late night apneas and events in rem stage

[jt1]

just curious if there is adjustments to be made for events happening in the rem stage? my ahi in my study was 22 but in the rem stage i was having 88 a hour. most of my events seem to be happening in the last few hrs of sleep or every few hours. i guess thats in my rem stage. my ahi is under 2 but last week was steadily under .50 and a few 0.0's with a smiley face in sleepyhead!! i can definitely feel the difference,under .50 i feel fantastic, under 2 pretty good. i am only a month or so into therapy.

[Wulfman...]

just curious if there is adjustments to be made for events happening in the rem stage? my ahi in my study was 22 but in the rem stage i was having 88 a hour. most of my events seem to be happening in the last few hrs of sleep or every few hours. i guess thats in my rem stage. my ahi is under 2 but last week was steadily under .50 and a few 0.0's with a smiley face in sleepyhead!! i can definitely feel the difference,under .50 i feel fantastic, under 2 pretty good. i am only a month or so into therapy.

Yeah. Same advice I gave you in this thread.

viewtopic.php?f=1&t=109674&p=1047685#p1047685

Your breathing changes in the deeper or REM stages of sleep (or in different positions.
You may have more Flow Limitations.......which are a trigger for the APAP to increase pressures.


Den

.

[jt1]

just curious if there is adjustments to be made for events happening in the rem stage? my ahi in my study was 22 but in the rem stage i was having 88 a hour. most of my events seem to be happening in the last few hrs of sleep or every few hours. i guess thats in my rem stage. my ahi is under 2 but last week was steadily under .50 and a few 0.0's with a smiley face in sleepyhead!! i can definitely feel the difference,under .50 i feel fantastic, under 2 pretty good. i am only a month or so into therapy.

Yeah. Same advice I gave you in this thread.

viewtopic.php?f=1&t=109674&p=1047685#p1047685

Your breathing changes in the deeper or REM stages of sleep (or in different positions.
You may have more Flow Limitations.......which are a trigger for the APAP to increase pressures.

so a constant pressure will head off events in rem stage better than apap mode?
Den

.

[ChicagoGranny]

You and I are ideal candidates for APAP mode. We require high pressures at certain times of the night and not so high pressures at other times of the night.

so a constant pressure will head off events in rem stage better than apap mode?

What would your constant pressure setting be? You would have to set it very high, maybe 20, to cover the whole night every night.

Then for those long periods of the night when you require lower pressures, you are running the high pressure. Why would you want to run a high pressure during those times?

I much prefer to run the lower, more comfortable pressures as long as they are effective, and only let the machine take the pressure up in the range when it is needed.

Your graphs look like you are doing very well - low AHI and low leaks and you are not whining about anything.

[Wulfman...]

just curious if there is adjustments to be made for events happening in the rem stage? my ahi in my study was 22 but in the rem stage i was having 88 a hour. most of my events seem to be happening in the last few hrs of sleep or every few hours. i guess thats in my rem stage. my ahi is under 2 but last week was steadily under .50 and a few 0.0's with a smiley face in sleepyhead!! i can definitely feel the difference,under .50 i feel fantastic, under 2 pretty good. i am only a month or so into therapy.

Yeah. Same advice I gave you in this thread.

viewtopic.php?f=1&t=109674&p=1047685#p1047685

Your breathing changes in the deeper or REM stages of sleep (or in different positions.
You may have more Flow Limitations.......which are a trigger for the APAP to increase pressures.


Den

.

so a constant pressure will head off events in rem stage better than apap mode?

Don't know for sure. But, you're having lots of flow limitations and very few "events" to be (potentially) squashed by more pressure. Even with the increased pressures, the apneas are occurring anyway.

When I look at your reports, I also focus on what pressures where there are NOT events. You don't know for sure whether these are happening in REM or if it's something "positional".

You came with a question and I'm just making a suggestion. Do what you feel comfortable with.
If you make changes and things get worse, you'll know that you need to rethink those changes.


Den

.

[palerider]

so a constant pressure will head off events in rem stage better than apap mode?

no. not unless you set that constant pressure very high, high enough to stave off events in rem, as Granny says.

[Wulfman...]

Did you ever actually TRY straight pressure as you indicated you might?

And, I STRONGLY disagree with the nay-sayers who think that you would need a very high (straight) pressure.


Den

.

[ChicagoGranny]

OMG

[Wulfman...]

In that thread I linked to earlier, you had an AHI of 0.46 and your overall pressures were lower......but the events you DID have occurred anyway and at higher pressures. So, even though your pressures rose, they didn't eliminate all of the events. Virtually no settings will prevent or eliminate all events. In Auto mode, the pressures are driven by Flow Limitations and Snores........not necessarily by Apneas.


Den

.

[LSAT]

With AHI as low as these why the hell would you change ANYTHING. He gave no indication of having sleep disturbances.. It an't broke!!!

[palerider]

I don't know whether it's just Den's incredible bias *against* modern machines and algorithms, or maybe he hasn't zoomed in the graphs and looked closely enough, or what... (also, please get rid of the useless AHI graph, and re-arrange things so you get events, flow, pressure, leak, flow and snore graphs, I believe some of the pressure bumps are due to snoring)

I don't see *any* events at the higher pressures, some at median pressures, some just before pressures went up.

that's how it works, the machine can't predict the future, it responds after events... and to snores, reras and flow limits in an effort to head off events.

snore and flow limitations *ARE* disturbances to sleep, no matter what Den wants to preach. they DO disturb sleep.
(it'll take digging, but nobody except Den says to ignore them: https://www.google.com/search?client=ub ... 8&oe=utf-8

[Wulfman...]

I don't think some of you even understand or comprehend how this therapy can affect "SLEEP".
Or, the concept that it's the Flow Limitations jacking up the pressures......and THAT may actually be what "disturbs" sleep.
If Flow Limitations were that "serious", then there would be NO straight pressure machines and ALL machines would try to go to astronomical pressures trying to squash them.


Den

.

[jt1]

I don't know whether it's just Den's incredible bias *against* modern machines and algorithms, or maybe he hasn't zoomed in the graphs and looked closely enough, or what... (also, please get rid of the useless AHI graph, and re-arrange things so you get events, flow, pressure, leak, flow and snore graphs, I believe some of the pressure bumps are due to snoring)

I don't see *any* events at the higher pressures, some at median pressures, some just before pressures went up.

that's how it works, the machine can't predict the future, it responds after events... and to snores, reras and flow limits in an effort to head off events.

snore and flow limitations *ARE* disturbances to sleep, no matter what Den wants to preach. they DO disturb sleep.
(it'll take digging, but nobody except Den says to ignore them: https://www.google.com/search?client=ub ... 8&oe=utf-8

here is last night's results with stuff rearranged to include snores. should i bump my minimum to try and reduce the snores or am i just being greedy and my results ok? im still learning, and i have a lot to learn! my prescription called for a 9.0cm and that wasn't working. changing to apap and bumping the minimum 3.0cm helped a lot. what is most people who are optimized with there treatment seeing for a ahi?

[jt1]

Did you ever actually TRY straight pressure as you indicated you might?

And, I STRONGLY disagree with the nay-sayers who think that you would need a very high (straight) pressure.


Den

.

no, actually i haven't. i did though try 11.0 min with a max of 13 for a few days. ahi was around 2

[ChicagoGranny]

should i bump my minimum to try and reduce the snores or am i just being greedy and my results ok?

If those were my stats, I would bump the minimum to 12.0. You are spending very little time below 12 anyway.

The machine takes some time to respond to problems in the airway. If your min is 12, it will take less time to get to where it needs to be when your pressure requirements increase.

what is most people who are optimized with there treatment seeing for a ahi?

I love to see 1.0 or lower, and I sleep a little later and feel better at that level. 2.0 is acceptable. 3.0 and above and I don't feel so peppy.