Consistent Use- Where Can I Improve?

[cnlakeshow]

Hi cpaptalk! I've recently dedicated myself to using the machine after taking a long haitus as I'm sick of feeling fatigued and tired all the time. I've purchased a new mask, AirFit P10 nasal pillow, and I'm surprised at how well I have taken to it. I am able to fall asleep in under a hour where as my previous two masks would keep me up at night which is one of the main reasons for me stopping use of the CPAP machine.

I am back to it and have been able to get consistent use over 4-6 hours a night. Last night was my longest use! I am noticing a definite change in my daily demeanor and am feeling generally more happy and alert!

However, I feel my AHI is still too high and have been seeing consistent "Clear Airway" events every night. I'm not sure where to start in tweaking any settings, etc. I know it's best to change one thing at a time. My chart is below. Any glaring issues that you notice right away?

[Pugsy]

Were you awake from 3:30 to roughly 4:30?
How long did it take you to fall asleep this report...was the 23:40 to roughly 0:00 time frame when you were awake?
How many times did you wake up during the night?
Do you take any medications of any kind? If so, what?

[cnlakeshow]

Hi Pugsy,

I'm not too sure when I was awake. Should I be logging these times every time I wake up at night? I don't take any type of medicines. Also, here are two charts from this Wednesday and last night.

I've been noticing a lot of vibratory snore signals. Would this be caused by my leaks? I have nasal pillow mask and I believe I sleep with my mouth open, but my tongue holds against the roof of my mouth from the pressure.



Last night: I believe I woke up at12:40-1:00am and 3:40-4:00

[Pugsy]

When you wake up during the night reach over and push the on/off button to turn the machine off and then push it to turn it right back on again. This will create a break in therapy so we can see for sure if awake or not.
It's more reliable and less work than trying to remember to log an awake time.

Anything flagged while awake doesn't matter. You MUST be asleep for the flagged items to matter.

We aren't ever really told just exactly how or why the snores get flagged but I don't think that leaks would cause it....besides your leak graph isn't all that exciting even when the snore flags are heavy.

Your machine doesn't want to increase the pressure for whatever reason which is a known issue with Respironics for some people.
Its algorithm just isn't very aggressive.

Usually snores are an indication the airway is trying to collapse. An early warning sign of an impending apnea event and the machine should increase the pressure better trying to prevent the collapse. For some people it just doesn't respond as we would expect.
For those people we usually suggest more minimum pressure to see if the flagged obstructive events (OAs/hyponeas) reduce as well as the snores.

If this were my report I would increase the minimum from 7.5 to 8.5 and see what happens. Usually snores, that are real airway related snores, are fairly easy to kill with just a little more baseline pressure. Prevention being the key and not so much trying to fix them after the fact.

[cnlakeshow]

I appreciate the info!

And yes that makes sense to turn on/off the machine everytime I wake up. I'll try and remember to do that. I'll increase my minimum to 8.5 tonight and leave the max at 11. I will post any updates after a couple days use at this level. Thanks again Pugsy!

[cnlakeshow]

This morning I woke up early and feeling great! I took the dog out and tried going back to sleep, but I couldn't as you can see from the morning gap.

Here is my chart from last night. Any concerns or should I keep these settings for now and see where I go from here?