baby dino's casa de los suenos, increasing ahi

[babydinosnoreless]

Thanks for the replies. Yes looks like most of my events are
SWJ. (Sleep wake junk hubby and I spent some time trying to figure out what that ancronym was we didn't even guess close ) so it looks like the machine is doing its job. Fixing the SWJ is not likely. That is old age and arthritis. Spend too long on one side it hurts roll over to the other and a couple of hours later it hurts, awake or asleep doesn't matter. Stay too long in one position and its gonna hurt. Unless someone invents a time machine and I can go back 30-40 years.

[Okie bipap]

My wife and I both have arthritis in our spine as well as the rest of our body. We purchased an adjustable bed around 12 years ago and have found it to help quite a bit with our sleeping. We can adjust either independent of the other. We are able to raise the head and foot of the bed to what ever level is comfortable for the night. It is similar to sleeping in a recliner.

[babydinosnoreless]

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Terrible night last night. It had been going so good. My pressure went higher than its ever been since I've gotten the machine. Any ideas what happened? here is the data from last night and then a close up of the cluster that caused the pressure to go so high.

[Pugsy]

When we see changes in pressure needs during the night like you see there are 2 main culprits.
Supine sleeping or REM sleep or maybe a combination.
It's very common for our OSA to worsen and we need more pressure when on our backs or during REM.
I myself have REM dependent OSA...in REM my OSA is 5 times worse than it is in non REM and sometimes I have seen pressure needs change 6 to 8 cm more in probable REM.

You can get an idea when REM normally happens by looking at some normal hypnograms and looking at the cycles of sleep and when REM normally happens. Google "sleep stages" and look at the hypnograms.

Either way....it's why we like auto adjusting machines....sure don't want to use 20 cm or more all night just to take care of the short period of time the pressure needs were higher for whatever reason.
Some people see a big difference in pressure needs....some don't. It's another one of those YMMV things.
Heck maybe you were on your back and in REM...where one by itself isn't that big of a trigger but both together causes a problem.

[babydinosnoreless]

Pugsy thanks for all your help! I must be driving you nuts with all these questions.

Does the sleephead graph for AHI correspond with the hypnograms for rem? If so then I am looking not at REM events but probably as you said supine sleeping. I am just not sure if I am looking at the right thing. Oh wait no it can't be, unless I'm looking at it upside down and rem is toward the top?

[Pugsy]

Those hypnograms will mostly show REM on top but some show it on the bottom. You gotta look closely at where they put REM on the graph.

REM normally cycles....first REM roughly 90 minutes after sleep onset and it's relatively brief. As the night goes on (and we don't wake up) REM comes on more frequently and will last longer with the greatest amount of REM occurring in those wee hours of the morning.
When we wake up (especially for several minutes and/or get up out of bed)...sort of resets that REM cycle pattern and you won't get as much REM in those wee hours. One of the reasons why frequent wake ups are unwanted...we can't get the normal sleep cycles and the cycles in the normal needed amounts. We need the normal balance in each stage for the restorative powers of sleep to work their magic.

From the few detailed reports you have posted...the event clustering looks an awful lot like REM timing to me. Your pressure increases cycle fairly regularly.
We can't really tell for sure and it could also be supine sleeping. Best we can do is make educated guesses.
A clue might be if you had your sleep study report and it showed sleep stages where you had more events during REM than other sleep stages. Same thing if it showed sleeping position event numbers that were markedly different with position.

Sleeping position wasn't a factor for me in number of events...REM was markedly a factor. Over 50 per hour in REM vs 10 to 12 in non REM. Main problem with that untreated...I never got much REM at all because once those events started happening at about 1 a minute then it wasn't long before I would wake up (may or may not remember it though) and then the sleep cycles would have to start all over again. I simply wasn't getting enough of REM or the deeper sleep for the restorative powers of sleep to work their magic because of the frequent resets.

It's a battle I am facing now but not because of therapy issues...it's because I have some pain issues causing the frequent wake ups...so I know I am not getting the normal cycles we need to feel optimal.
My OSA therapy...piece of cake and the rare nights where I don't wake up a gazillion times from pain or dog or cat or whatever...I feel really good that day.
Sleep apnea isn't the only thing that can really mess with sleep quality.

[Pugsy]

Oh...about all the questions. Keep them coming no matter how important it may or may not seem to you or anyone else.

When someone asks questions and expresses a desire to learn...I am more than happy to try to help someone that is trying to learn so they can help themselves.

What I don't like is to continually spoon feed people who make no effort to learn anything from the novels I tend to post to explain things so they can learn and hopefully actually try to make their own decisions because they understand the "why" behind things.
I love to educate so that people can think for themselves. I am happy to do the work to educate if they are willing to do the work needed to learn.
What I don't like to do is all the work by myself.
And don't worry for one minute that I feel that you don't want to do your share of the work....not anywhere remotely feeling that way with you. You want to learn and you want to use what you learn to help yourself...and I never get tired of helping that type of person.
I don't care how mundane a question might be in that situation or how many times I might have already answered it. I will do it over and over again when I can or sometimes I cheat and copy/paste stuff or provide links to prior long winded narratives to save my typing fingers some work.

Keep up the good work....someone once made a statement that struck home with me.
This cpap therapy stuff and education....it's all about progression and not perfection.

[babydinosnoreless]

In my sleep study I was not reaching Rem at all. The doctor who came in and told me to have the tritation study made the "oh you poor thing" comment to me and said she didn't know how I was still functioning.

The tritation study was a little better but not much. This is all over a year old now though. I had the studies done in Nevada but didn't get the machine until we moved here to Arizona.

[prodigyplace]

What I don't like to do is all the work by myself.

But you do it so well

[Pugsy]

How could they say you never got to REM and then report REM latency (how long it takes you to get to REM after sleep onset) if you never got to REM? That's in the interpretation section...REM latency 52 minutes.

What may have happened with your lack of REM was as soon as you hit REM you got bounced out of REM because of the apnea events.

From your report...looks like a strong positional component with the supine AHI being so high. I don't see a side sleeping comparison..maybe you didn't spend much time on your side.

We don't know about REM AHI and to be honest at this point it probably isn't a critical thing to know. If playing the odds...I am betting you are like me and your AHI would be even worse in REM. It's that common.

Definitely need auto adjusting machine IMHO...let the machine sort out the pressure needs for either supine sleeping and/or REM and not worry about it. It's not like you can do much about it anyway. We can sometimes alter sleeping position and stay on our side but that's easier said than done for any number of reasons and we have zero control over REM..
So just use a machine that you can set it and forget it and it will deal with whatever happens when it happens.
That's what I have done. Find the settings that deal with whatever and why ever...and I don't worry about it.

Focus on mask fit and sleep quality in general so that you improve your overall sleep quality (get the needed amounts of each sleep stage with minimal wake ups to mess with things). Now it is normal to have a few wake ups...like at the end of a REM cycle.
Normally we just roll over and go back to sleep so the wake time is very brief and we don't even remember it. Those brief wake ups don't really mess with the cycles all that much. It's when we wake up and stay awake for several minutes and/or maybe get up out of bed that can mess with the sleep cycles.

[babydinosnoreless]

I love to learn. I started out as an aid at my kids school when they were little and worked my way up to cohort coach at the college and substitute teacher at the high school while taking classes whenever I could. That was in Nevada and of course thanks to " Murphy " my credentials are not the ones I need to sub here in Arizona. I am considering working at a preschool or daycare so I can enjoy the little ones since my kids don't seem in any hurry to make me a grandma. .

[Pugsy]

What I don't like to do is all the work by myself.

But you do it so well

Well...you have been here long enough to know that I am a lazy sot and don't like doing any more of anything that I don't have to.
I am the first to admit it.
I will put forth the effort to do the work when I have to....but I gotta have a reason to feel like I "have to".
Someone wanting to learn is enough to spur my "have to" need.

And the cold hard fact of life is I can't teach everyone and I can't help everyone and I can't save everyone.
I also have a limited amount of energy to devote to this stuff because of my own health issues, etc.
So I choose to use that energy with people who I think I can help or teach...and I simply don't for the ones that I don't think my way of doing things can help or I feel that they don't want to learn.

I don't comment in every thread/topic...most of the time it is because other forum members have already said what I would have said and I see no need to duplicate a response...but sometimes I don't say anything because I simply get the sense that nothing I say would matter for any number of reasons. I choose to use my energy when I think I have the best chance of making a difference.
I can't save them all...hard lesson I learned when it came to animal rescue...one of the hardest lessons I have ever had to learn because I am a major big animal lover and not limited to dogs and cats and pets.
Some animals won't let you rescue them....some people won't either for any number of reasons.

[babydinosnoreless]

Will definately be working on the mask issue. I am allowed a new one from my insurance in January. Unless I can buy the pieces seperate from Amazon, I will have to wait until then to change masks. My dme wants $160+ for the one I want and after buying the back-up machine... well January really isn't that far off right ? Thats what I keep telling myself.

[Pugsy]

What masks are you looking at to try?
I might have one in the donations box that you could have for cost of postage.

[prodigyplace]

What I don't like to do is all the work by myself.

But you do it so well

Well...you have been here long enough to know that I am a lazy sot and don't like doing any more of anything that I don't have to.
I am the first to admit it.
I will put forth the effort to do the work when I have to....but I gotta have a reason to feel like I "have to".
Someone wanting to learn is enough to spur my "have to" need.

And the cold hard fact of life is I can't teach everyone and I can't help everyone and I can't save everyone.
I also have a limited amount of energy to devote to this stuff because of my own health issues, etc.
So I choose to use that energy with people who I think I can help or teach...and I simply don't for the ones that I don't think my way of doing things can help or I feel that they don't want to learn.

I don't comment in every thread/topic...most of the time it is because other forum members have already said what I would have said and I see no need to duplicate a response...but sometimes I don't say anything because I simply get the sense that nothing I say would matter for any number of reasons. I choose to use my energy when I think I have the best chance of making a difference.
I can't save them all...hard lesson I learned when it came to animal rescue...one of the hardest lessons I have ever had to learn because I am a major big animal lover and not limited to dogs and cats and pets.

We appreciate your work.

Some animals won't let you rescue them....some people won't either for any number of reasons.

We see a few of those people here too.