zonker's crib--somewhere over the rainbow

[Jas_williams]

Looking at these graphs your AHI seems to be higher when your CA’s are higher. There is nothing much you or your machine can do about them can you zoom in on one of times where you have the cluster of Hypopnea and CA’s maybe one of the green sections where your machine has flagged csr’s


It looks to me like an element of your sleep apnoea is mixed apnoea which your machine won’t treat. But at not a very high level that would warrant a different type of machine.

One of the features of mixed sleep apnoea is that the number of CA’s and Hypopnoeas caused by periodic breathing can be variable from night to night.


How do you feel any different on these nights with a higher AHI. It’s not all about numbers

[zonker]

Looking at these graphs your AHI seems to be higher when your CA’s are higher. There is nothing much you or your machine can do about them can you zoom in on one of times where you have the cluster of Hypopnea and CA’s maybe one of the green sections where your machine has flagged csr’s


It looks to me like an element of your sleep apnoea is mixed apnoea which your machine won’t treat. But at not a very high level that would warrant a different type of machine.

One of the features of mixed sleep apnoea is that the number of CA’s and Hypopnoeas caused by periodic breathing can be variable from night to night.


How do you feel any different on these nights with a higher AHI. It’s not all about numbers

ah! now, you see, when i see those CA's, i typically put them out of my mind, particularly if they come in the very last hour or do of my sleep. i just disregard them as junk. so my brain carries that over to ALL of the CA's and thus i discount them. thanks for pointing them out.

i thought i'd stated at the beginning about how i'm feeling after a high AHI number sleep. but it's possible i didn't. at any rate, yes, higher numbers have impact on how rested i feel the next day. i can actually feel the difference if i'm over the 1.5 and 2.0 range. i feel more fuzzy and not alert. anything over 5 and i will wake up with a headache.

it would be a bummer, indeed, if it turns out there's nothing to be done about it with this machine.

i appreciate you letting me know what you've seen so far. here is a zoomed section. please let me know if you want further examples or let me know if this is inadequate and i'll post others.

screenshot-9-27-18scrolled.png

[Jas_williams]

That graph looks remarkably like mine when I am in Rem sleep I have periods of 30 minutes where every one of those drops becomes a CA and my CAI count could be as high as 30 per hour all CA’s I found it was still causing O2 desats.


The answer is a machine that can provide a backup rate such as an Aircurve ST or an ASV I self purchased a Resmed S9 VPAP Adapt (this is an ASV machine) my nightly AHI is now 0 or 0.1 and I no longer have the lethargy and morning head ache’s, I feel great.


I am in the UK and bought a used ASV machine from the US and I am self treating but working with the NHS for compliancy reporting otherwise the DVLA will remove my driving licence unless the NHS certify my Sleep Apnoea is adequately treated.


Also I have seen from your other posts you are trying to use EPR... I do not understand why you insist on using it if you feel worse.

It could be that the EPR is causing you to be over ventilated causing the periodic breathing. Do you have the same Waxing and Waning flow graphs when the EPR is off ?

[zonker]

That graph looks remarkably like mine when I am in Rem sleep I have periods of 30 minutes where every one of those drops becomes a CA and my CAI count could be as high as 30 per hour all CA’s I found it was still causing O2 desats.


The answer is a machine that can provide a backup rate such as an Aircurve ST or an ASV I self purchased a Resmed S9 VPAP Adapt (this is an ASV machine) my nightly AHI is now 0 or 0.1 and I no longer have the lethargy and morning head ache’s, I feel great.


I am in the UK and bought a used ASV machine from the US and I am self treating but working with the NHS for compliancy reporting otherwise the DVLA will remove my driving licence unless the NHS certify my Sleep Apnoea is adequately treated.


Also I have seen from your other posts you are trying to use EPR... I do not understand why you insist on using it if you feel worse.

It could be that the EPR is causing you to be over ventilated causing the periodic breathing. Do you have the same Waxing and Waning flow graphs when the EPR is off ?

okay, i'll take the machine recommendations under advisement. i had thought before that it may be the way to go, but didn't think my centrals were enough for it to do any good.

as to my relationship with epr, it's down to me not being able to explain it properly. i have that problem when trying make myself clear when putting something in writing. i'm much better at making myself clear verbally. but i will try again.

somehow or other, i got the clearly mistaken impression that epr would help me to tolerate higher pressures. if i could get comfortable with the higher pressures, i then thought it would help me 'd reduce my ahi. with ahi reduced, i then thought i'd have a better night's sleep, wherein i'd be even more refreshed in the morning then an ahi of, say between 1 and 1.5.

still not sure if that makes any sense.

tonight, i will turn off epr and see what the chart looks like.

i want to thank you so very much for giving me your opinion on my charts.

i hope others will chime in as well.

[djams]

somehow or other, i got the clearly mistaken impression that epr would help me to tolerate higher pressures. if i could get comfortable with the higher pressures, i then thought it would help me 'd reduce my ahi. with ahi reduced, i then thought i'd have a better night's sleep, wherein i'd be even more refreshed in the morning then an ahi of, say between 1 and 1.5.

still not sure if that makes any sense.

Actually, I understood your thought process from the initial post. Trying to find a way to increase min pressure without aerophagia biting you.

I GET you, man...

EPR does help me tolerate higher pressures, so you're not wrong about that. However, my first impression of EPR was "ahhh - that feels better", and if I recall correctly yours was "I don't really care for this". I think that difference speaks volumes.

[zonker]

somehow or other, i got the clearly mistaken impression that epr would help me to tolerate higher pressures. if i could get comfortable with the higher pressures, i then thought it would help me 'd reduce my ahi. with ahi reduced, i then thought i'd have a better night's sleep, wherein i'd be even more refreshed in the morning then an ahi of, say between 1 and 1.5.

still not sure if that makes any sense.

Actually, I understood your thought process from the initial post. Trying to find a way to increase min pressure without aerophagia biting you.

I GET you, man...

EPR does help me tolerate higher pressures, so you're not wrong about that. However, my first impression of EPR was "ahhh - that feels better", and if I recall correctly yours was "I don't really care for this". I think that difference speaks volumes.

well, now, THERE'S a frightening thought!

yeah, didn't really seem to be a natural form of breathing at all. have turned off epr and we'll see how it goes tonight.....

[Jas_williams]

But even if your using epr I see no need for extra pressure. More pressure won’t help your AHI as I do not believe the elements that are left are obstructive based on the graphs you showed me so more pressure won’t help in fact it will wash out more CO2 and probably make you AHI higher...



Fun this isn’t it

[palerider]

But even if your using epr I see no need for extra pressure. More pressure won’t help your AHI as I do not believe the elements that are left are obstructive based on the graphs you showed me so more pressure won’t help in fact it will wash out more CO2 and probably make you AHI higher..

I have to disagree, more pressure, though probably less EPR, will smooth out the pressure trace, which is pretty active.

However, that may end up causing more aerophagia, so it's 'delicate balance' time....

[zonker]

But even if your using epr I see no need for extra pressure. More pressure won’t help your AHI as I do not believe the elements that are left are obstructive based on the graphs you showed me so more pressure won’t help in fact it will wash out more CO2 and probably make you AHI higher...



Fun this isn’t it

yes, so far, it's been three years of fun. don't know how much more i can take!

here's last night-

screenshot-10-05-18.png

screenshot-10-05-18zoomed.png

it's JUST that one hour. if i could be rid of that, i think i'd be in better shape.

[zonker]

But even if your using epr I see no need for extra pressure. More pressure won’t help your AHI as I do not believe the elements that are left are obstructive based on the graphs you showed me so more pressure won’t help in fact it will wash out more CO2 and probably make you AHI higher..

I have to disagree, more pressure, though probably less EPR, will smooth out the pressure trace, which is pretty active.

However, that may end up causing more aerophagia, so it's 'delicate balance' time....

last night, i turned off epr. there was a BIT more aerophagia, but i think it was mostly down to me eating too much yesterday. unless someone says different, i will keep my settings as is and see what sleepyhead shows tomorrow.

[palerider]

. unless someone says different, i will keep my settings as is and see what sleepyhead shows tomorrow.

Let it sit for a few days, and look at the averages.

[zonker]

. unless someone says different, i will keep my settings as is and see what sleepyhead shows tomorrow.

Let it sit for a few days, and look at the averages.

will do.

and dammit! i THOUGHT a made another post to this thread. too involved but boiled down to "yikes! vpap be expensive." and "unsure if i want to buy machine if it not work".

also the two nights pictured above of 1.113 and 1.09 ahi showed significantly less ca's than the rest. the lower of the two had min of 9 while the other was min 8.8. the 9 was uncomfortable. if i can just get to an ahi that makes me comfortable and allows me to wake up rested and without headaches, that may just be the best i can hope for.

[palerider]

and dammit! i THOUGHT a made another post to this thread. too involved but boiled down to "yikes! vpap be expensive." and "unsure if i want to buy machine if it not work".

Well, here's the deal.. you don't like EPR, (and based on the extra centrals it looks like you get with it, it doesn't seem to like you.

The entire point of a bilevel (vpap) is to give you even more pressure support than EPR. (EPR is just pressure support limited to 3).

I can't see any reason for you to buy a vauto at this point.

also the two nights pictured above of 1.113 and 1.09 ahi showed significantly less ca's than the rest. the lower of the two had min of 9 while the other was min 8.8. the 9 was uncomfortable. if i can just get to an ahi that makes me comfortable and allows me to wake up rested and without headaches, that may just be the best i can hope for.

Waking up rested and without headaches is the end goal... it's the best any of us can hope for.

[zonker]

and dammit! i THOUGHT a made another post to this thread. too involved but boiled down to "yikes! vpap be expensive." and "unsure if i want to buy machine if it not work".

Well, here's the deal.. you don't like EPR, (and based on the extra centrals it looks like you get with it, it doesn't seem to like you.

The entire point of a bilevel (vpap) is to give you even more pressure support than EPR. (EPR is just pressure support limited to 3).

I can't see any reason for you to buy a vauto at this point.

also the two nights pictured above of 1.113 and 1.09 ahi showed significantly less ca's than the rest. the lower of the two had min of 9 while the other was min 8.8. the 9 was uncomfortable. if i can just get to an ahi that makes me comfortable and allows me to wake up rested and without headaches, that may just be the best i can hope for.

Waking up rested and without headaches is the end goal... it's the best any of us can hope for.

thank you, good sir. always glad to have your opinion. will carry on with current settings and see how she goes over the next few days.

[Pugsy]

FWIW....I agree with PR here.
Let's see what a few nights at these new settings without EPR bring you and cross our fingers that the aerophagia monster stays away.