Does Therapy Look Optimized?

[USMCVet]

I know its only been 5 days but my data seems pretty consistent and AHI looks good but not to sure what I am looking at with the rest. Please let me know if i need to add more info.
Thanks

[LSAT]

I wouldn't change anything....

[Matt00926]

You have some flow limitation/hypopneas that may go away with a bit more min pressure. You don't seem to spend much sleep time at 6cm h2o.

Just observations - I defer to more knowledgeable peeps.

[TedVPAP]

The data looks good. Notice that you are getting some flow limitations so the machine is responding by increasing pressure. As it should. If the minimum was set a little higher, there would be less of a need for pressure changes. No way to predict if that would help you sleep better.

[Pugsy]

Next time you share an image of a report omit the snore graph and respiration graph. Snores are shown on the Events graph and we don't need respiration rate graph.
When you try to get too many graphs in one screen shot the graphs are too small. You can resize the graphs and 4 graphs makes it about the right size of graphs on the right.
No need to redo this one though. I just mention it for future reference.

How are you sleeping? How are you feeling? Is this new starting minimum of 6 more comfortable for you?
Did you sleep for the bulk of that 7 3/4 hours? Or were you awake a lot?

There is no urgent need to change the pressure at this time. If the FLs and snores continue at about this level then I would try 0.5 to 1.0 cm more minimum but it's more of a fine tuning tweak and I would want to make sure that this one report isn't a fluke bad night for you.
I like to get at least 3 or 4 nights at a setting (unless it is obviously horrible bad setting) before deciding on any more changes. We go by trends and patterns and not by one night because things can vary so much in one night.

[USMCVet]

I'm still tired and getting around 6 hours of sleep and do wake up a good amount. I have been at this setting for 4 or 5 days and that data is about average. I have had slightly worse nights or slightly better.

Last night something new happened and I haven't looked at data but when I was half awake a few times I noticed my mouth fill with air which then caused mouth to open for a second.

[USMCVet]

I just checked and here are FL and snore numbers except last night.
FL. 1.35, 0.38, 1.92
Snore. 1.62, 3.08, 1.79

[Pugsy]

6 hours really isn't enough sleep to expect much difference in how we feel during the day especially when those 6 hours are highly fragmented with a lot of wake ups.

There's so much more to feeling the good numbers than just getting them. Getting them is the easy part....feeling them is whole different story.
I have lots of first hand experience in that regard. Not all our problems can be fixed by a cpap machine.

In your situation...I don't know if those FLs or snores are impacting how you feel or not but it is worth trying to kill them to see if it helps or not.
You are so much further along than I was one week into therapy though...so there is also a lot of truth to the "give it time" thing.

If you are totally comfortable with the starting pressure of 6...maybe try 6.5 and see if it helps or not. Snores and FLs are usually easily killed with just a little more pressure when the AHI is low.

[Mark55]

As others have said, looks like you're doing good to me. I have the same issue with lack of sleep time. Mine is always in the 5 to 6 hour range. I usually sleep like a log most of the night, but after that amount of time, my really horrendous back and neck issues force me out of bed.

Not much I can do about that short of taking the shot at surgery, and I'm not ready to take that flip of the coin yet. Time for another thoracic epidural on 12/28, and then lumbar followed by cervical. They rotate the steroid injections on me.

[USMCVet]

Well I guess the next hurdle is making sure I'm sleep through the night with the least amount of wake ups.

That's always been a problem for me and I for as long as I can remember my sleep has been fragmented.

I used to have issues falling asleep but I have worked those out for most part.

No pain to wake me up, I actually have been practicing good sleep hygiene especially recently. I take amplodipine besylate and Lisinopril both of which I don't think would effect sleep. When I wake up its not because of bad dreams or life stressors.

During sleep study I only had 5% of REM sleep. During study I only had 6 apneas during the 3.6 hours of sleep so the 118 hypopneas are my issue.

I asked VA for Ambien CR and they said it is bad for people and wouldn't give it to me. Should I push for it to help stay sleeping?

I'm pretty driven when I want something and feeling better is something that I really want.

Thanks again for all the help and support here!

[Goofproof]

Well I guess the next hurdle is making sure I'm sleep through the night with the least amount of wake ups.

That's always been a problem for me and I for as long as I can remember my sleep has been fragmented.

I used to have issues falling asleep but I have worked those out for most part.

No pain to wake me up, I actually have been practicing good sleep hygiene especially recently. I take amplodipine besylate and Lisinopril both of which I don't think would effect sleep. When I wake up its not because of bad dreams or life stressors.

During sleep study I only had 5% of REM sleep. During study I only had 6 apneas during the 3.6 hours of sleep so the 118 hypopneas are my issue.

I asked VA for Ambien CR and they said it is bad for people and wouldn't give it to me. Should I push for it to help stay sleeping?

I'm pretty driven when I want something and feeling better is something that I really want.

Thanks again for all the help and support here!

Zombie drugs aren't the answer. Jim

[Wulfman...]

Your Flow Limitations and Snores are what is driving your pressure increases. You're also not having many apneas or hypopneas.
I would suggest gradually moving the minimum pressure upwards to keep the pressure increases to a minimum. It may head off some of the events that are driving the pressure increases, too.


Den

.

[USMCVet]

I just got my Heated hose which I am planning on turning on highest temp with humidity of 4. My room is usually around 62ish so I am hoping not to have and condensation issues.

I just woke up from nap and downloaded last nights data. Based on comments here and since snores and FL are still sameish ill try increasing minimum to 6.5 tonight and see how it goes.

[TedVPAP]

Well I guess the next hurdle is making sure I'm sleep through the night with the least amount of wake ups.

That's always been a problem for me and I for as long as I can remember my sleep has been fragmented.

I used to have issues falling asleep but I have worked those out for most part.

No pain to wake me up, I actually have been practicing good sleep hygiene especially recently. I take amplodipine besylate and Lisinopril both of which I don't think would effect sleep. When I wake up its not because of bad dreams or life stressors.

During sleep study I only had 5% of REM sleep. During study I only had 6 apneas during the 3.6 hours of sleep so the 118 hypopneas are my issue.

I asked VA for Ambien CR and they said it is bad for people and wouldn't give it to me. Should I push for it to help stay sleeping?

I'm pretty driven when I want something and feeling better is something that I really want.

Thanks again for all the help and support here!

No. You should instead try the advice that has been given by a few people - small increase to minimum pressure.

[USMCVet]

Yea like I said im going to try a 0.5 bump to minimum and see how that goes.