Last 2 days have been miserable. Grrrrr

[lordvader]

My AHI has consistently been under 2. Well the last 2 nights have been miserable and I cant figure out why. First miserable night was 8.4 events per hour and last night was 20.6 events per hour.

[Pugsy]

What is the event category break down? What category seems to have increased?

Care to share last night's detailed software report? Something might stand out.

Something changed obviously....usual first suspects are medication side effects or sleeping position. Maybe another suspect would be health change or external factors affecting sleep quality.

[lordvader]

What is the event category break down? What category seems to have increased?

Care to share last night's detailed software report? Something might stand out.

Something changed obviously....usual first suspects are medication side effects or sleeping position. Maybe another suspect would be health change or external factors affecting sleep quality.

I will get the report when I get home and then post it. I've taken the same 2 meds for anxiety without issues. I'm not a drinker but Saturday night I celebrated and had a few and was feeling pretty darn good. Lol. Anyways that night my AHI was 1.7 like it usually is. Sunday night I didn't drink because I felt like crap from the night before and my AHI that night was 8.4. Monday I didn't drink and that night my AHI was 20.6 (ouch) felt like crap that day. Last night was a little better, my AHI was 5.1. Saturday and Sunday I was sleeping on a uncomfortable air mattress but Monday (worst day) I was back in my Tempur Pedic bed.

[Pugsy]

Were you away from home for the holiday?
Any "bad" nights prior to these recent bad nights while at home?
Or the only really bad nights happened when not sleeping in your usual bed?

So we know one variable that changed...the bed.

[lordvader]

Were you away from home for the holiday?
Any "bad" nights prior to these recent bad nights while at home?
Or the only really bad nights happened when not sleeping in your usual bed?

So we know one variable that changed...the bed.

Away from home for the holiday. No bad nights as high as these ones. Definitely a different bed and I had a few drinks one night. I have my Sleepyhead charts. How do I save them to post on the forum?

[Pugsy]

I prefer imgur for hosting images.
https://sleep.tnet.com/reference/tips/imgur

Don't want all the graphs...just the basics
See this thread for examples.
viewtopic/t103468/Need-help-with-screen-shots.html

How to organize...3 pages so read all of them
https://sleep.tnet.com/resources/sleepyhead/shorganize

You might do last night and the one really bad night but I am not going to worry much about an outlier really bad night away from home.
Just a bit curious about the really ugly night.

[lordvader]

Hopefully you can see them. Image posting wasn't showing up correctly.

http://imgur.com/a/nHRMg

[lordvader]

Saturday and Sunday were away from home. Monday and Tuesday were at home.

[ajack]

see what others think, but my guess is that the hypopnea are positional from a sleeping position. different pillow, chin to chest and blocking airway or similar.

I would bump the pressure up to 14 for the OA, increase the epr to 2 or 3 if you want to.
page 33 Titration Protocol
https://www.resmed.com/us/dam/documents ... lo_eng.pdf

[Pugsy]

Any special reason you are using fixed pressures?
I got no problem with that but was just wondering why.
Something has changed to cause the fixed pressure setting to not work so great during some parts of the night.
Usual suspects are REM stage sleep or supine sleeping or maybe a little of both.
If these new little dense clusters persist to become a permanent annoyance then a change in pressure is likely needed.
Either more fixed all night or consider maybe a small range to let the machine fight the clustering.

[lordvader]

Thanks Pugsy and ajack.

I've been with this new sleep Dr. for 13 months now. He wanted me on the straight pressure. Last night my AHI was 2.4. I do see where a certain part of my sleep is interrupted and it seems to be around the same time every night. Am I seeing that correctly?

[Pugsy]

If sleep times are consistent and you are seeing the same cluster pattern at approx the same time each night....might be REM stage sleep related.

Google "hypnogram" and look at the various "normal" hypnograms and compare your clusters to same time frame.
First REM stage is usually around 90 minutes after sleep onset and it's relatively short lived. As the night goes on REM comes on more frequently and lasts a little longer.

While we can sometimes do something about supine sleeping (if that's the culprit for needing more pressure) we can't do much about REM.
I have always been of the mindset to just let the machine sort it out and not dwell overly long on the "why"...and I just want to fix it.
So yeah,, pretty obvious that sleep is disturbed for some reason...exactly which we can't say for 100% certainty but we know that more pressure is needed during those times.

If this persists after a few more nights then you have to decide how you want to proceed with needing more pressures during those time frames.
I can share my experience...my OSA is worse in REM...documented about 5 times worse in REM than in non REM and I sometimes need substantially more pressure during REM. Sometimes as much as 6 to 8 cm more....it's doable but not very enticing in fixed mode.
Now if I only needed 1 or 2 more then I could probably be a little happier with fixed pressure mode.
That's why I prefer auto adjusting mode. I just let the machine sort it out and not worry about position or whatever (though the one time I experimented with a wall to keep me on my side I still needed the higher pressures so I don't think my pressures are related to being on my back).

You could try slightly more fixed pressure if you wish...or try a vary small auto adjusting range if you want to stay with more like fixed pressures. We don't know how much more pressure those clusters of hyponeas are going to need....something you have to sort of figure out depending on what you want to try....assuming the clustering persists and you want to try something.
On the other hand if you are sleeping great and feeling great there may be no urgent reason to do anything if doing something creates a problem.

I think if it were me and I had done well at this fixed pressure for a considerable length of time and things just started getting ugly with the trip ....I might give things a few more nights at home to see if things settle down without doing anything.
Now if you just recently changed to fixed pressure...obviously not the optimal fixed pressure choice.

[lordvader]

I've been on this same fixed pressure for a little over 13 months. I will give it a few more days and see how it goes. Thanks for your help.

[cands]

Hi,
I, too have been on CPAP for about a year, was prescribed fixed pressure of 13 and have a Resmed AirSense 10 Autoset.
Untreated, I have 2 or three periods per night of high obstructive events, presumably during REM sleep. Through gradual and careful changing of my settings in AUTO mode, I have got my AHI down to a 6 month average of 0.31

I find a tight range works best for me, with the lower setting pretty close to my prescribed pressure. My auto range is 12.2 to 17.2
Most of the night is spent in the 12.2 to 13.0 range, then for the REM sleep periods it moves up to 15 or 16. I don't even notice the pressure changes and the range is tight enough to not cause problems with air-leaks.

Good luck with whatever you decide to do. If I were you, I would switch to Auto, leaving the low setting at 13 and gradually moving the upper setting higher. You will soon see if the pressure moves higher to combat obstructive events.

[lordvader]

Well I haven't changed anything yet except for tube temp. Went from 80 to 75. Humidification is set to 1. Noticed my nose got wet a few times. Thursday night AHI was 5.2 and Friday night AHI was 1.6.

Not trying to change the subject. Where do the fellow AirSense 10 users set their humidification settings and tube temp at?

Thanks!