1 week in...

[SharkBait]

Some random ramblings from a noob after his first full week...

First off, I have to beat this dead horse yet again and say how much I appreciate all of you vets that made sure us noobs were properly educated. Again, thank you, thank you, thank you!

I played with APAP for a few days but I've settled in on CPAP at my titrated pressure of 10 cm (running on APAP and looking at the reports confirmed that was the right number), C-Flex of 2, humid at 2, and NO RAMP. With C-Flex or A-Flex I don't see the need for ramp at all at my pressure...

I'm averaging around 3 AHI for the week, but once again as I look at the reports I'm seeing a few centrals as I drift off to sleep. Last night I caught myself a few times not breathing as I was dozing (I tend to fall asleep with my book open and the light on...) One theory is my breathing as I'm reading is not really as natural as it should be. I'm thinking about my breathing instead of letting it happen naturally and as I drift to sleep my body just takes a break from it all. I'm gonna work on that.

My graph also shows that most apnea events are accompanied with a jagged line of leak rates; not sure what's going on there...And once the leak rate develops a smooth line, the A's and H's are rare. Take out the centrals as I'm awake and falling asleep and the apneas accompanying the jagged lines and my AHI would drop to below 1 per hour...

I'm not sure what Flow Limitation Index is but I've taken Rested Gal's advice and ignored it and for some reason it completely disappeared after 3 days. 4 straight nights of 0 Flow Limitation Index (well at least three -- I forgot to put my card back in night before last. I'm still a little miffed about that...).

James Skinner's Encore Pro Analyzer is way cool and made me glad that I took the effort to find the Encore Pro software version. I'm not big on torrenting software, but if they ain't gonna sell it to save me from myself , then I'm going to use whatever resources I can to obtain what I want or need to support the equipment I paid for out of my own pocket... I'm wondering what "Variable Breathing" percent is...

I tried the AEIOMed headrest last night and I really like the design. I had about a 35 lpm leak rate vs the vent rate of 25, but I had a good night's rest with about 5 Apnea events in an 8 hour span so I'm thinking I'll let that slide for now. The graph showed a 2 hour period where the leak rate was around 50 lpm and not a single event (a or h), and then it moved back to around 35 and went another hour before one finally snuck in... I certainly liked the Mirage Swift LT, but if the leakage doesn't seem to pose any problems I'm probably going to go with the "headrest".

I finally experienced what "rainout" was last night. I forgot to turn the central heat on (it got up to around 80 degrees here in Texas yesterday...), and despite my huggy cover I rolled from my side to my back this morning and got a nose full of water. If this was an ongoing problem, I'd certainly do whatever is necessary to correct it...

Thanks again, everyone. This has been a huge success for me and it's in large part to you guys. I feel great and with the reporting module am actually getting a kick out of monitoring my process. If every one that was sentenced to CPAP had my experience we'd have a 100% compliance rate. I'm hooked for life...

[ChipsXJ]

you are doing great!

I wish I was doing as well as you are.

I have been on it for 10 days now.

Doing better everyday but great to see that you are doing so well with it.

Keep up the excitement and good luck!

[Gale Hawkins]

Great report Sharkbait. It has been 4.5 years for me so I have forgotten much of the flustrations.

I solved the rain out like many others by stop using the humidify. I am glad I had it on the start but finally a good chin strap kept my mouth shut and the dry mouth problem ended.

I found first the pressure needed to be right and it sounds like you are there so that is good. Second was to get mask tight enough yet still comfortable. To shut down the snoring I had to get up to 12 so that made the mask sealing a little harder.

Due to having Ankylosing Spondylitis (fixed spine as in no head rotation or movement period) I sleep on my back. Finally with the CPAP machine under the head of the bed (not crammed up again the wall) and the hose coming over the top of a very low head board things worked well. In the motor home and hotels I often just slide the mattress forward a couple inches and make do.

Keep up the good work. Learn from the site BUT DO NOT let information overload trip you up. Often things that work SO well for another (like I have mentioned in my case above) have NO validity for the next reader. Find by trial and error what works for you.

It sounds like you are on the road to a better life. I mean here on earth.

[SharkBait]

I tried the AEIOMed headrest last night and I really like the design. I had about a 35 lpm leak rate vs the vent rate of 25, but I had a good night's rest with about 5 Apnea events in an 8 hour span so I'm thinking I'll let that slide for now. The graph showed a 2 hour period where the leak rate was around 50 lpm and not a single event (a or h), and then it moved back to around 35 and went another hour before one finally snuck in... I certainly liked the Mirage Swift LT, but if the leakage doesn't seem to pose any problems I'm probably going to go with the "headrest".

I'm gonna have to stick with my Swift LT. I love the "headrest" design but the leak is just bugging me and making my eyes feel a little burnt in the morning... I switched back to the Swift LT last night and get just NO leak at all with the thing. I love it.

Some more ramblings...

I'm 1 for 1 getting thru the airport security without having my CPAP swabbed. I went thru DFW yesterday, put the unit in it's own little tray (like my laptop), and they just sent it on thru without a word...

I'm staying at a friend's house, I hooked up my rig and fired it up at bed time and for some reason it felt like it wasn't working. The pressure felt so minimal and I probably could have gone without C-Flex. I checked to see if maybe it reset itself back to 4 while enroute, but it was on 10 and working just fine. I guess I'm just getting so used to the thing it doesn't feel like what opponents describe as "Hurricane CPAP" any more.

I got up this morning to a 1.6 AHI, so guess it was blowing okay. I'm probably going to back my C-Flex to 1 since I seem to be getting so acclimated to it.

I experienced some mouth leakage last night for the 2nd night out of 9 nights. It manifested itself as a wierd dream, but it woke me up and I closed my mouth and didn't have any problem with that for the rest of the night. Hopefully I'll get to where I don't open my mouth on any nights...

My friends said it was "eerily quiet" as far as lack of snoring coming out of my bedroom last night. They said had I not informed them that I was on the machine they might have checked to see if I was still alive in there. They say I used to be BAAAAAAD... Still feeling like a new man in the morning.

[rested gal]

You're doin' great, Shark!

Loved this!

My friends said it was "eerily quiet" as far as lack of snoring coming out of my bedroom last night. They said had I not informed them that I was on the machine they might have checked to see if I was still alive in there. They say I used to be BAAAAAAD...

About the Headrest leaking -- I wouldn't be able to wear it at all (would get leaks like crazy) if I didn't put a homemade strap around to cradle the nasal pillows. With extra strap, it's my fave. Without...wouldn't be able to use it, period.

Swift LT is a good one too. If it suits you better, then yep, that's the one to go with.

[SharkBait]

You're doin' great, Shark!

Loved this!

My friends said it was "eerily quiet" as far as lack of snoring coming out of my bedroom last night. They said had I not informed them that I was on the machine they might have checked to see if I was still alive in there. They say I used to be BAAAAAAD...

About the Headrest leaking -- I wouldn't be able to wear it at all (would get leaks like crazy) if I didn't put a homemade strap around to cradle the nasal pillows. With extra strap, it's my fave. Without...wouldn't be able to use it, period.

Swift LT is a good one too. If it suits you better, then yep, that's the one to go with.

I was thinking the same thing. I put my hand up and give it a slight push to snug it, and it seals right up. I think I'll give that a go...

[Gerald]

Shark.....

If you think that the "headrest" might be the best one for you, I can send pictures of the mods I made to mine.

I haven't been able to find a better mask.

PM me........

Gerald

[Mike081376]

Shark,

You and I have the same equipment, same pressure setting of "10," and the same time frame of 10 days on cpap!! I also had my Mseries Humid set on "2" and was getting rainout 2 times, I have now set it on "1" and its perfect, may even try turing it off. Ive had the same issues of opening my mouth at times, it does trip you out a little and im still unsure how bad that is at night, I got a chin strap from my Dr., its NOT comfortable but may try it. The Swift LT nasal pillows is awesome, so far its very comfortable but I do have to be careful about turning over. I also travel A LOT and im heading off tomorrow for 4 days on business, first time with my CPAP...little aphrehensive but we'll see. Also, my leak rate has been averaging 33.5.....the manual for OUR mask says that is in the normal range for the pressure setting of 10...are you seeing this leak rate too????

Mike

[Gerald]

Shark......

Earlier today, I read your first post in this thread.......and let it simmer in the back of my mind until now.

Your opening post caused me to wonder about what "centrals" are....and what causes them.

If our sub-conscious is the part of our brain that runs the show when we're asleep......and our conscious mind runs the show when we're awake, the shift from one consciousness to the other might cause some strange events to happen.

I've noticed when I'm right between awake and asleep, I sometimes have a pronounced "spasam".....something like a "knee-jerk"....except it's my whole body that does the "jerk".

So my thought is.....What if "centrals" happen in that twilight zone between awake and asleep....when one consciousness is "shutting down"....and the other consciousness is "taking over"? What if some of us experience longer than normal "transition periods" at the "consciousness shift point"? Might we be having "centrals" during that period of time when neither consciousness is "in charge"?

I always thought that "breathing" was controlled by that part of the brain that never shuts down......but, might that circuitry get confused....during the transition shift between consciousness and sub-consciousness?.....especially if the transition period is extended more than is normal?

If we could get close to figuring out what causes "centrals", we might be able to figure out a way to stop them.

The answer is probably very simple.

[SharkBait]

Shark,

Also, my leak rate has been averaging 33.5.....the manual for OUR mask says that is in the normal range for the pressure setting of 10...are you seeing this leak rate too????

Mike

Yes, right around that. 35 lpm last night, 33 night before, and 32 before that... And I don't feel anything coming out of it at all...

I was up around 35 last night because I woke up face down on the mattress... ??? Needless to say, I was getting a few leaks in that position, although it didn't last long...

[SharkBait]

Shark......

Earlier today, I read your first post in this thread.......and let it simmer in the back of my mind until now.

Your opening post caused me to wonder about what "centrals" are....and what causes them.

If our sub-conscious is the part of our brain that runs the show when we're asleep......and our conscious mind runs the show when we're awake, the shift from one consciousness to the other might cause some strange events to happen.

I've pretty much eliminated the wide awake centrals since I've relaxed my breathing and started breathing much more naturally. It's like my brain was saying, "okay, if you're going to consciously do all this breathing, then go ahead and the unconscious will just take off for awhile until you're done playing Darth Vader...".

Interesting thought on moving into "the zone" between awake and asleep... I still see some apneas forming right about the time I've fallen asleep, although I don't know for sure they are centrals.

[rested gal]

What if "centrals" happen in that twilight zone between awake and asleep....when one consciousness is "shutting down"....and the other consciousness is "taking over"? What if some of us experience longer than normal "transition periods" at the "consciousness shift point"? Might we be having "centrals" during that period of time when neither consciousness is "in charge"?

"Sleep onset centrals" are normal:

viewtopic.php?t=18117
on page 2, from a post by StillAnotherGuest:

Assuming that the obstructive events are properly managed, then the likelihood of these being sleep-onset centrals is fairly high (you'd need PSG to be 100%) and those things are pretty much a normal event.

Jean Krieger in her chapter on Breathing During Sleep in Normal Subjects in Principles and Practice of Sleep Medicine by Meir H. Kryger summarizes the incidence of central apnea/periodic breathing at sleep onset from 40-80% of normal subjects, and lasting from 10-60 minutes. The trigger is hypercapnia, as opposed to the hypocapnia that creates all the cental apnea havoc in CSBD and CSR. Chemosensitivity and apnea threshold also change (sleep onset is a busy time).
SAG