zonker's crib--somewhere over the rainbow

Mark55 wrote: ↑

Sat Nov 24, 2018 12:23 pm

I'm glad to hear things are going better for you. You just spoke about the response setting, and it being easier to breathe with the soft setting.

I was always under the impression that standard/soft response settings only related to how quickly the machine raised the pressure in response to an event in APAP mode? Mine is still in the default mode unless I hit a button in the clinical menu by mistake.

I may have just learned something new!!

i don't know, to be honest. i treat my cpap machine like i treat my computer. i use both daily, but i don't know much of anything regarding the nuts and bolts of either. there was a time, waaayyy back in 1983 when i thought i would learn to program and write my own code. hot damn!

but quickly found out that one had to be fairly proficient in math in order to write code. alas, i was not then nor am i now anywhere near proficient in math. it's sort of the same thing regarding cpap and sleepyhead software. i just twiddle the knobs.

give the soft option a try and see if works the same for you. meanwhile, perhaps palerider or pugsy will come by and explain it for us!

Looks like the answer is right here,............

viewtopic/t154759/Newbie-with-AirSense1 ... ponse.html

Mark55 wrote: ↑

Sat Nov 24, 2018 7:07 pm

Looks like the answer is right here,............

viewtopic/t154759/Newbie-with-AirSense1 ... ponse.html

thank you for finding that and for posting! it's rather interesting. it does, however, kind of confuse me. before trying "soft" mode, i couldn't find any relief with epr. with "soft" on and an epr at 1, i can breath much more naturally.

if i'm reading the post you linked properly, it seems that the one responder is saying that "soft" IS a form of epr. and if that's so, i don't see why all epr doesn't function the same.

at any rate, as i said above, i don't understand all of sleepyhead or cpap. i'm just happy it works!

zonker wrote: ↑

Sat Nov 24, 2018 11:26 am

all right, time to bring this thread to it's conclusion. i am well pleased with my current situation.
...
i'm sleeping well as i continue to get a handle on the fragmented sleep. thanks for the help on that.

Maybe you're finally finding your "CPAP happy place"!

zonker wrote: ↑

Sat Nov 24, 2018 11:26 am

i've found out something that has helped out my sleep comfort, too. a user in another thread(wish i had made a note of who!) suggested to a newbie that they try, under "response", the setting of "soft". i figured what the hell, i'll try that myself.

what a HUGE difference that made! i can now breath more normally against the pressure. now, when i breath out, i don't feel rushed to inhale. i can let there be a more comfortable lag in between.

Mark55 wrote: ↑

Sat Nov 24, 2018 12:23 pm

I was always under the impression that standard/soft response settings only related to how quickly the machine raised the pressure in response to an event in APAP mode?

Mark55, AFAIK, no one has found and posted the nitty gritty details that we'd like to have for the "Soft Response" setting. I suppose it could include a bit of EPR, or not. I asked about the setting at my last sleep doc appointment - the PA didn't even know the setting exists. She went to check with an RT, and came back with the same general information that you found. What I'd like to know, is details like these, that palerider has posted for the Airsense 10 Autoset.

palerider wrote: *documented*:
OA/hypopnea response: Increases pressure based on current pressure every 10 s of apnea: increment max 3 when pressure is 4. Increment drops linearly down to 0.5 when pressure is 20.

Flow limitation response: S9/Air10
: uses 3 breath average FL index. Increment typically around 0.6/breath for severely flow limited breaths. Lower increment if lower FL index, high leak or as pressure increases further above 15;

Snores: S8–S9: increment max 1/breath. Lower increment if snore is less severe, high leak or as pressure increases further above 10 S10: increment max 0.6/breath for a loud snore otherwise same as S9.

I tried out the soft response for 10 days a couple of months ago. Just to see what it's about. In my case, it's not an option. My AHI is greatly impacted by supine sleeping. Soft response was fine if I stayed on my side. But when I roll on to my back, the soft response is just too not enough increase to kill my FL's, and I would have event after event. Here's an example - my AHI over the time I was supine is 8, my AHI using Standard response is under 2 (so far) zonker, AFAIK you don't have a positional aspect to your AHI, and your FL's aren't like mine, so i doubt you'll see anything like this. I'm not trying to discourage anyone from trying out Soft Response - just pointing out that it isn't for everyone.

djams wrote: ↑

Sun Nov 25, 2018 2:22 pm

Maybe you're finally finding your "CPAP happy place"!
<snip>
zonker, AFAIK you don't have a positional aspect to your AHI, and your FL's aren't like mine, so i doubt you'll see anything like this. I'm not trying to discourage anyone from trying out Soft Response - just pointing out that it isn't for everyone.

thanks for the best wishes! as to the other, i'm not entirely sure that my position isn't having some impact. i didn't post it, but last night was filled with many obstructives. it's not something i worry about. i know i'm going to sleep on my back every now and then because of my lower back pain which is relieved by sleeping on my back with a pillow under my knees. normally i'm a side sleeper.

but i'll keep an eye on that. it could jolly well be that "soft" is TOO soft when i'm on my back.

Here is another 'generic' piece of info off a ResMed page. Not much in terms of detail here either. I left mine on standard response FWIW.

"AutoSet Response comfort setting offers gentler pressure increases and a smoother night’s sleep to help patients with high pressure intolerance."

zonker wrote: ↑

Sun Nov 25, 2018 2:29 pm

djams wrote: ↑

Sun Nov 25, 2018 2:22 pm

Maybe you're finally finding your "CPAP happy place"!
<snip>
zonker, AFAIK you don't have a positional aspect to your AHI, and your FL's aren't like mine, so i doubt you'll see anything like this. I'm not trying to discourage anyone from trying out Soft Response - just pointing out that it isn't for everyone.

thanks for the best wishes! as to the other, i'm not entirely sure that my position isn't having some impact. i didn't post it, but last night was filled with many obstructives. it's not something i worry about. i know i'm going to sleep on my back every now and then because of my lower back pain which is relieved by sleeping on my back with a pillow under my knees. normally i'm a side sleeper.

but i'll keep an eye on that. it could jolly well be that "soft" is TOO soft when i'm on my back.

If you really want to find out about the impact your sleeping position has on AHI, you can get a $25 Wyze cam. PR recommended this in my therapy thread. You can set it to record motion, infra-red and save to the SD card. This really made a lot of things click for me. You can directly associate Flow Rate chart disturbances to video motion. Definitely answers any question about sleeping position. Gave me a better understanding of what I see in my charts. It takes up quite a bit of time, for me it was worth it. And I happen to know that you're retired and don't have anything better to do anyways.

Mark55 wrote: ↑

Sun Nov 25, 2018 5:22 pm

Here is another 'generic' piece of info off a ResMed page. Not much in terms of detail here either. I left mine on standard response FWIW.

"AutoSet Response comfort setting offers gentler pressure increases and a smoother night’s sleep to help patients with high pressure intolerance."

A noble purpose.

Hopefully some details will leak out one of these days.

Hello I am new to this and have an Airsense 10. My Dr. said we need to disable soft mode right before leaving for the weekend. Can I turn off soft mode myself or is this a clinical only setting? Thanks!

SARBAL wrote: ↑

Fri Dec 07, 2018 7:34 pm

Hello I am new to this and have an Airsense 10. My Dr. said we need to disable soft mode right before leaving for the weekend. Can I turn off soft mode myself or is this a clinical only setting? Thanks!

Go to the link at the top of apneaboard.com, follow the instructions, and someone will email you a copy of the clinical manual.

hi, kids. it's been awhile so i thought i'd update this thread and give it a jazzy new name to boot!

the original intent of this post was my concern about what i considered a wide swing in my ahi numbers. without looking back to check (cuz i be lazy) i seem to recall that i would go from 2.5 to below one. what i wanted to happen was to stick to an ahi, ANY ahi, for a bit. just so i could have some routine in my sleep journey.

much was covered. in fact, i learned something about myself. i was drinking too much red wine, which was causing me to wake with a slight headache in the morning. not exactly a hangover but kind of/sort of like that. so i cut back and the headaches disappeared.

for the most part, my aerophagia went away! not sure exactly why that is. i suppose that after 3 years, by body adapted? at any rate, i'm happy about that. because i've adapted, i was able to increase my minimum ahi without fuss.

the first post in this thread, i shared a chart showing a minimum pressure of 8.8. by SLOWLY increasing my minimum a bit at a time, with long periods allowing me to adapt, i am now using a minimum of 12.6! this has resulted in an average ahi for the last month of 1.13. so that's terrific!

however, something happened in the last week or two and i think it sheds some light on my troubles in getting my therapy maximized. my ahi numbers started rising . i reached the range of 1.39 to 1.91 this last week, although last night the total ahi was 1.03. i realize, again, that we don't sleep the same way each night, but this causes some concern for me.

so, let's turn the clock back a bit. two weeks ago, during a routine check up, was telling the doctor of a choking incident i had. he wanted me to have a barium swallow.

what that barium swallow revealed is that i have as the doctor describes it a "light hiatal hernia". at this point, after discussing it with my doctor, we think this isn't something that needs to be acted upon at once. truth to tell, i don't have the classic symptoms. i don't have gerd. i rarely have heartburn, though that seems to be changing as i age.

it could, indeed, be silent gerd. but i don't know enough about this to make any sort of judgement. the doctor and i have agreed to keep an eye on this and revisit it in six months. i have had difficulty in swallowing over the last 10-15 years. so i'm going to keep an eye on this, for sure.

i realize that the folks on this forum aren't doctors, but still, i want to ask-could this hiatal hernia or gerd negatively impact my sleep apnea? could this be the cause of my numbers going up?

does this "condition" wax and wane? does it grow strong at times, then subside?

or am i just putting together some medical conditions i have and coming up with a silly conclusion?

i know there has been lots of talk about gerd here on the forum. but as i didn't think it applied to me, i've not paid any attention to the subject.

as always, happy to post charts if you want 'em.

what do you all think?

My suggestion is to start a journal.

In the morning when you first wake up, enter in how restorative and restful your sleep was, and also note if you are experiencing any pain.

After this, review your data and enter in your numbers.

At this point you can do some review...

Prior to going to bed, enter in your accomplishments for the day and also enter in what you are looking forward to tomorrow and next week.

Repeat for a week and review, then after a month and review again. This should help you decide what significance to place on your variable AHI numbers.

In the end it is not about AHI but about how you feel. The goal is to wake up restored, rested, and pain free.

Z......I had severe gerd about 16 years ago. At that time I had Fundoplication surgery to fix the gerd and hiatal hernia. During various visits to my GI, he told me that he estimated that 40-50% of the population had some sort of HH and most don't know it because they have no symptoms and have never been scoped. In my case there was no relation between OSA and HH. At her last endoscopy, my wife was told that she has a HH. Many HH are called "sliding HH" because they slide in and out of the diaphram. They could be here one day and gone the next.

LSAT wrote: ↑

Sun Mar 03, 2019 6:05 pm

Z......I had severe gerd about 16 years ago. At that time I had Fundoplication surgery to fix the gerd and hiatal hernia. During various visits to my GI, he told me that he estimated that 40-50% of the population had some sort of HH and most don't know it because they have no symptoms and have never been scoped. In my case there was no relation between OSA and HH. At her last endoscopy, my wife was told that she has a HH. Many HH are called "sliding HH" because they slide in and out of the diaphram. They could be here one day and gone the next.

thank you for that. yup, a google search takes me to nissen fundoplication surgery. while i'm not a fan of surgery in general, at least this method seems the least invasive. there is a newer type of this surgery, but it's not common yet.

and my doctor mentioned that statistic. good to hear it backed up. as i say, i'm not presenting with any of the more classic symptoms. but it's always good to hear from others.

thanks!

hey, guys, got a question about this chart-



those clusters of oa, do they look real or swj? i don't particularly remember being awake at those times, but it's possible.

what do you think?