A few questions

[Airwolf]

[Pugsy]

Your settings are 4 min and 20 max...what we call wide open and that minimum of 4 is a bit low and it takes too long to get to where you need to be for the pressure to hold the airway open and prevent the airway collapses...I suspect 7 cm would be a better minimum starting point....maybe 8 or 9.

I sure don't see the need for 12 or 14 fixed pressure though.

[Airwolf]

I'm actually kind of perplexed because in the sleep study, it was predominantly hypopnea. At home, it's very heavily weighted towards obstructive apnea. What would explain that?

I'll kick the base pressure up to 7 tonight. Being able to see these stats is pretty nifty; I will definitely need to remember to go back and donate to the developer.

What else should I be considering... granted it's first night with the new machine. I did turn off the apap when I was awake in the middle of the night to keep the stats sane.

[Pugsy]

Sometimes the difference between hyponea and OA isn't really all that big and we don't know what criteria your sleep study place used for their definitions.

Example...with these machines the cessation of breathing has to last 10 seconds and the flow reduction as to be
at least 80 % to get an OA flag...it doesn't have to be a 100% no air flow to get an OA flag.
and 40 to 79& to get a hyponea flag.
The difference between 75% and 80% air flow reduction really isn't all that much in the grand scheme of things.

And I wonder about that first OA cluster pretty much immediately when you turned the machine back on during the middle of the night.
Unless you immediately went right to sleep right after pushing the button...I am wondering if some of that isn't Sleep/Wake/Junk getting flagged by mistake. The machine only measures air flow...it has no idea if you are asleep or not.

There's still enough clustering at other times that I am fairly sure you were asleep though...so you need more minimum no matter if that cluster was SWJ or not.

[Airwolf]

As I recall I was out within 3-4 minutes. I had actually startled myself back awake a bit and was stuffy, realized the machine was in fact off, turned it back one, and was out cold before I knew it... I can only positively remember maybe 2 minutes of trying to determine if my nose was going to clear back up or if it needed some nasalcrom.

That huge leak spike was me waking up briefly with an itchy nose. I pulled the mask a half inch off my face, scratched, and reseated it.

[Pugsy]

Were you on your back by chance?...when that one cluster happened so soon after turning the machine on?

Your pressure needs roam around a bit and when we see that we wonder about supine sleeping and REM sleep...both which commonly can cause our OSA to be worse and/or need more pressure.

I don't have the supine thing so much but I have the REM thing a lot...my OSA is about 5 times worse in REM than when in non REM and my pressure needs are sometimes significantly higher in probable REM sleep.

[Airwolf]

I think you just nailed it. Yeah, I think I was. I usually sleep on my right side (reflux issues once upon a time, habit stuck) but supine is a go-to in my sleep. LadyWolf was constantly rolling me back onto my side (well, making me...) for snoring.

[Airwolf]

Doing a bit better and getting things dialed in closer. I started with 7.0 and had an AHI of 6.6. Kicked it up to 8 and had it 6.4. Looked at the time spent at pressure graph, and found a reasonable cluster at 8.4 so set it there last night. Tonight was better, but would definitely like to get that number -down-.... The wakeup about 3:40 am was due to nightmare; I'm sure the cluster of CA events was me tossing and turning trying to get back to sleep.




It kind of look like it's suggesting I do 9-ish on the pressure. Am I thinking correctly?

Thank you,

[Pugsy]

Roughly half of that AHI is Clear Airway/Central apnea and you need to remember that more pressure won't reduce/fix those centrals with your machine.
From the timing and clustering of those CAs close to known awake times where the machine was obviously turned off and back on again I suspect that the centrals probably aren't real but instead are what we call Sleep/Wake/Junk. Meaning awake breathing irregularities getting some sort of apnea flag and awake stuff doesn't count.

And yes...the overall average does seem to be running in the 9 cm range which might be a good ultimate goal for the minimum pressure when in auto mode.

Your report last night...why the wake ups? The wake ups concern me more than the AHI of 4 which half of it is central anyway. I am thinking if less wake ups that the AHI would be less because of less chance of SWJ flags happening.

[Airwolf]

Last night the big wakeup was a pretty nasty nightmare. The other ones I think were light related, not certain, full moon and all. Also, there's some tickborne stuff thats running around my bloodstream that can cause sleep disturbances; and I'm also having comfort issues staying on my side all night; my hip feels like it's been kicked and I think thats not helping me stay asleep.