Crappy Night

[caffeinatedcfo]

Anyone seen something like this with CPAP. Auto settings 7.4-20cm.

Went to bed about 10:30. Started supine as usual but by midnight the little leaks were driving me mad so I ripped off my mask and turned CPAP off. (And then re-masked after a few minutes of calming down.)

The first bad cluster of OAs:

The whole night:

The leaks!!!

[Denial Dave]

Aside from the pressure changes due to your auto-settings, it looks a quite a bit like my first 3-4 weeks of being on CPAP.

My nightly average AHI for my first 3-4 months was in the 2-4 range with some nights showing much higher AHI.

Aside from finding the right mask, controlling leaks, etc.... I suspect that our bodies & brains need time to adjust to the process.

[sleepstar]

did you roll on your side when you put it back on?

[sleepstar]

From that data I suspect that you need a much higher pressure when you're supine. You're obstructing repeatedly.
If you're comfortable, bump your minimum pressure up. Your 95% pressure is around 14 cm h2o - so you need significantly more than the 7 cm h2o you start on.
Do you use a ramp? maybe shorten the ramp if you're not comfortable bumping your pressure up. I'd bump it up by 1-2 if you are comfortable though.

[NotLazyJustTired]

Good morning caffeinatedcfo,

If it helps any, I don't blame you one bit for wanting a break. You were approaching 19cm with all those apneas and hypopneas. That is quite a bit of pressure for us newbies. I would have done the same. I would echo the remarks about sleeping supine. Are you comfortable sleeping on your side or is this something new? I have developed a sort of "partial supine" sleeping...not quite on my back, but not quite on my side either. Hard to describe, but it sort of evolved out of my first couple weeks due to the mask issues I was having sleeping in my normal side way. I am sleeping more now on my side now as I am adapting to the mask and learning ways to roll over without jarring the pillows away from my nares.

If I was to venture a guess, I would say you need some more min pressure. I am kind of in the same boat, my doc prescribed 5 to 15 for me. Kind of "wide open range until we get this figured out" sort of thing. When is your titration study coming up?

[MS Gray Man]

Just my personal view but looking at that night I'd look at moving my start pressure to about 11, to see results. Although one night's data isn't the best approach to determining pressure settings.

If other nights looked similar to the pressure pattern for Thursday though the min pressure is definitely too low and appears to be setting you up for difficult nights.

Cheers.

[Kenwood]

I'm one week+ into CPAP and have similar experiences with my mirage quattro ffm. The first 3-4 hours usually goes great, but after that first awakening I can not seem to maintain a solid fit and end up with fragmented sleep the last 4 hrs. I have the medium mask and I'm wondering if dropping to a small will help.

Print this out and see...
http://www.resmed.com/ap/assets/documen ... ow_eng.pdf

[caffeinatedcfo]

did you roll on your side when you put it back on?

Yes I did. I wimped out while raising my min pressure because it's easier to breath the higher pressure in supine. However, per my initial sleep study, my AHI was 45.5 but over 60 in supine position. I don't use the ramp feature but have been slowly increasing min pressure each night.

Good morning caffeinatedcfo,
When is your titration study coming up?

April 21st

Print this out and see...
http://www.resmed.com/ap/assets/documen ... ow_eng.pdf

Just as I thought, I fall just below the med/small line. My DME has been awesome but thinking back - he never measured me! I'll report back on this.

IN addition to feeling a little better, I am also more aware of WHAT is waking me up each night. Cool stuff!

Edit: I love my DME (Lincare) - I called and they said sure c'mon in we'll leave a small one at the counter for you at no charge.