Strange snoring issue

[davewalsh]

The brain trust is currently logged off, so here is my opinion.

You're as much a part of the brain trust as anyone else here.

At the end of the day, make a note of how you felt during the day. Energetic? Any excess sleepiness?

Thank you for your insights. I'm feeling pretty good. Not necessarily energetic, but I have had very few energetic days since going on CPAP in 2017, even though for the longest time I had an AHI of roughly 2.0 or better. It wasn't until recently when I looked at my OSCAR data after not having looked at it in months when I noticed that my AHI jumped up to around 8 or so in late December/early January that I began to pay attention to pressure/leaks, etc.

[palerider]

Here is the link to my OSCAR data from last night. What does the brain trust think?

https://www.dropbox.com/s/cmbkg6y3odn1q ... 1.png?dl=0

Looks better, I'd go for 11 minimum and see how that goes tonight.

[robysue1]

If you can fall asleep with a min of 10, then go for it, If it gives you trouble, then you can use the ramp to start at a lower pressure (6? 7?) and let it ramp up to 10.

My understanding of the Autoset 10 is that I can have it ramp up from min to max, but not from 6 or 7 to 10, and from there to a max of 20. Are you saying that 10 should be my max, or that 20 should still be my max and that 10 should be my min?

In AutoSet mode with the ramp, there are three different pressure settings:

Ramp pressure = the pressure the machine delivers at the start of the ramp period.

Min pressure = the minimum pressure the machine is allowed to use when the ramp is not active

Max pressure = the maximum pressure the machine is allowed to use.

How the machine ramps up from Ramp pressure to Min pressure depends on whether you have the ramp set to Auto or a fixed time frame. If you use AutoRamp, the machine will stay at the Ramp pressure until one of four things happens:

• 30 breaths of stable breathing (roughly 3 minutes) is detected
• 5 consecutive snore breaths is detected
• 3 obstructive apneas or hypopneas are detected within 2 a minute period
• 30 minutes have passed since the machine was turned on

When one of these things happens, the machine then ramps up the pressure to the Min pressure setting over a reasonably short period of time (maybe 5 minutes).

If you have a Ramp Time selected, the machine starts at Ramp pressure and steadily increases the pressure so that by the time the ramp period ends, the pressure is at Min Pressure. As an example, if the Ramp pressure = 5 and Min pressure = 10 and the ramp period is set to 10 minutes, the machine will linearly increase the pressure at a rate of 1/2 cm per minute.

What palerider is suggesting is for you to set Min pressure = 10 and Ramp pressure = 6 or 7 so that you can still comfortably get to sleep.

[davewalsh]

What palerider is suggesting is for you to set Min pressure = 10 and Ramp pressure = 6 or 7 so that you can still comfortably get to sleep.

Thanks. palerider explained it to me yesterday. Last night I set the Min pressure to 10 and the Ramp pressure to 8. Tonight I am setting the Min to 11 and lowering the EPR from 3 to 2.

[davewalsh]

Here's the link to last night's data. The AHI is good, but the leak rate is higher. I noticed that the time was off on the device by about fifteen minutes so I fixed that.

https://www.dropbox.com/s/kaw2ievmtlg91 ... 1.png?dl=0

Other than the leak rate my biggest concern is that my water tub is almost empty every morning. Are there any concerns with lowering the humidity level from 4 to 3 to conserve water? Is there anything else I can do?

[robysue1]

Here's the link to last night's data. The AHI is good, but the leak rate is higher.

The size of the leaks is still well under Resmed's definition of "Large Leak", but the troubling thing is that you are leaking almost constantly all night long. And that brings up the question of whether they are disturbing your sleep in some way.

Other than the leak rate my biggest concern is that my water tub is almost empty every morning. Are there any concerns with lowering the humidity level from 4 to 3 to conserve water? Is there anything else I can do?

The leaks may be contributing to the excess use of water: When there is a leak, the machine blows more air through the machine and over the water in the tub. And that can increase the evaporation of water in the tub. Fix the leaks, and the water usage should go down.

As for just lowering the humidity level from 4 to 3: That's worth experimenting with. If your nose gets dried out at 3, it will let you know. The thing to keep in mind about humidity is that different noses like very different humidity levels. There are some noses that strongly prefer a lower humidity level and get stuffy when the humidity level is set too high. There are other people (like Pugsy and myself) who have noses that would drink water if they could and get dried out unless the humidity level is set very high.

Ambient humidity is also a factor in how much water you go through during the night. The more humid the air in your bedroom is, the less moisture the heated humidifier has to add to the air being blow in by the machine. If you live in an area with low humidity OR you use forced air heat OR if you use A/C, then adding a room humidifier might help your CPAP's water supply last through the night.

[davewalsh]

The leaks may be contributing to the excess use of water: When there is a leak, the machine blows more air through the machine and over the water in the tub. And that can increase the evaporation of water in the tub. Fix the leaks, and the water usage should go down.

The only thing I can think of that would be leaking is the mask (P30i) itself. I just got replacement headgear, heated hose, etc. yesterday. Perhaps I need to tweak the tightness of the headgear a bit as it's fresh out of the box and hasn't been worn in yet.

If you live in an area with low humidity OR you use forced air heat OR if you use A/C, then adding a room humidifier might help your CPAP's water supply last through the night.

I'll seriously consider the room humidifier as my home uses forced air heat. Do you have any recommendations? Also, doesn't a room humidifier introduce potential new problems? I seem to recall that dust mites thrive in higher humidities.

[ChicagoGranny]

Perhaps I need to tweak the tightness of the headgear

I wouldn't do it. You haven't indicated that leaks are bothering you in any way. As RS said, your leaks are well below the level (24 lpm) that the machine can adjust for.

I'll seriously consider the room humidifier as my home uses forced air heat.

Why?

my water tub is almost empty every morning

Turn your humidifier setting down one notch each night. If you get nasal dryness, turn it back up one notch. Many of us don't even use the CPAP humidifier, and our homes are centrally heated. Each individual has to experiment to find what works for his case.

[ChicagoGranny]

BTW, engineers of the HVAC society recommend keeping relative room humidity in a range of 40 to 60%. Buy a hygrometer before thinking about a room humidifier.

[davewalsh]

Perhaps I need to tweak the tightness of the headgear

I wouldn't do it. You haven't indicated that leaks are bothering you in any way. As RS said, your leaks are well below the level (24 lpm) that the machine can adjust for.

Understood, but I just got the replacement gear yesterday, so I need to tweak it a little bit to get the fit and feel of the old gear.

I'll seriously consider the room humidifier as my home uses forced air heat.

Why?

Because RS mentioned it.

my water tub is almost empty every morning

Turn your humidifier setting down one notch each night. If you get nasal dryness, turn it back up one notch. Many of us don't even use the CPAP humidifier, and our homes are centrally heated. Each individual has to experiment to find what works for his case.

Will do. I know that we all wake up one or more times during the night, but I'm optimistic in that I don't remember any of my waking periods from last night. I usually remember waking up on my back at least once.

[robysue1]

The leaks may be contributing to the excess use of water: When there is a leak, the machine blows more air through the machine and over the water in the tub. And that can increase the evaporation of water in the tub. Fix the leaks, and the water usage should go down.

The only thing I can think of that would be leaking is the mask (P30i) itself. I just got replacement headgear, heated hose, etc. yesterday. Perhaps I need to tweak the tightness of the headgear a bit as it's fresh out of the box and hasn't been worn in yet.

When you get new headgear, you do have to adjust it.

If you live in an area with low humidity OR you use forced air heat OR if you use A/C, then adding a room humidifier might help your CPAP's water supply last through the night.

I'll seriously consider the room humidifier as my home uses forced air heat. Do you have any recommendations? Also, doesn't a room humidifier introduce potential new problems? I seem to recall that dust mites thrive in higher humidities.

There are always tradeoffs.

My husband and I have a whole-house humidifier on the forced air heater. It doesn't add as much moisture as a room humidifier adds, but it does keep our whole house's relative humidity high enough to keep my dry skin problems under control. (In our old house in a different part of the country, my elbows and ankles would get so dry in the wintertime that they would literally crack and sometimes bleed because they were so dry.)

If dust mites are a problem, you've got to weigh that against whether turning down the humidifier on your PAP or running the risk of running out of water in the tank is more or less problematic than a possible increase in dust mite population.

Keep in mind too, that if you make your bed just as soon as you get up in the morning, you are effectively trapping moisture and heat in the covers and making the dust mites in the bedding and mattress and pillows happier.