Pressure Pulse Events

[Dojers]

How many pressure pulse events is considered "average" (knowing that everyone is different)? Just curious as I'm running a lot of times in the 200s (one was 776!! So you know why I'm curious!!) and am wondering if that's normal. Last night, however, I was only at 52 but usually around 200 is my norm.

I'm thinking I'm gonna need to get an actual sleep doc and not just for titration tests. My AHIs are running higher (close to 10, a lot of times more) but now I'm also noticing a slight increase in my clear airway apneas and a new one on me "Cheyne Stokes Respiration" which I didn't see before but I haven't checked much since I did the update. Been probably 2 weeks since I checked it last so will be going back and checking them out.

Still not getting these number things figured out yet. But I will!!!

[tetragon]

I tend to get between 150 - 250 pulses each night (with some outliers), with an AHI that appoximates 3.5. (again, some outliers). I don't yet have enough data points for me to trust any actual analysis, as I've only been using my current machine for a month (got it on 2011-10-12).

[Dojers]

I tend to get between 150 - 250 pulses each night (with some outliers), with an AHI that appoximates 3.5. (again, some outliers). I don't yet have enough data points for me to trust any actual analysis, as I've only been using my current machine for a month (got it on 2011-10-12).

My AHIs run close to 10 and above so I know I need to get it checked out - I just didn't know how "worrisome" the pressure pulses are/were/

[robysue]

My understanding is that the pressure pulses are sent out by the System One to determine whether the airway is open or closed. And the machine does that when the wave flow indicates something funky is going on: In other words, the machine is wondering if it's begun to detect an apnea or a pretty severe hypopnea. Now note: An apnea is only going to be scored if the event lasts at least 10 seconds, but the machine doesn't wait the full ten seconds before sending out a PP. If my data is typical, that first PP gets sent out around 4--6 seconds after the flow has come close to dropping to 0. And if the apnea is a long one, multiple PP will be sent out---I suppose to keep measuring whether the airway is still open or closed. A good question occurs to me: I wonder how the PR scores an apnea where the first pulse indicates the airway was open, but the second indicates the airway is closed.

As for how many PP are typical? I don't know. I do know that in the last 30 days mine have numbered between 4 and 20, with AHI's ranging from 0.3 to 4.0 (on a rare bad night that happened a couple of weeks ago.) Most nights my AHI is below 2.5 and below 2.0 at least half the time.

[stevos2000]

If you can, get yourself an infrared video set-up and record a night's sleep. My experience is that my pressure pulse events usually match up to some kind of disturbance in body position that also means my sleep has been fragmented. With 200 pulses you are probably experiencing terrible sleep fragmentation and will probably feel like crap the next day no matter what your AHI numbers might say. In fact, sometimes low AHI numbers can indicate crummy sleep since you didn't get enough REM to drop into obstructive apnea events. I have some kind of rhythmic movement disorder in my sleep in addition to sleep apnea and upper airway restriction and insomnia. I found that I had to deal with all of these in order to start feeling better.

Besides using CPAP long enough to let your body heal, you need 3 things to occur before you will really feel better:

1) You need to get enough sleep with the CPAP. That means getting to sleep, staying asleep most of the night, and not waking up until you've had your 7 or 8 hours that you require. For this, I need a sleeping pill. I use lunestra and now can get 7 to 8 hours of sleep consistently versus the 5 or 6 I was getting on ambien.

2) You need to get your AHI numbers steady and low. This means you have to figure out what mask works for you, how to control your leaks, and what pressure settings give you the best results. Too high a pressure can be sometimes be even worse than too low a pressure, since more leaks will occur and probably more sleep disturbances as well. My doctor wanted me to go higher, but that turned out to be wrong.

3) You need to get your fragmentation under control. You can use your pressure pulse number count as an indication of this if you have no video or Zeo. For me that means controlling my thrashing and flipping as much as possible. I take gabapentin and most recently a magnesium supplement. The magnesium seems to be helping a lot (much to my surprise). My pressure pulse counts have dropped to the 20s and 30s since I began taking it and my AHIs are averaging about 0.3 or so.

In summary, good AHI numbers means you're not being strangled in your sleep. That's a good thing. But you won't ever feel better unless you also get enough uninterrupted REM and deep sleep to allow your mind and body to recharge. You need to figure out what your body is doing while you sleep. But whatever you do, don't give up on the CPAP. Its a big part of the fix.

[Dojers]

In summary, good AHI numbers means you're not being strangled in your sleep. That's a good thing. But you won't ever feel better unless you also get enough uninterrupted REM and deep sleep to allow your mind and body to recharge. You need to figure out what your body is doing while you sleep. But whatever you do, don't give up on the CPAP. Its a big part of the fix.

Well, I've been a restless sleeper since birth - I take 10 mgs of Ambien (Lunesta didn't do squat) along with some other meds that are sedating and that does no good. I'm also on a muscle relaxer and pain medication - I'm probably never going to get a good night's sleep with my body being this way (I have nerve damage so I can't stop all the restlessness anyway) but I will NEVER EVER give up my CPAP!! Maybe when they pry my cold dead fingers off of it! It's the first time I've not had to sleep with fans blowing in my face on both sides of the bed or waking up feeling like I was suffocating. My CPAP is going nowhere bad numbers or not!

I'll put Magnesium on my grocery list and give it a go once I make sure that it won't counteract with any of my prescriptions that I'm taking - see if that helps any. Would be nice

[Pugsy]

The pressure pulses are the machine's way of determining what category to place the potential event in.
Perhaps you have a rather unique situation due to the other health problems and other medications that you take (like the muscle relaxer which is known to possibly make OSA worse) which means the machine simply has to sort through more of the questions the pressure pulse is designed to answer.

So perhaps this is a "normal" thing for you in your situation. I don't know.. we are never given a ball park range for pressure pulse numbers.