Confusing Results, FFM vs Pillows

[theoldman22]

An S9 VPAP Auto device, mode setting Auto, is used here.

I have been alternating masks between a Quattro Air and a Swift FX. I have to tape my mouth when I use the FX. Consistently, with the Air most, if not all, apneas are central, with the FX nearly all apneas are obstructive.

Settings that have been used, max Ip 16, min Ep 5, PS 3, usually result in 95% Ip being above 15 with both masks. Sometimes, with the Air, the 95% Ip is around 11 and the AHI around 4, all central.

Last night, using the Swift FX, I experimented, changing the max Ip to 11.0, min Ep to 6.6—resulting in the event printout at the beginning of this post. Other results were 95% Ip 11.0, leak 9, RR 13, AHI 25.9, total AI 24.5, central AI 1.0.

I was completely awake, resting comfortably in bed, while the event group right after 8:00 was recorded.

No professional quality help is near where I reside.

Any explanations, suggestions, and/or help would be greatly appreciated.

[Pugsy]

I suspect the EPAP is too low and last night you tied the machines hands further with limiting the Max IPAP to 11.

Would need to see more complete reports and more than one to know for sure.

[Julie]

And I may well have misunderstood something, but are you saying you recorded your awake breathing (after eight o'clock) and are comparing it to results from asleep (on machine) breathing? Because how you breathe when awake is very different to asleep breathing and shouldn't be used as any kind of talking point re Cpap.

[theoldman22]

Thanks flor the replies.

I called attention to the events recorded after 8 o'clock because I wondered how there could be any events recorded while I was completely awake, resting quietly, breathing normally, before I stopped the machine. I suspect some kind of artifact but really have no idea of what was happenning.

[khauser]

We call that SWJ, or Sleep-Wake Junk. The machines are meant to record data while you're asleep. When you are awake, and especially in transition from asleep to awake and vice-versa, they are going to flag all kinds of events because we breathe differently when we are awake. The "hand off process" when we go from asleep with breathing controlled by the sub-conscious to awake where breathing responsibility is shared between the subconscious and conscious mind causes all sorts of normal breathing irregularities. (And again, the same is true in the other direction.)

In short, pay no attention to data that's recorded in those time periods.

Similarly, if you wake up a lot during the night, there's going to be a lot of SWJ around each of those, and sometimes we aren't even aware that we woke up (you won't remember it unless you woke up ALL THE WAY).

Nonetheless you have a heck of a lot of events throughout the night. If you can post full reports as Pugsy asked you'll get much better assistance.

[Connectplus1]

Do you really believe everything that your machine says? Serously? NONE of the machines can accurately diagnose this. It seems so many people put their trust in those AUTO machines - its rediculous. Proper sleep study at the Sleep Center will show what is really going on. Taping your mouth? Its crazy! When you are properly fit and titrated none of those issues should be there. Period. Trust me - I've done this for over 20 years. And it really makes me mad that today's health insurance companies try to push AUTO machines, try to rely on them vs in-lab procedure. Sounds to me that you need a fullface mask that fits well and a good titration that will fix all these issues. I'd contact your Sleep doc and have these things addressed.

[Stormynights]

My machine doesn't lie. Not everyone has a good sleep doctor. Your sleep study shows results from one night only. What is your problem?

[theoldman22]

Thanks for the replys.

The problem that motivated me to post was the very great lack of consistency among nightly posts, wondering what had caused the apparently very bad results. What I posted was an example of a bad night.

khauser's response sheds some light on the answer. My sleepimg problems date all the way back to WW II. Since no solutions were found, I did what I could--I learned to relax, becoming able to reduce blood pressuire down to the range of 105/55 and pulse in the mid 50's bpm. I can lie in bed for hours resting--figured that was better than turning and tossing. Sometimes I go in and out of a very light sleep, probably more times than I realize. If that puts me into never, never land as far as data that has some validity, then I am there. I cannot remember the last time I slept soundly for 4 hours. Now I have to learn how to find out which data is useful.

One very good result from starting back on apnea treatment--time between urinations and volume output each time have both increased.

[zoocrewphoto]

Do you really believe everything that your machine says? Serously? NONE of the machines can accurately diagnose this. It seems so many people put their trust in those AUTO machines - its rediculous. Proper sleep study at the Sleep Center will show what is really going on. Taping your mouth? Its crazy! When you are properly fit and titrated none of those issues should be there. Period. Trust me - I've done this for over 20 years. And it really makes me mad that today's health insurance companies try to push AUTO machines, try to rely on them vs in-lab procedure. Sounds to me that you need a fullface mask that fits well and a good titration that will fix all these issues. I'd contact your Sleep doc and have these things addressed.

Sleep studies are great. I was lucky and had a very good one. A lot of people do NOT have good sleep studies. And it is hard to sleep normally in a lab setting.

Also, my auto machine was prescribed, not for the purpose of determining settings, but for the express purpose of allowing me to sleep most of the night at a more comfortable settings, while still be able to accommodate my needs when I sleep on my back. And you know what else, the fact that the pressure does go higher when I sleep on my back also works as a quiet nudge to put me back on my side. I now sleep on my side almost the whole night allowing me to go without using that higher pressure most of the time. I spend about 10-20 minutes a night above 14 and most nights, I don't go past 15. If I do, it is less than 5 minutes. Since I started a year and a half ago, I reached my max of 17 once. I did get up to 16.9 a few times.

Most of the night, I am in the 11-13 range. And my ahi is usually below 1, rarely above 2. Twice above 5.

My mom has been using cpap for over 20 years, and she never felt much improvement. After seeing my noticeable success, we decided to do a sleep test with my machine (after I did my 6 week followup with my doctor). We live in the same house, and I am a severe night owl, so she used my machine from 11pm to 3am, and I went to bed after 4am. I uploaded her data and printed her reports before I added my own data. Her set pressure of 10 produced an ahi of 3.4 which sounds good. But she had a cluster of events over 30 seconds each, and one of them last 62 seconds. The next night, I set the machine for 10-13 to see what the machine wanted to do without going too high to add new problems. She made an appointment with sleep doctor who reviewed who old sleep study and the two reports from the machine he prescribed to me. He prescribed a new machine to her set at 10-15. She sleeps much better now, takes fewer naps, and feels a lot better.

I should add that she asked for a new sleep study a month before we did the home test with my machine. Medicare refused to authorize a new study because her last study was only 2 years old. Yet clearly, she needed more pressure than the prescription that the sleep study recommended.

Both the sleep study and the data from cpap machines are valuable tools. Both can have mistakes or be misinterpreted. Both both are valuable. It is far better to have an auto machine with data and use it when you need it, than to not have it and suffer along with poor sleep and no way to determine what is wrong. Ask my mom how that feels. She has 20 years of experience of feeling like crap despite treatment. I have a year and a half of success. I really value my auto machine, thank you very much.

I am hoping to get a backup machine next year. I would love to have an extra machine for travel as often my worst nights are my first night home from a trip (usually a couple a month). I usually get home late, haul in the important stuff, and fall asleep without setting up my machine. Then I oversleep to catch up, and end up sleeping an extra long night without cpap. I'm figuring I will look for an S9 auto as a backup, and that one can be an escape if I find a good deal since I don't need data for every single night. My trips are usually 1-3 nights, so I could leave my main machine set up and ready to go when I get home.

Just because you are happy with a straight cpap machine, and don't care about the data, doesn't mean you should attack those who find value in it.

And really, if the last 20 years of cpap treatment has been so good for you without data or auto machines, why did you join the group? Most people join when they are looking for help. Did you come here to tell us how well you are doing?