Newbie Self Diagnosis - In Denial - AHI Question

[palerider]

Yeah, they mention,

"UK summer sunshine by and large is not desperately strong. It's important not to translate the Australian sun avoidant messages straight to the UK.

Dallasish - proceed with caution.

Yeah... I can promise you that down here... Noonday sun is *NOT* more gentle than morning or evening.

It's more "bake cookies on your car dashboard and fry an egg on the sidewalk" kinda thing.

[chunkyfrog]

A colleague used to dehydrate produce in her station wagon--in Utah.

[marktheshark]

When I do manage to sleep thru the night and still feel terrible, could it be I messed my sleep patterns up so badly that they need to be corrected?

Try really strict sleep hygiene. Include good diet and moderate exercise. Get early morning sun. No caffeine - not even "hidden" small amounts in things like chocolate and green tea. Some decaf coffees still have amounts of caffeine that are significant to sensitive people.

Browse "sleep hygiene" and read a couple of articles from reputable sources.

Hey all, I'm back lol.

I found a chin strap that seems to be working and I continue to use the cpap every night.

Seems my sleepyhead data is mainly showing Open Airway events each night, which now that I understand things more, it just looks like I'm waking up causing these. Averaging about 2.0 AHI per night with about 8-9 hours of sleep. I can tell I'm still waking up quite a bit, I'm thinking it will just take more time to adjust. I can honestly say I'm not feeling much better, but I do feel worse the next day if I pull the mask off half way thru the night. My question this time is, what causes pressure to increase? If I have the min pressure set at 5.0 for the first 20 minutes, then auto set after that. It looks like my overall nightly pressure is hovering around 9.0-9.5. Again, I'm still looking for clues, so my thought is if I didn't have some kind of sleep apnea, would the pressure NOT be increasing? I've tried to look around on the forum and I couldn't really get a straight answer. I've mainly been paying attention to events, but last night I read a post that mentioned pressure increase could be a sign of the machine rasing pressure because it senses a blocked airway?

[Jas_williams]

When I do manage to sleep thru the night and still feel terrible, could it be I messed my sleep patterns up so badly that they need to be corrected?

Try really strict sleep hygiene. Include good diet and moderate exercise. Get early morning sun. No caffeine - not even "hidden" small amounts in things like chocolate and green tea. Some decaf coffees still have amounts of caffeine that are significant to sensitive people.

Browse "sleep hygiene" and read a couple of articles from reputable sources.

Hey all, I'm back lol.

I found a chin strap that seems to be working and I continue to use the cpap every night.

Seems my sleepyhead data is mainly showing Open Airway events each night, which now that I understand things more, it just looks like I'm waking up causing these. Averaging about 2.0 AHI per night with about 8-9 hours of sleep. I can tell I'm still waking up quite a bit, I'm thinking it will just take more time to adjust. I can honestly say I'm not feeling much better, but I do feel worse the next day if I pull the mask off half way thru the night. My question this time is, what causes pressure to increase? If I have the min pressure set at 5.0 for the first 20 minutes, then auto set after that. It looks like my overall nightly pressure is hovering around 9.0-9.5. Again, I'm still looking for clues, so my thought is if I didn't have some kind of sleep apnea, would the pressure NOT be increasing? I've tried to look around on the forum and I couldn't really get a straight answer. I've mainly been paying attention to events, but last night I read a post that mentioned pressure increase could be a sign of the machine rasing pressure because it senses a blocked airway?

I am not sure what you mean by Open Airway if you mean Clear Airway (CA) then nothing your machine can do about that or do you mean Obstructive Apnoea (OA) then more pressure needed. But graphs from sleepyhead posted here for recommendations is best.

[marktheshark]

When I do manage to sleep thru the night and still feel terrible, could it be I messed my sleep patterns up so badly that they need to be corrected?

Try really strict sleep hygiene. Include good diet and moderate exercise. Get early morning sun. No caffeine - not even "hidden" small amounts in things like chocolate and green tea. Some decaf coffees still have amounts of caffeine that are significant to sensitive people.

Browse "sleep hygiene" and read a couple of articles from reputable sources.

Hey all, I'm back lol.

I found a chin strap that seems to be working and I continue to use the cpap every night.

Seems my sleepyhead data is mainly showing Open Airway events each night, which now that I understand things more, it just looks like I'm waking up causing these. Averaging about 2.0 AHI per night with about 8-9 hours of sleep. I can tell I'm still waking up quite a bit, I'm thinking it will just take more time to adjust. I can honestly say I'm not feeling much better, but I do feel worse the next day if I pull the mask off half way thru the night. My question this time is, what causes pressure to increase? If I have the min pressure set at 5.0 for the first 20 minutes, then auto set after that. It looks like my overall nightly pressure is hovering around 9.0-9.5. Again, I'm still looking for clues, so my thought is if I didn't have some kind of sleep apnea, would the pressure NOT be increasing? I've tried to look around on the forum and I couldn't really get a straight answer. I've mainly been paying attention to events, but last night I read a post that mentioned pressure increase could be a sign of the machine rasing pressure because it senses a blocked airway?

I am not sure what you mean by Open Airway if you mean Clear Airway (CA) then nothing your machine can do about that or do you mean Obstructive Apnoea (OA) then more pressure needed. But graphs from sleepyhead posted here for recommendations is best.

Sorry, I meant "Clear Airway"

[ChicagoGranny]

graphs from sleepyhead posted here for recommendations is best.

+1

[Julie]

You're using an auto machine, whatever the ramp and/or pressures are set at, but 4 is the default min. pressure so depriving yourself of even the tiny bit of therapy attained by having it set at 5 vs 4 for 20 mins while the ramp is on (something more meaningfully used if e.g. min. setting were 12 and ramp was set for 10 mins) is fairly pointless. Pressure settings are settings... ramping is different and has its own settings and timing, and shouldn't be confused. I'd raise your min. setting to 7, ditch the ramp altogether and see how you feel after a couple of nights.

[Pugsy]

my thought is if I didn't have some kind of sleep apnea, would the pressure NOT be increasing?

The machine increases the pressure because it senses the need to hold the airway open because the airway is trying to collapse.
If the airway wasn't trying to collapse in some fashion it wouldn't increase the pressure.
Snores or flow limitations are part of what the machine looks for in terms of signs or warning signals that the airway is trying to collapse...along with the full grown evidence of a flow reduction that earns and OA or hyponea flag.
If your pressure minimum is 5...and the machine wants to go to 9 ish and stays there a lot...then you pretty much have confirmation that you have some level of obstructive sleep apnea.
You pretty much gave yourself proof of the diagnosis. We don't have any way to know just how many airway collapses it might have prevented but the machine saw something it didn't like and responded in an effort to kill it.

If you didn't have OSA or some sort of sleep disordered breathing related to airway tissues collapsing...the machine wouldn't move off 5 cm all night long. Your situation is pretty clear cut.
What gets muddy sometimes is people who might only need 5 cm to hold the airway open and the machine never moves off 5 because 5 does a good job.

[marktheshark]

You're using an auto machine, whatever the ramp and/or pressures are set at, but 4 is the default min. pressure so depriving yourself of even the tiny bit of therapy attained by having it set at 5 vs 4 for 20 mins while the ramp is on (something more meaningfully used if e.g. min. setting were 12 and ramp was set for 10 mins) is fairly pointless. Pressure settings are settings... ramping is different and has its own settings and timing, and shouldn't be confused. I'd raise your min. setting to 7, ditch the ramp altogether and see how you feel after a couple of nights.

Great point, I will give that a try!

[marktheshark]

my thought is if I didn't have some kind of sleep apnea, would the pressure NOT be increasing?

The machine increases the pressure because it senses the need to hold the airway open because the airway is trying to collapse.
If the airway wasn't trying to collapse in some fashion it wouldn't increase the pressure.
Snores or flow limitations are part of what the machine looks for in terms of signs or warning signals that the airway is trying to collapse...along with the full grown evidence of a flow reduction that earns and OA or hyponea flag.
If your pressure minimum is 5...and the machine wants to go to 9 ish and stays there a lot...then you pretty much have confirmation that you have some level of obstructive sleep apnea.
You pretty much gave yourself proof of the diagnosis. We don't have any way to know just how many airway collapses it might have prevented but the machine saw something it didn't like and responded in an effort to kill it.

If you didn't have OSA or some sort of sleep disordered breathing related to airway tissues collapsing...the machine wouldn't move off 5 cm all night long. Your situation is pretty clear cut.
What gets muddy sometimes is people who might only need 5 cm to hold the airway open and the machine never moves off 5 because 5 does a good job.

Thanks for your input, I assumed as well that the machine pressure rising indicated I needed it. I will say I don't like the idea of sleeping without the mask now and I have a hard time falling asleep without it, go figure lol.

I will keep tweaking!

[Pugsy]

I will say I don't like the idea of sleeping without the mask now and I have a hard time falling asleep without it, go figure lol.

Go back and read your first posts...you have come a long way. Good job.

Keep tweaking and you will get there.

[marktheshark]

I will say I don't like the idea of sleeping without the mask now and I have a hard time falling asleep without it, go figure lol.

Go back and read your first posts...you have come a long way. Good job.

Keep tweaking and you will get there.

No doubt!

[marktheshark]

Hello all.

I am trying to understand the leak rate, I noticed on this screenshot it says it was Max: 12.00. I will say the next day I felt "well" like something worked well that night. I do know that I woke up after sleeping 3 hours and the machine said AHI of 0.0 and I felt like I was in this AMAZING deep sleep! The following night my AHI was about the same but my leak rate Max was 25.00, and I know air was coming out of my mouth multiple times thru the night. Is there a target leak rate to be under?

[Snoregone Conclusion]

I do believe your post has answered your question in practical terms: if you don't have too much leaking out of your mouth to where you get dry mouth and it's otherwise under the rate the machine can deal with (I think it's 24 for a ResMed) for proper treatment, it sounds like you've otherwise got things optimized.

[Pugsy]

I don't worry so much about the actual leak numbers as I do if the leaks are waking me up or not.