Get to play Doctor

[DeadlySleep]

"the wife"

You would get an earful if you used that around the independent women in my family.

And calling her "the wife" is a decent way to make it clear when I'm talking about her instead of the OP.

Even to crusty old me, it sounds archaic and demeaning that you did not say, "your wife".

Maybe I've been brainwashed? Or just taking the path of least resistance.

Time for a drink. Cheers.

[palerider]

Maybe I've been brainwashed? Or just taking the path of least resistance.

well, it's certainly the *safer* path, less likely to result in bodily harm and emotional trauma.

[Tatooed Lady]

So, you were thinking to try Pugsys suggestion of 6-10 cm, did you, and how is that working?
And FWIW, I agree that making changes too fast will screw things up. Every time I make a change, I get GREAT numbers the first night...after a second or third, however, notsomuch. And if my AHI is under about 1.4, with a good number of hours of sleep AND proper humidity, I feel pretty okay. AHI over that, I start to feel rough. 3 or higher? Just shoot me now. Everyone is different, so while you watch the numbers, ask how your wife feels. See what works best to keep her happy and comfortable.

[Sircadian]

I've been away ~ 24 hours and there are too many post to respond to all, especially after golfing and the 19th hole. They've all been read. Appreciate the feedback and glad to see some have entered the thread. For those that have a problem with me being sneaky, kiss m. ... ,
She was not told of the pressure changes because she is the type that may get concerned or worry about that, and that would disturb her sleep. Keep in mind that initial therapy can cause anxiety for some. When I finally told her after two nights what I had done, she was fine with that and understood because it was somewhat under clinic guidance. Those following should understand the testing wasn't done with wild and crazy numbers. AHI hasn't gone >4. I asked 'the wife' to pick the pressure for the 3rd CPAP test and she chose 8 because that was the number the clinician suggested.

Some still are not getting the fact, the clinic was happy, felt that they had enough info from the first 7 nights (at wide open settings) and the fiddling or changes could start. Some may want to read that last sentence again, either way the testing continues.

Now onto the meat of the matter, graph below for last night.
I'll add this info to aid in a better understanding of the details:
* said she had a poor night cause she was up for breaks, first one was a bathroom break.
* next 5 minute break you see was to fix a problem with one nostril that was plugged (first time she had an issue with that)
* next 1/2 hour break was because she couldn't get back to sleep after the last 2 breaks.
* said she's felt better in the last 10 days.
AHI is lower overall than the CPAP nights, pressure got closer to 10 than previous settings Hopefully Pugsy gets a little info from this and I'm thinking about leaving it on Pugsy's suggested settings (6-10) for another night, last night was a bit of an anomaly.

[palerider]

Some still are not getting the fact, the clinic was happy, felt that they had enough info from the first 7 nights (at wide open settings) and the fiddling or changes could start. Some may want to read that last sentence again, either way the testing continues.

and you're still not getting the fact that most clinics are happy with part of a night's data, and call it good, and send people off...

more data is better! you'll have years to fart around with a constant pressure machine.

[Pugsy]

Overall a decent report except for of course the wake ups and breaks in therapy but those sort of things can happen to anyone new to therapy or a veteran of years.

If she is/was good overall last night then I would suggest one more night with the 6 to 10 range and if the median number still wants to be around 7 ish...that would be my next suggest to try...7 cm minimum and 10 maximum.
Normally I would take a little longer and suggest going up in 0.5 cm increments but we are short on time and I suspect that she is going to need more anyway.

[Sircadian]

Thanks Pugsy,

I'll let it run 6-10 cm tonight and get back in another 24 hours with the new graph.
Cpap settings can wait for a bit more info. Still have approx 7 days left before we give it up.

[Sircadian]

It's 12:02 am, you have a good birthday and thanks again for all your help.


Sirc

[Sircadian]

Hope your birthday is going well and your family and friends are doing you right.

When you return, maybe you can take a peek at this one with even wilder results.
CA's are up again, seems she gets the odd night with these. AHI is at an all-time high.
Seems the pressure went up at 1:30 AM (placed green vertical line near the increase), right after that the leaks started to surface and the pressure stayed high.
Due to the unusual leaks (P10 nasal pillows for her) this may be a bad night to learn anything from the charts.

[Pugsy]

Well the bulk of that AHI is CA/central at 2.44 and we don't use pressure to treat centrals with this machine.
It could be awake/semi awake breathing irregularities getting flagged or it could be real centrals but we still have to mentally remove them from the evaluation process.

First half of the night was really quite decent but the seconds half sort of went down the tubes between the leaking and the pressure increases which probably made it more difficult to keep a seal.
I don't remember which mask is being used but a good bit of that leak looks like mouth breathing plateau leaking.

You know the snore graph isn't really all that helpful but the flow limitation graph might be more useful.
I wonder if the flow limitations are what is driving the pressure up in that last half of the night.
Could you maybe replace the snore graph with the flow limitation graph and let's see what that might show?

Given that the bulk of the AHI is central and the bulk of those centrals seem to go along with the leaking and more pressure in that second half of the night ....I am thinking that those centrals are either awake/semi awake breathing irregularities or post arousal flagging. I doubt that they are related to the pressure itself as in causing unstable breathing centrals.
I am thinking a crappy second half of the night due to leaks and maybe the pressure changes and we sort of have to set the second half of the night aside in terms of meaningful information being gathered.

I would like to see that flow limitation graph when you have time. No rush. Going to go run some errands right now...well not run in the literal sense with the bum knee but you know what I mean.
Not doing anything special for the big day today...going to have lunch with my mom tomorrow. Right now going to take a little drive and see if I can find some strawberries that I don't have to pick.

[Sircadian]

To answer your questions:
* she has been using the P10 nasal pillows that have been free of leaking issues, up until now.
Mouth breathing hasn't been an issue that we know of. She says she is comfortable with the nose breathing.
Previous chart leaks over redline are excellent (0.00 - 0.5 range) and there no dry mouth in the mornings.

* pressure hasn't been this high in the previous charts

* here is the chart with flow limit.

Thanks for your time and analysis. Now it's time for me to do a little running around and look after the ' honey do' list.

[postitnote]

"the wife"

You would get an earful if you used that around the independent women in my family.

And calling her "the wife" is a decent way to make it clear when I'm talking about her instead of the OP.

Even to crusty old me, it sounds archaic and demeaning that you did not say, "your wife".

Maybe I've been brainwashed? Or just taking the path of least resistance.

Time for a drink. Cheers.

I used to refer to my spouse as my "old man". That stopped once he realized he is now old, lol. Now he's "the hubs". He refers to me as "grumpy" mostly. He has a tee shirt that says "sometimes I wake up grumpy and sometimes I let her sleep". I don't have a problem with that. I like to sleep late.

[bwexler]

Some of us prefer our sweet manual transmissions. I and hubby have two Mazda3s, both with manuals. They're much more fun to drive than an automatic.

Some people are just weird. I have driven many manual transmissions, but given the choice I will go automatic every time, and I have felt this way for 50 years.
The exception might be for an occasional trip to the mountains.

[HanzT]

My wife likes being called "wife", but really likes to be called my "queen". Since that makes me the king, I good with that.

[postitnote]

My wife likes being called "wife"

I read the whole thread. The point here wasn't that robysue said "wife". It was that she said "the wife".

"The wife" or "the husband" is condescending, not so subtly dehumanizing and archaic.

It's pretty common where I live to call people "the...". I think it's just an expression not meant to hurt.