ASV: PTB drops at beginning of sleep

[adipasqu]

All,

I know I shouldn't really complain since everything else looks pretty good, but I've been wondering lately why my PTB drops at the beginning of my sleep cycle. Sometimes its only after I wake up in the middle of the night (like last night...data below). On other nights, it will be at the beginning of the night and after I have woken up, as well. Has anyone else experienced this or have any ideas? Could it just be that particular stage of sleep depressing my breathing rate? I don't think I am rolling over onto my back as I am predominantly a stomach or side sleeper.



-A

[ameriken]

You know my PTB's always run between 80 and 90% and I drop down to 0% at least once or twice during the night. Usually it is gradual with the deep canyons happening after 3 or 4 hours, but there are nights when my PTB's fall off a cliff and hit bottom within the first 30 minutes of sleep.

[adipasqu]

You know my PTB's always run between 80 and 90% and I drop down to 0% at least once or twice during the night. Usually it is gradual with the deep canyons happening after 3 or 4 hours, but there are nights when my PTB's fall off a cliff and hit bottom within the first 30 minutes of sleep.

I was flat-lined at 0% for a good 45 minutes the night before. Strange stuff...good thing I have the ASV, otherwise I would not be feeling as good as I do now.

-A

[Snooze_Blues]

I'm no expert, but it looks like you are both snoring and experiencing hypopneas during that period (I'll bet you saw that ;o) so I'd guess, if it were me, but of course it's not, that you might be a bit stopped up (like me sometimes) when you awaken at night. Maybe some sinus tissue swelling from being horizontal or too-much/too-little humidity.

You might also be incredibly relaxed in the wee hours causing a quick return to sleep and a super relaxed airway that collapse quickly as you are nodding off, but seeing the pressure has been raised during the events seems counter intuitive to what I'd have expected in this scenario. So, in short, I don't know. Not sure why I'm responding here, either. Feeling chatty, I guess. ;o)

Interestingly, before I looked at your data, I expected to see central apneas there instead of hypopneas and snores (both obstructive in nature, I'm assuming). That is what I was told I experienced during my last sleep study (ASV titration). I can't verify it yet because the Encore Viewer2 software I got from my DME doesn't support my new PRS1 ASV machine (per Philips help line). Oops. At least I now have a USB SD card reader (sarcasm). ;o)

I'll try to get Encore2 running soon, but I notice in your sig you are an alpha tester for Sleepy Head. Are you using that with a PRS1 ASV? For some reason, I was thinking Sleepy Head didn't support the PRS1 ASV yet. Last check, Onkor didn't support PRS1 ASV, either.

All that data sure looks pretty. ;o)

[adipasqu]

I'm no expert, but it looks like you are both snoring and experiencing hypopneas during that period (I'll bet you saw that ;o) so I'd guess, if it were me, but of course it's not, that you might be a bit stopped up (like me sometimes) when you awaken at night. Maybe some sinus tissue swelling from being horizontal or too-much/too-little humidity.

You might also be incredibly relaxed in the wee hours causing a quick return to sleep and a super relaxed airway that collapse quickly as you are nodding off, but seeing the pressure has been raised during the events seems counter intuitive to what I'd have expected in this scenario. So, in short, I don't know. Not sure why I'm responding here, either. Feeling chatty, I guess. ;o)

Interestingly, before I looked at your data, I expected to see central apneas there instead of hypopneas and snores (both obstructive in nature, I'm assuming). That is what I was told I experienced during my last sleep study (ASV titration). I can't verify it yet because the Encore Viewer2 software I got from my DME doesn't support my new PRS1 ASV machine (per Philips help line). Oops. At least I now have a USB SD card reader (sarcasm). ;o)

I'll try to get Encore2 running soon, but I notice in your sig you are an alpha tester for Sleepy Head. Are you using that with a PRS1 ASV? For some reason, I was thinking Sleepy Head didn't support the PRS1 ASV yet. Last check, Onkor didn't support PRS1 ASV, either.

All that data sure looks pretty. ;o)

Thanks for your input. It gives me something to think about... My humidity may not be high enough. I might have to turn off the System One function and go with classic humidifier mode that worked well on the "tank" before I got its younger, little sister.

SleepyHead does work for the PRS1 ASV, and its great even though it is still in Alpha testing:

http://sourceforge.net/projects/sleepyh ... e/download

You'll need Encore Pro 2.5 to work with your PRS1 ASV data. No version of Encore Viewer nor Encore Pro 2.4 or earlier supports the PRS1 ASV.

-A

[Mr Bill]

Its common to have an increase an AHI and decrease in PTB just as you fall asleep. Try searching the string "sleep onset centrals"

[dsm]

adipasqu

Interesting chart

What I see is that some time before you got up (that short break) you started to have an increase in flow lims & hypops.

After you got up, your body would be adjusting to a wakened state, increased heart rate, respiration etc: - then you
go back to bed & the machine now has to adapt to your body going from an alert state back to a sleeping state &
your breathing is changing pretty quickly as you slow it down. The machine registers the changes as flow lims & hypops
and begins varying the pressure (IIRC a 4 min peak flow window).

What I see then is you going from an awake state back to sleep & with your breathing disrupted & the machine adapting.

The snores indicate that at that time your epap is too low. Are you using a range of epapMIn-epapMax ? - what is it
maybe an epap settingof 1 CMs higher would have allowed epap to respond to the VS & thus stabilize your breathing at
that point.

Mind you, it is pretty minor - usually the epapMin-epapMax setting is there to deal with OSA type events that intrude just
as these have.

Cheers

DSM