1st night of stats - not good imo

[sleepyowl]

Again, this is only one night with all new stuff, and I'd like to confirm that the mask leak was to blame. Any help/insights would be greatly appreciated.

The leaky mask is to blame for only some of this ugliness. Your leaks are excessively high for an excessively long period of time. The data when large leaks are detected could be even worse than it looks here because the machine can lose track of your breathing.

But there's a whole lot of ugliness that can't be blamed on the large leaks. In particular, that cluster of events between 5:15 and 6:00 can't be blamed on a leaky mask. The clusters that happen between 7:40 and 8:15 (between the large leaks) and the clusters that happen after 8:30 also cannot be blamed on a leaky mask.

Now as palerider and others have commented, your machine is limited with a max pressure of 11cm. And the machine zoomed right up to 11cm at the beginning of the night and sat there except for the pressure decreases when the machine was trying to "fix" the large leaks.

Question: Did you have a titration study? If so, what was the recommended pressure setting? If not, why did the doc decide to tell the RT to set the machine up in Auto mode with a pressure range of 4-11cm?

Next Question: How long were you awake before falling asleep at the beginning of the night? How long were you lying in bed awake before deciding to get up this morning?

Final Question: What was your AHI on your diagnostic test?

We need that kind of information to tease out exactly what might be happening here.

Hey robysue, I did have a study but it was 6 years ago (and 30lbs ago). I didn't have another this year b/c I couldn't meet my deductible, so my doctor got me the auto cpap. He's working off of 6 year old data. In lieu of a new study, I think I'll be stuck going a few days and contacting my doctor for him to up the pressure.

I was awake for maybe 10 minutes. I went right to sleep.

Unfortunately, I don't have the AHI from 6 years ago. Sorry.

Also - there was a period around 5am when my wife woke me up due to a massive leak. I also went to the restroom and fell right back asleep.

[palerider]

Also - I think it's incredibly stupid for the Airsense 10 to give all smiley faces with the little "sleep report" after a night like this. A smiley for mask seal? Really?

there probably should be a 'meh' face between frowny face and happy face.

the frowny face comes in when you're over the max for more than 30% of the night, which is pretty bad.

[palerider]

I think I'll be stuck going a few days and contacting my doctor for him to up the pressure.

if it were me, I wouldn't wait, I'd change the settings right now.... an ahi of 60 is ... well... worse than a lot of peoples untreated apnea.

[robysue]

Hey robysue, I did have a study but it was 6 years ago (and 30lbs ago). I didn't have another this year b/c I couldn't meet my deductible, so my doctor got me the auto cpap. He's working off of 6 year old data.

Did you have a titration study done six years ago? It's strange that the doc did not order the APAP set to run wide open (4-20) under these circumstances.

In lieu of a new study, I think I'll be stuck going a few days and contacting my doctor for him to up the pressure.

I can understand your reluctance to change your own pressures. But you should contact the sleep doc tomorrow rather than waiting until next week.

I was awake for maybe 10 minutes. I went right to sleep.

That indicates these large clusters of events can't be written off as "mis-scored wake breathing". You need more pressure to control the obstructive events.

Also - there was a period around 5am when my wife woke me up due to a massive leak. I also went to the restroom and fell right back asleep.

The CPAP data for the night shows the machine was first turned on at 5:03 AM. Is your CPAP clock off? If so, by how much? When did you go to bed? When did you wake up?

[sleepyowl]

Hey robysue,

I just noticed, but this data is for my second sleep session. When I launch SleepyHead, it shows an AHI of 45.x. However, when I click on daily stats, it only shows that second session after I woke up briefly. I wen to sleep around 12:30am and woke up at 5am like I mentioned. Hmmm....

[sleepyowl]

And if you're a back (vs sides) sleeper, which provokes many more apneas, do whatever you can to keep off your back overnight, even if it means wearing a backpack (or sewn-in ball) til you've converted. I also suggest using a soft cervical collar to keep your head off your chest (if it applies), your airway more open (you could be cutting off air quite a bit otherwise) and your mouth closed.

Hey Julie,

Can you recommend a soft cervical collar? I think I'd like to try it. I want to make sure it doesn't get my neck too hot at night. Thanks!

[Julie]

Hi - your stats may not appear properly if you look at them after noon hour because the machine records from noon to noon, not e.g. 6 am or pm to 12 or 24 hrs later... so you have to check reports before noon time.

And being in Canada I'm not sure of the best places to buy collars there, but use the forum search box to look because there were just a bunch of suggestions made yesterday by others (and lots in the past).

[ChicagoGranny]

Can you recommend a soft cervical collar?

I recommend a cervical collar over a chin strap. The collar works better for me and doesn't interfere with the mask headgear like chin straps tend to do. A collar is also very cheap to try.

Currently, I am using DMI Universal Firm Foam Cervical Collar - http://www.walmart.com/search/?query=DM ... l%20collar (Shipping is free if you pickup at a local Walmart store.)

Note that the firm comes in sizes from 3 to 4 inches wide. I recommend 3.5-inch for average size person and 3.0-inch for small person as a starting point. After using one for a while, you might need to go up or down a size when you reorder.

[sleepyowl]

Wow. Switched back to my Wisp mask and increased the pressure. This is good stuff. I have so much energy.

[ChicagoGranny]

Wow. Switched back to my Wisp mask and increased the pressure. This is good stuff. I have so much energy.

Look at how much higher your pressure requirements are in the last two hours of sleep as compared to the first two hour. There are at least two possible explanations.

- You slept on your side the first two hours and your back the last two.

- You had a couple of long periods of REM sleep during the last two hours.

In any case, congratulations on the good results especially, the energetic feeling. Energy is the real target. Data is just a tool (though an excellent tool) to help get to energy.

[sleepyowl]

ChicagoGranny - I remember waking up several times right at the end of the sleep session. The mask was mashing my nose so I readjusted it and went right back to sleep. I was, in fact, on my back when that was happening. Also, the pressures are way higher than I thought I needed. Isn't there a possible condition associated with high pressures? Seems like I read about it on this forum but can't remember.

[robysue]

Isn't there a possible condition associated with high pressures? Seems like I read about it on this forum but can't remember.

Approximately 10-20% of new PAPers can develop pressure induced central apneas if the pressure gets too high. For many of them, the CAs will resolve in a few weeks without any additional tweaking of therapy, but a few go on to need ASV machines.

You have no central apneas at all on this night so chances are you won't have any problem with pressure induced central apneas.

Some people's stomachs also have a difficult time tolerating pressures that are very high. But if you didn't have any issue with aerophagia when you woke up this morning, then chances are your stomach is just fine with this much pressure.

Congratulations on the wonderful night! And here's hoping you have lots and lots more just like it.

[ChicagoGranny]

You have no central apneas at all on this night so chances are you won't have any problem with pressure induced central apneas.

+1

Isn't there a possible condition associated with high pressures?

I made it a habit to look at the machine display upon arising each morning. I check the AHI, number of OAs, Hs, CAs and leak level. As long as these are consistently good and I am feeling well, I'm through looking at that data - no SleepyHead download.

If anything ever looks out of order or I feel bad, I'll make a download and look at some detail in SleepyHead. Sometimes I go for months without looking at SleepyHead.