"I'm Sorry, Auto"

Sleepless on LI · Post by **Sleepless on LI** » Sat Sep 10, 2005 9:09 am

My apologies to APAP. For those of you who didn't read what I was going through a week or two ago, I had tried switching my Remstar Auto from cpap at 10 to auto 6-10 and had worse results with my AHI's and felt horrible for the first time since starting therapy. A lot of knowledgeable people on these boards told me it may not be the auto setting but something else causing me to feel this way as my AHI's were still pretty damn good but higher, but my snores were high as compared to zero that I had at straight 10. I won't go through the whole thing again.

Well, once I switched back to CPAP, I wasn't getting any better results or feeling better. So two nights ago, out of desperation, I readjusted my Swift from scratch, changed the white filter on my machine, reset my machine's settings to something new, 8-12 auto from straight 10 this time, not like the weeks before at 6-10 when I blamed the APAP for my feeling worse, and gave it another try. The past two nights have been great. I am back to my low AHI's and am feeling full of energy again. I don't know the real cause of my sleepiness, multiple arousals/brief wakings during those nights, higher AHI's or what was going on, but it definitely was not the auto.

But I have learned a good lesson. The AHI readings are not always as a result of your settings. They can fluctuate from so many other variables that we may not even be able to identify. Don't get crazy and start adjusting things when your numbers change thinking the settings aren't working in your best interests. Those numbers can be as a result of many things.

Also, if you're feeling good, don't let the numbers bother you. The one thing I do have to say is, my snores on auto are really high at a 4.0 or so. They are always zero at my titrated pressure of 10. So I have a high snore index. If it's not waking me up, or my husband, does it matter? I'm sure he'll let me know (I'M SURE) if they get back to pre-treatment decibel levels, but he hasn't so far.

So, once again, my apologies to APAP and to those who read my hasty evaluation of it. I have learned a lot this past week not only about not watching the numbers too carefully, but to go by HOW YOU FEEL. That is really the best guide as to how you're truly doing. And give your new settings a reasonable amount of time, not a week but longer, to see if it's the settings that are truly not working for you or if something else may be going on within that is causing them to appear as if they aren't.

neversleeps · Post by **neversleeps** » Sat Sep 10, 2005 9:24 am

Posted: Tue Sep 06, 2005 1:37 am Post subject:

rested gal wrote:Lori, just a thought....

You say you've been feeling less energetic, and you're attributing it to one thing - the very small differences your seeing in your AHI. And yes...going from 0.8 to 1.8 is a very small difference. Maybe your body is that sensitive to such small "change" (deliberate pun on christine's extremely good post.).

But... maybe the less energetic feeling could be arising from other factors (those ever present variables in life) such as less restful sleep while dealing with getting used to your new Nose Breathe device, or the diet/exercise wearing you down a bit temporarily, or the PLM flaring a bit, or any number of stresses in a busy daily life.

And that brings me to "the thought" - if you're willing, try this:

Set your autopap into whatever mode and pressure that gives you the most comfortable treatment. Take two seconds to decide that. Don't try to second guess it or "analyze" which mode, which pressure, which results the next morning you thought looked best number-wise, or even whether you felt rested the next morning.

Don't think back on any AHI numbers or data of any kind. Just go with your FIRST instinct...the very first thing that pops into your mind...giving yourself exactly two seconds to think about this question:

"What mode and pressure or pressure range lets me sleep comfortably and wake up without bloating or gassiness?"

Two seconds. What's the answer?

Nope..stop that...don't think about, "But, but, I have to consider this...", or "But, the data showed...", or "Well, I thought it was good at first, but then....."

Start over again. Ask yourself the question again, but this time take exactly two seconds to come up with the first answer that pops into your mind..."What's been the most comfortable?"

Now, do this:

1. Set the machine that way. Don't second guess at this point. Just do it.

2. Do not download it for 4 days.

3. Do not change any settings for 4 days.

4. Do not change any mask or accessory you're using.

5. Keep a brief diary of how you feel when you wake up and how you feel through the day.

Above all, don't look at any data for four whole nights. Keep your mind absolutely untainted by any knowledge of what your AHI was during those four nights. (Bigtime withdrawal symptoms starting already?)

After the 4th night of not looking at any data at all, do the download and see what it says. See if the AHI's correlate exactly up and down with what your diary says about how you felt each morning and during the day.

Could be an interesting lab-rat experiment. Are you up to going on auto-pilot for a few days and doing it just like that?

rested gal, you were right on the money as always.

Sleepless on LI · Post by **Sleepless on LI** » Sat Sep 10, 2005 9:30 am

rested gal, you were right on the money as always.

So what else is new??? I've never seen anyone who knows so much - and is self-taught, too. Can you imagine how she did when she was in school? Probably one of those who got 4.0's without opening a book...

You know, neversleeps, sometimes you hear what people are saying but you need time to absorb it, or it takes something to make you open your eyes and accept what is being told to you. When the lack of feeling well came coincidentally at a time when the settings and numbers changed for me, it seemed black and white. But I have to remember that there are a lot of gray areas with this condition (and life in general, too) and to not make hasty judgments as there can be more to things than what meets the eye.

PS: I reread the quote you put in from RG and had to laugh out loud when she said, "Nope...stop that." She even knows me without knowing me. I must be pretty transparent.

Guest · Post by **Guest** » Sat Sep 10, 2005 9:32 am

Sleepless on LI wrote:... But I have to remember that there are a lot of gray areas with this condition (and life in general, too) and to not make hasty judgments as there can be more to things than what meets the eye.

Amen to that!!!!!!!

neversleeps · Post by **neversleeps** » Sat Sep 10, 2005 9:35 am

Well, I resolved the previous guest's IP and discovered it was me--once again forgetting to sign in.

dsm · Post by **dsm** » Sat Sep 10, 2005 4:17 pm

Sleepless on LI wrote:
<snip>but to go by HOW YOU FEEL. That is really the best guide as to how you're truly doing.
<snip>

Amen Lori, Amen !.

Very interesting post. Am very happy you feel back in the driver's seat & feeling good.

Cheers

DSM

PS will do a write up on my experiments with Dr Sue's NB later today (local time)

seagull · Post by **seagull** » Sat Sep 10, 2005 4:37 pm

I like to have it on auto because it takes me so long to go to sleep that I have to keep pushing ramp after 30 minutes on straight cpap. I don't have to do it but it is more comfortable. I don't know when I am actually getting to sleep unless I have it on auto. It stays at 7 or 7.5 till something starts happening. By the way I had it set on straight cpap 7-10, and this morning it appeared I stayed at 8 alot. How in the world did that happen on straight cpap? I didn't send that part to you, Will Succeed, because I forgot to save it when I sent other data.

rested gal · Post by **rested gal** » Sat Sep 10, 2005 4:53 pm

By the way I had it set on straight cpap 7-10, and this morning it appeared I stayed at 8 alot. How in the world did that happen on straight cpap?

seagull, I don't quite understand what it is you said you did. Are you saying you set a pressure range of 7 for low and 10 for high? If that's what you did, your machine was set for Auto, not straight cpap.

Sleepless on LI · Post by **Sleepless on LI** » Sat Sep 10, 2005 6:00 pm

Thanks, DSM, for the encouragement and support, as always. I am trying really hard to stay in that "driver's seat," although it gets a bit taxing sometimes.

By the way, how is the NB device working for you? I'd be interested to hear your opinion when you get a moment.

Guest · Post by **Guest** » Sun Sep 11, 2005 6:11 pm

rested gal wrote:
By the way I had it set on straight cpap 7-10, and this morning it appeared I stayed at 8 alot. How in the world did that happen on straight cpap?
seagull, I don't quite understand what it is you said you did. Are you saying you set a pressure range of 7 for low and 10 for high? If that's what you did, your machine was set for Auto, not straight cpap.

Rested Gal, No, I had it set on cpap, and started the ramp at 7. The machine was set at 10. So it should have ramped up to 10 in 30 minutes. On the software though it showed it stayed on 8 for quite awhile. That is what I don't understand. I did keep ramping from beginning again and again because I wasn't asleep after 30 minutes. I still don't understand how it stayed at 8. Thanks

seagull · Post by **seagull** » Sun Sep 11, 2005 7:57 pm

Of course that was me. I was on someone elses computer and forgot to log in.

WAFlowers · Post by **WAFlowers** » Mon Sep 12, 2005 8:14 am

Sleepless on LI wrote:The one thing I do have to say is, my snores on auto are really high at a 4.0 or so. They are always zero at my titrated pressure of 10. So I have a high snore index. If it's not waking me up, or my husband, does it matter? I'm sure he'll let me know (I'M SURE) if they get back to pre-treatment decibel levels, but he hasn't so far.

If you get to the point where you feel you need to get your snores under control, approach it gently in a series of small steps.

Try raising your bottom pressure by 0.5 at a time, and leave it at the new setting for at least a week before trying to come to any conclusions. When you get to the "magic number" it might be as if a switch was flipped that turns off your snores. At least, it worked that way for me. I tried a bottom pressure of 6 and had lots of snores. At 6.5 I'm typically at 0.1! .

Sleepless on LI · Post by **Sleepless on LI** » Mon Sep 12, 2005 8:55 am

Bill,

The only problem with raising the bottom number, even by .5 is, I am set right now for 8-12. My titrated pressure is 10. I get zero snores at 10. My data shows I never go up to 10 at night, but my snores are high. I stay at 8-9. Even at 9, I snore. So that doesn't leave my all but .5 room for improvement and kind of takes away from the auto aspect of it, no?

I had a great night last night, just one apnea and one hypop the entire night, but my snore index was 3.0, both events occuring, though, at 8. If I move it up to 8.5, maybe???

I just wish I knew if these snores, as recorded by the software, are anything to be concerned about. Also, Aura makes her arrival tomorrow, so I don't want to mess with too much at once, like a few weeks ago...never again. One thing I can say about me is that I USUALLY learn from my mistakes.

Thanks for the advice.

WAFlowers · Post by **WAFlowers** » Mon Sep 12, 2005 9:36 am

Ah, well. Everyone is different. Trying to generalize from my experience doesn't work too well; I seem to be an odd duck (instant relief, no trouble adjusting to wearing a mask, 100% happy compliance from day 1, etc.).

As to the snores, if they aren't bothering you and they aren't bothering your husband and you are waking up feeling refreshed, just ignore them!

Wulfman · Post by **Wulfman** » Mon Sep 12, 2005 9:49 am

Lori,

"One thing I can say about me is that I USUALLY learn from my mistakes."

QUIT LOOKING AT (or worrying about) YOUR SNORE INDEX!!!

I think RG gave you some similar advice recently, too.

MY snore indes got down to around 4 and 6 on a few nights and I thought I must have died during the night......
They're usually 10X (or much more) that amount, and my AHI is usually lower when the SI is higher, too. (and I have no idea why)

Have a good day

Den

"I'm Sorry, Auto"

"I'm Sorry, Auto"

Re: "I'm Sorry, Auto"

Re: "I'm Sorry, Auto"