months of no sleep. Thank you for all the advice everyone!

HoseCrusher · Post by **HoseCrusher** » Thu May 31, 2018 2:16 pm

Looking good...

The bigger question is how do you feel?

When I was trying to figure all of this out I kept a written log of how I felt. I would update it throughout the day. In the evening I would download the data to see if there was any correlation to how I felt.

There were times when I could make an adjustment and end up feeling better. At other times I felt great in spite of the machine scoring events.

In theory when you get to an AHI of 0 you should never complain of being tired. In actual practice sometimes things are a little different...

zebras · Post by **zebras** » Fri Jun 01, 2018 8:44 am

That sounds interesting! Have you found that it helps your sleep quality consistently? Combining CPAP and MAD

Centrals and obstructive apneas in the same night — how to adjust pressure?

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?

Re: Centrals and obstructive apneas in the same night — how to adjust pressure?