Low AHI but wife says I'm snoring at night?

[Jangles]

On APAP now for 3 months. OSA at 7-20. Average pressure is 9. Ramp on and EPR on 3. AHI is always under 5 but wife says I snore at night for a bit, then it stops. (She calls it 'rumbling' which is me snoring under the mask)

Obviously I'm snoring then in a few breaths the machine kicks up the pressure. I have read that it takes three breaths for the machine to adjust or one breath if it's the 'For Her' model.

I have not tried sleepyhead but will if I must.

Is this normal? Is my therapy working?

[yaconsult]

I think sleephead would be an excellent idea because I have no clue what "rumbling" is! Maybe your wife could describe in other words?

Still, it never hurts to check the data as it records every single breath you take all night long. Stickies at the top of the forum contain the information you need to get started.

[Jangles]

I think sleephead would be an excellent idea because I have no clue what "rumbling" is! Maybe your wife could describe in other words?....

I'm snoring under my mask.

[Wulfman...]

On APAP now for 3 months. OSA at 7-20. Average pressure is 9. Ramp on and EPR on 3. AHI is always under 5 but wife says I 'rumble' at night for a bit, then it stops.

Obviously I'm snoring then in a few breaths the machine kicks up the pressure. I have read that it takes three breaths for the machine to adjust or one breath if it's the 'For Her' model.

I have not tried sleepyhead but will if I must.

Is this normal? Is my therapy working?

It sounds to me like your settings (and therapy) are not optimal.
Would strongly suggest using the software and bumping up the minimum pressure to about 9 cm.
APAPs mainly respond to Snores and Flow Limitations........not Apneas.
Even at that pressure ( 9 cm. ), I doubt that you'd really need EPR unless your pressures are going "high" later on.

But, you really need to see what's going on and for that you need the software.


Den

.

[kaiasgram]

SleepyHead could confirm the pattern you're thinking about -- you could actually see if activity on the Snore graph corresponds to a change in the Pressure graph line. If it does, you could then consider a pressure adjustment to see if you can reduce the rumbling, and then watch to see if there's a good trend with the pressure adjustment. You might also want to look at the Flow Limit graph -- pressure usually increases with flow limitations.

[Baja]

Another possibility if you are using a nasal mask is the air exhaling through your mouth and causing a 'rumbling' sound.

My wife complained about the same problem when I started. I assumed it was snoring or a mask leak until it woke me up one night.

My body eventually compensated, but you could also consider a full face mask (nose & mouth) because the air pressure will be equalized.

P.S. You could also ask your wife to video tape one of your rumbling sessions or just do a voice recording all night.

[Jangles]

I got the Sleepyhead going! Most nights have snoring, some more than others. Pretty concerned now...Is this much snoring normal?

I fall asleep in another room, then go to bed, thus the 4 hour average. I plan to either fall asleep in bed (change of routine) or get a second machine for the other room.

[Wulfman...]

I got the Sleepyhead going! Most nights have snoring, some more than others. Pretty concerned now...Is this much snoring normal?

I fall asleep in another room, then go to bed, thus the 4 hour average. I plan to either fall asleep in bed (change of routine) or get a second machine for the other room.

All in all, those numbers aren't all that bad and that report isn't either. However, it may improve your therapy to increase your minimum (like I suggested), also maybe try turning off the Ramp and reduce the EPR setting.
You might want to reduce the maximum pressure setting. It's going higher, which may be disruptive to your sleep......especially if it's chasing snores or flow limitations.......neither of which are necessarily detrimental to one's health. But, the machines are programmed to respond to them under the belief that they may precede apneas. For some people they do and for some they don't. Consequently, it helps to read these reports and learn what happens during the night.


Den

.

[SleepDisturbed]

1. Definitely STOP sleeping without the CPAP. Get that second machine or change your pattern. Every time you sleep without the cpap you are undoing some (or all) of the good the therapy is doing for you all.
2. Turn off the ramp or shorten the time.
3. Set the top pressure to 15.
4. Gradually increase your minimum to 9. Up it maybe .5 at a time and allow your body to adapt for a few days before going up more. Idea is to first not disrupt your sleep by making a large jump and second to check your reports every day and make sure no unwelcome results pop up.

I see you have the P10 listed? Are you sure that is right? That is a minimal nasal pillow mask and I don't get the rumbling 'under' the mask comment, nor do I usually so much leaks with it?

[Jangles]

...I see you have the P10 listed? Are you sure that is right? That is a minimal nasal pillow mask and I don't get the rumbling 'under' the mask comment, nor do I usually so much leaks with it?

Yes, Airfit P10. The rumbling is me snoring (with the mask on).

Is my leak rate out of whack on the charts? I thought the leak rates were in an acceptable range.

**I turned Ramp from Auto to 10 minutes and EPR from 3 to 2. Will continue to decrease this. Turning both off completely made the exhale a bit suffocating for now. Why does this help?

3. Set the top pressure to 15.
...

What is the reason for this?

[Wulfman...]

...I see you have the P10 listed? Are you sure that is right? That is a minimal nasal pillow mask and I don't get the rumbling 'under' the mask comment, nor do I usually so much leaks with it?

Yes, Airfit P10. The rumbling is me snoring (with the mask on).

Is my leak rate out of whack on the charts? I thought the leak rates were in an acceptable range.

**I turned Ramp from Auto to 10 minutes and EPR from 3 to 2. Will continue to decrease this. Turning both off completely made the exhale a bit suffocating for now. Why does this help?

3. Set the top pressure to 15.
...

What is the reason for this?

What's the logic for setting at 20?

Actually, for some people, it's better to set a lower "ceiling" pressure rather than to let it go too high if the person's breathing characteristics are such that it drives the pressures up. For example, some people have many flow limitations which trigger pressure increases in an Auto algorithm, but actually do not precede apneas.
In short, it helps minimize sleep disturbances caused by (needless) pressure increases.


Den

.

[SleepDisturbed]

The avg leak numbers are ok, but on the graph it seems to be a lot of spikes. I use the same mask and the same graph is essentially flat, hence my question. Do the leaks bother you, wake you up? If not, probably not a big issue.

I think you can leave EPR the same, I did not recommend changing it and don't know why you would need to.

I suggested reducing the ramp because of your wife's comment that you start out snoring then stop. Sounded like you might be falling asleep before the pressure reached a high enough level to stop the snore. Reducing the ramp would get the pressure up faster.

I suggested 15 as a max because with these auto adjusting machines set wide open (20) it seems to me that they can overshoot when it starts chasing snores, hypopneas and apneas. This seems to cause a jagged pressure graph, with lots of short period pressure excursions. Reducing the top may help. The fewer of these "extreme" pressure changes, the less likely they are to disturb your sleep, and ultimately what we are after is high quality sleep.

Most people seem to operate pretty well with a more limited pressure range maybe five or six. I was thinking you looked like you might fit in the 8 to 14 or 9 to 15 area, but only continued checking of the reports and a little tweaking will tell you for sure.

Hope this helps.

[Macpage]

**I turned Ramp from Auto to 10 minutes and EPR from 3 to 2. Will continue to decrease this. Turning both off completely made the exhale a bit suffocating for now. Why does this help?

With the ramp pressure setting or initial minimum pressure set below what is appropriate for you, the machine will not be able to respond quickly enough to provide optimum therapy.

EPR refers to exhale pressure relief. The number you choose will reduce inhale pressure by that amount on exhale. For instance, if your machine has you at a 13cm pressure your pressure exhaling will be at 10cm if the EPR is set at 3, 11cm if EPR at 2, or 12cm if EPR at 1. The numbers will track by this same way at any given pressure you hit with a Resmed auto and EPR. This does make it easier to exhale against pressure. Some of us like it. Others not so much. It's important to consider how much EPR you are using when finding your correct pressures for therapy. If you really need "x" amount of pressure on exhale and the EPR is engaged, you may find yourself below the optimal pressure at times causing the machine to play catch-up and missing some events. Not unlike having the ramp set too low or the minimum pressure too low. EPR needs to be considered in setting pressures for many. Good Luck!

Best,

Mike

[englandsf]

Snoring with a P10 means you're mouth breathing - but not for log as you have a low leak rate. How long does your wife say your snoring for and is it just once or all night on and off?

Definitely get a second machine or get more hours - how long are you sleeping in the chair?

[Jangles]

Snoring with a P10 means you're mouth breathing - but not for log as you have a low leak rate. How long does your wife say your snoring for and is it just once or all night on and off?

Definitely get a second machine or get more hours - how long are you sleeping in the chair?

Wife says I snore for a short time and then it stops. This happens on and off through the night.

I fall asleep for a few hours before heading to bed...Don't like the idea of maintaining two machines so will have to force myself to the bed.