150 Second Apnea Event

[Somnos]

I am now 2 weeks into treatment. Because I was having way too many events (~15 per hour; 37 per hour on initial study) with My AirSense 10 Autoset despite maximal pressures, I returned that device and 3 days ago got an AirCurve VAuto Bi-level, which can produce pressures up to 25 cm H2O. Unfortunately, still having similar AHI with the new machine. Also, having very long apneic episodes. I believe the first graph documents a 150 second obstructive apnea. Sleepy Head breaks down what appears to me clearly to be a single episode, into three consecutive apneas of 48, 52, and 50 seconds duration. I think they're all the same episode, because nothing in any of the tracings suggests to me that Episode 1 or 2 ever ended, until the "3rd" episode terminated. If true, that total duration was 150 seconds. Just prior to that long one I was breathing for about 60 seconds, but just prior to that, I'd had a 68 second obstruction!

Downright sickening, worrisome, and discouraging. I'm open to any thoughts or ideas about my case. Not seeing the sleep specialist until 8/27.

If there is any good news: I'm tolerating the high pressures well without major leaks, subjectively sleeping well and, believe it or not, my ResMed myAir app this morning told me that I got a "great score" of 92 out of 100! WTF?!?

I'm inclined to trust Sleepy Head who rated my results as "Horrible" this AM.

[JimW159]

... believe it or not, my ResMed myAir app this morning told me that I got a "great score" of 92 out of 100! WTF?!?

I'm inclined to trust Sleepy Head who rated my results as "Horrible" this AM.

"WTF!," indeed. That's like finishing five minutes behind the winner in a three-person hundred metre dash and hearing: "congratulations, you won a bronze medal!"

[Julie]

It would be better to see the AHI at the top of the left hand stats than the enormous(!) MyAir stuff (that you shouldn't be bothering with anyhow).

[Pugsy]

Were you on your back from about 4:20 to 4:50?

Your pressure needs weren't sufficient at that time of the night and seemed to be sufficient for other parts of the night.

It would have been helpful to see the non zoomed in detailed graph so we could see what the pressure was doing before those flagged events.
Something caused the pressure needs to change significantly because other parts of the night you weren't have such a massive density of OAs. Usual culprits for when that happens ..supine sleeping and/or REM sleep stage. Both of which it is common for our OSA to be worse and need more pressure.

[Somnos]

It would be better to see the AHI at the top of the left hand stats than the enormous(!) MyAir stuff (that you shouldn't be bothering with anyhow).

So helpful. Thanks!

Were you on your back from about 4:20 to 4:50?

Your pressure needs weren't sufficient at that time of the night and seemed to be sufficient for other parts of the night.

It would have been helpful to see the non zoomed in detailed graph so we could see what the pressure was doing before those flagged events.
Something caused the pressure needs to change significantly because other parts of the night you weren't have such a massive density of OAs. Usual culprits for when that happens ..supine sleeping and/or REM sleep stage. Both of which it is common for our OSA to be worse and need more pressure.

The non-zoomed in graph is below the zoomed in one. You might mean a zoomed, but not-so-zoomed in, graph from the period of time before the prolonged apnea. If that's your meaning, see below.
I don't know what position I was in when the prolonged apnea occurred. I go between my left side and back. I put a pillow behind my back to try to prevent/minimize supine sleeping, with variable success.

[Pugsy]

I just wanted to see if the pressure was already up when that ugly cluster happened...and it was and had been for a little while.
So it's not a response time thing.

You need more minimum EPAP to prevent clusters like that from happening...of if you were on your back then you need to stay off your back which is often easier said than done.
The thing is you were already at EPAP of around 19 before that cluster even started to happen.
Not much room for more epap.

I think it if was me I would make more of an effort to stay off my back.
While this might have been REM stage sleep related I have my doubts because you probably had REM prior to this time frame and the pressures were sufficient at those times.

[Somnos]

Thanks Pugsy. Will keep trying to stay off my back. The graph below is pulled from this article on sleep position in sleep apnea...Length of Individual Apnea Events Is Increased by Supine Position and Modulated by Severity of Obstructive Sleep Apnea https://www.hindawi.com/journals/sd/2016/9645347/. Interesting that the degree of difference in several measures (desaturation events on this graph, but especially true for hypopnea duration) is less in severe apnea cases than in mild to moderate cases. Thanks again.