Using Respironics asv bipap lost weight, apena worse

[Boop]

D

I don't Watch TV in bed. I took it out of my bed room years ago.
Sometime I drink a smoothie before bed.Blueberries and almond milk, almond butter.I don't anymore. It's hard to go to bed hungry.
I never use caffeine ever. Rarely drink alcohol except in my Kombucha. I drink that before 4pm.
If I awake during the night my cognitive therapist said I must get out of bed and go in another room. When I try that I never get back to sleep. And the whole day is horrible. Whether i get out of bed or stay in bed my sleep is the same the next night.

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[Boop]

I have had this headache for almost 2 weeks now. So you are saying after a week I should change it to 7. It's at 6.5 now.

[Pugsy]

I don't know that the headache is related to the increase in apnea/hyponea events but it might (slim chance I would think) and if it were me and I was seeing the AHI you are seeing I would not wait to increase the minimum EPAP and see if I could reduce those hyponeas a little more.
JDS74 and I have a difference of opinion as to just how important those hyponeas might be.

While I doubt the headache is oxygen related...maybe more of a poor quality sleep indicator with the possibility of arousals (that you may not remember) with those hyponeas. I know if I have a crappy night's sleep with more than usual number of arousals I will wake with a headache.
You could look at the event duration for those events you are having....the number in parentheses is a very close approximation to event duration in seconds...within 2 or 3 seconds usually. If those hyponeas aren't prolonged I doubt that the reduction of airflow during a hyponea is going to cause desats unless you have something else going on.

I did use a 960 machine for about a month...my hyponea count was also a little higher like yours until I increased the min EPAP. I felt fine though...no real difference in how I felt or slept with a rather ugly AHI and a nice low AHI.

So I don't know that the headache is related to AHI or not...but it hurts nothing to try a little more EPAP to see if reducing the hyponeas make any difference.
Bear in mind we were suggesting this for aerophagia relief...didn't know about the headaches until now.

[JDS74]

Pugsy wrote:

JDS74 and I have a difference of opinion as to just how important those hyponeas might be.

Not really a serious difference of opinion but one of priority in getting them resolved. I didn't know about the two weeks of headaches or I would have moved solving the hypopneas a little higher on the list.

That said, moving the EPAPMin up to 7 from 6.5 may help and may affect the headaches if they are caused by low oxygen levels. As always, watch the Aerophagia to make sure the increased pressure doesn't bring that back and mess up what sleep quality you have.

My personal experience with hypopneas on the Respironics 960 machine is that it is quite a bit more sensitive to them and reports them when the Auto BiPap 750 I used to use showed very few. The general solution for too many hypoponeas is to jack up the pressure a lot and then they will go away. In your case, that resurrects the Aerophagia monster so it is really off the table. Do you have or can get a copy of Encore? Encore is a much better tool for looking for signs of arousals than SleepyHead. It shows every breath, all night and breathing patterns that indicate arousals are more easily seen. That is the way to distinguish arousal based hypopneas (ignorable) and others related to airway issues (more pressure is needed to fix that).

Bear in mind, the goal here is good sleep and not good numbers which are a surrogate. When I was using the 750, my AHI was almost always below 5 and mostly my sleep was lousy. On the 960 it is rarely below 5 and mostly my sleep is pretty good. The difference now is the number of arousals/wakenings is a strong indicator of better or worse sleep. Good nights, I wake up 5 or six times in 7 hours, bad nights 8-13 times. My all time record for 7 hours was 17 times fully awake. For me, none of that is breathing related since the 960 fixes all of those things nicely.

[Boop]

Thx for the explanations. Tonight I will put it up to 7. I will see if my son can put on encore. I once did have it but there were some problems with it.

[Boop]

Last night data.

Another disaster. I went to bed at 11. Took a while to get to sleep. Maybe went to sleep between 12-12:30. Woke up at 3. Couldn't get back to sleep. I think the aerophagia woke me. Turned the epap back to 6.5. Stayed in bed. Keep mask on the whole time until 5:55, then took it off. I even changed the ps max, down because I could feel the inhaling, in the mask and it seems like the mask is moving. Then I turned the ps max back to the original number 10. I even went to my old mask, which didn't help. I am so discouraged right now. I don't even go outside anymore. I am so exhausted. Can't even get the sleep doc's office to respond. On both 6.5 and 7 epap min (while awake) i could feel the air coming in my mouth and it was on inhaling. 5-6 hours of sleep was much better than this and I was complaining.

Hope I am not rambling.

[JDS74]

Sorry about the return of the Aerophagia. Looks as if the EPAPMin of 6.5 is your upper limit and some level of Hypopneas will have to be tolerated. With differing pressures, that's where I am.
Looking at your graph, the time between 12:30 and 3:00 looks really good. The time before 12:30 not so much but if you were mostly awake then, it can likely be ignored.

As part of sleep hygiene, if you get in bed, mask up and then can't go to sleep within 20-30 minutes, you should really get out of bed, go to another room, and read something not so exciting until you feel sleepy again. Tired and sleepy are two different things and sleepy is what you want as you go to bed. Even if you don't succeed in getting sleepy, you will be helping to developing the habit of "I'm in bed, I'm masked up, and I'm going to sleep." Lying in bed for long periods of time not being able to go to sleep supports the habit of "I'm in bed and I don't need to go to sleep right now."

Setting PSMax to 10 will probably be OK. The issue here is the ability of the 960 to actually breathe for you during periods of central apnea. I feel, and my sleep doctor concurs, that a difference of about 10 cmH2O is about the minimum that will work properly and PSMax of 10.0 will provide that.

What was going on after 3:00 that caused the really large spikes in the leak rate? Is that the old mask not fitting properly?
Do you have a hose hanger so that the hose is supported and doesn't tug on you when you move at night? Do you use a soft cervical collar to help with jaw drop and help control the leaks? I get mine from Amazon - be sure that if you get one, it is really soft and not the kind that is stiffer and is used to keep your head lined up.

[Boop]

Thx again. After 3, I was tugging on the new mask. I kept pulling it up. It didn't feel comfortable. I was tossing and turning while in bed with the mask on. I should have gotten out of bed and taken the mask off. I didn't keep the old mask on long. Just a few minutes. Which cervical collar and hose hanger do you recommend?

[Boop]

Last night data.

I feel a little better this morning.Headache not too bad. The aerophagia was there, but not too painful. I also hung the hose on my bed stand, until I can get a hose stand. I went to bed at 11. It didn't take long for me to fall asleep. I woke up at 3. Couldn't go back to sleep. Got out of bed and went into another room to read. Tried to go back to sleep at 5, but I couldn't. Got out of bed. I wish I could get sleepy enough to return to sleep. I think some of it is stress and anxiety related. I do exercise when I am not so tired. I am not a person that likes to take medication. But I am thinking of some alternative ones. Have any suggestions?

Maybe at Epap 6.5 the hypopneas could get better. Last night they look better and I can feel the difference. When they are a lot, I feel lousy. I am hoping to sleep longer. Before the weight lost, I was sleeping between 5-6 hours. I function better on those hours. Today at a certain time I will get tired, too soon. Also I would appreciate JDS74 if you could let know which cervical collar to get. I checked online but there are so many. I know you said soft, but I don't want to purchase the wrong one.

[JDS74]

Your graphs from last night look pretty good. The numbers of hypopneas, etc. are not to high.
For the hose hanger, search on Google for "hose hanger cpap" and you'll see a lot of choices. A price between 8 and 15 dollars will get you one that is quite nice and effective.

The ones I use are made by Duro-med and I get them from Amazon. To ensure the correct size, the length specified relates to your neck size. The width is related to the distance between your chin and your collar bone. Lie down flat and then measure the distance. It will be quite different than when you are sitting or standing up.

Here is a link to the brand I use.
http://www.amazon.com/Cervical-Collar-S ... cal+collar
This one is too small for me but it is an example of what I'm referencing. The medium relates to neck size of 13-15 inches.

You mentioned cognitive therapy earlier. Did your person give you any exercises that could help with anxiety? I studied TM many years ago and find that mediation helps with anxiety at night and getting me to sleep. The process helps clear your mind of any thoughts at all, no images, etc.

When you wake up in the middle of the night, first just try to go back to sleep don't make a big deal of it. If in 20 minutes or so you are still awake, then unmask, get out of bed, go to another room and sit quietly but don't dwell on the fact that you are up and not in bed. During this period in your CPAP therapy, such occurrences are really no big deal. It takes time for your body and mind to get used to having a nice steady flow of air and to having some restful sleep. Up 'til this time, your mind has had to struggle to keep you breathing and that struggle that goes on while you are sleeping is stressful. You have to give your mind some time to adjust to the new circumstances of "I'm in bed and I can sleep without the struggle." It's a tough habit to break but it will be. The other part of the habit is the "I'm in bed and it's OK to not be going to sleep." That's what the going to another room is all about, training your mind to realize that bed means sleep and rest not struggle.

All of this takes time. We are all on a long journey, some just starting, some really long-time travelers. I've only been on the 960 part of my journey for about 2 years, and before that an AutoBiPap for 3 years, and before that a lifetime of sleep means a struggle to breathe and stay alive. Everybody who is on the 960 or equivalent has a difficult struggle. What got them there is much more complicated than obstructive sleep apnea alone.

Hang in there. It will get better.

[Boop]

Thanks for all the good information. I will be purchasing the the collar and hanger. I prefer breathing exercises.

I know I have to be patience with everything. I have been on cpap almost 3 years. I didn't expect to go backwards in a since. My latest goal was to try to sleep more than 6 hours, but I am back to 3 and 4 . The weight loss really did change things. Anyway thanks again

[Boop]

Last night data.

Was a strange night. I went to bed at 11. Woke up at 3:50. Couldn't go back, so I went into another room and read. Felt sleepy about 5:20. Went back to bed. May have taken me 20 minutes to go back to sleep. Woke up at 7:24. I went pass my wake up time, which is 6:00, which I didn't want to do. One good thing is that I did go back to sleep, but I don't think going pass wake up time is good. What do you think? Also I don't know if the mask was a problem last night.I felt like there was air coming out. I don't think I put it tight enough.

[archangle]

Check the Useful Links in my signature line at the bottom of this post. There's a link to a youtube video about a trick to avoid aerophagia. It doesn't cost anything to try, but it does involve sleeping on your back.

[Pugsy]

Are you on a strict "time in bed/asleep" thing and that's why wondering about sleeping past 6?
Trying restricted sleep hours to maybe help with the insomnia? CBT type of thing?

[Boop]

When I started with the sleep clinic they had me see a sleep therapist who wanted me to go to bed at the same time and wake up at the same time. I never got this under control. They wanted me to always get out of bed the same time every morning. So I set my time for 6,even through I am always awake before that time. So when I went back to sleep last night and slept to 7:24, I feel I am throwing my time clock off. I don't go anymore to see her because I still can't sleep past 5 hours. I not only have complex sleep apnea but I also have a problem sleeping past 5 hours. Anyone know anything Abt CBT.

I will look at the aerophagia video. Thx