1st Day Results

[Cherokee180c]

Last night was my first night on my Dreamstation CPAP machine that went a bit better than I thought. Had some problem falling asleep and then woke up at 12:00am, 3:00am and then at 5:00am so not a perfect night of sleep, however I had a 100% mask fit rating and 7.26 hours with the mask on. I think I woke up more than that, but those were the major wakeups where i looked at my clock. My original sleep study said I had an AHI of 16 but reached a low of 80% oxygen saturation during the study.

I had an AHI of 9.1 last night with TCAA = 26, TOA= 16 and TH= 26. My doctor set up the pressure setting wide open at 4 min and 20 max. I also had the ramp on with a 45 min ramp time. What are my next steps to try to get the AHI down? Should I start by downloading OSCAR and posting details? I was surprised to see total clear airway apneas at 26, but is this more likely due to light sleeping with several wake ups during the night? I read somewhere on the forum that you should not be concerned with TCAA events until over 5/hour or 35 in this case? Looking for a simple point in the right direction for next steps.

Oh yea, last data was min pressure = 4, max = 20 (i think when i removed mask to go to bathroom) and 90% pressure was 9.1

[Miss Emerita]

Congratulations on starting your apnea therapy -- you're off to a great start! It would be great if you downloaded Oscar and then posted a daily chart. That would enable the experts here to help you fine-tune your settings to minimize events and maximize comfort and good sleep.

[palerider]

I had an AHI of 9.1 last night

ugh. bad.

with TCAA = 26, TOA= 16 and TH= 26.

Maybe it's just to early, but I have NO idea what that is.

My doctor set up the pressure setting wide open at 4 min and 20 max.

stupid stupid stupid.

I also had the ramp on with a 45 min ramp time.

possibly even stupider.

What are my next steps to try to get the AHI down? Should I start by downloading OSCAR and posting details?

DO IT! DO IT NOW! are you done yet? are you done yet? are you done yet?
How about now?

I read somewhere on the forum that you should not be concerned with TCAA events until over 5/hour or 35 in this case?

Centrals (what Respironics calls 'clear airway', aren't stressful, but too many of them will lower your O2 saturation.

Looking for a simple point int the right direction for next steps.

Raise the min pressure. try 8, (wild guess, need oscar pics, wiki/index.php/Sleepyhead:Organize

90% pressure was 9.1

90% pressure is just a number, it has little use.

[Pugsy]

Cherokee180c wrote: ↑
Tue Oct 22, 2019 10:02 am
with TCAA = 26, TOA= 16 and TH= 26.

Maybe it's just to early, but I have NO idea what that is.

From DreamMapper numbers...T equals total over the entire night
TCAA....total clear airway apneas
TOA...total obstructive apneas
TH...total hyponeas
Obviously total hours has to be known for it to mean much

[zonker]

Last night was my first night on my Dreamstation CPAP machine that went a bit better than I thought.
<snip>
Should I start by downloading OSCAR and posting details?

welcome to the zoo! you've come to the right place with the right attitude. you'll go far, i'm sure.

when you do share that oscar data, please put it in this thread. keeping your information in one convenient place will help the experts keep track of you.

good luck!

[Cherokee180c]

Thanks for all the great encouragement and assistance. Here is the OSCAR file. Let me know if I screwed anything up or you need something I didn't include.

[palerider]

Cherokee180c wrote: ↑
Tue Oct 22, 2019 10:02 am
with TCAA = 26, TOA= 16 and TH= 26.

Maybe it's just to early, but I have NO idea what that is.

From DreamMapper numbers...T equals total over the entire night
TCAA....total clear airway apneas
TOA...total obstructive apneas
TH...total hyponeas
Obviously total hours has to be known for it to mean much

Oy.. yeah, what useless numbers.

[Cherokee180c]

Seeing some patterns here. It looks like the CPAP was not doing much at all below 7-9 in H20 of pressure which appears to be most of the 10:30 to midnight data. Then I had a very nice period of sleep until I woke up at 02:30. I also took my mask off and went to the bathroom without turning the machine off. I suspect I should have shut the machine off and then just restarted again when I got back? I lowered the ramp time at some point to 20 minutes and restarted in ramp mode. It looks like the pressure didn't get back up into the effective range until 03:00 where I still had very crappy sleep until about 04:10 when it looks like I fell back asleep and had a nice bit of sleep until around 04:45. At this point I don't think I have any ability to raise the minimum pressure, but I am thinking I may want to lower the ramp time even more? Also that I should not hit ramp if I get up or try to restart?

[Pugsy]

When your settings are minimum pressure of 4...makes zero sense to even use ramp.
The idea of the ramp is to work up to the minimum pressure setting and the machine can't go below 4 cm...so the ramp has no where to go up to unless you set your minimum pressure higher than 4 cm.

Make sense? As it is right now the ramp isn't doing anything.

Now if you were to increase that minimum pressure to up around 7 cm (where it seems to be at least in that area when you are asleep) then you might actually feel the benefit of the lower starting point of ramp should you have problems just starting out with 7 cm.

It's really difficult to evaluate the first night's results when there have been a lot of wake ups involved.
There's a good chance there's some awake irregular breathing going on that muddies up the results. The machine doesn't ever know if you are asleep or not. It only measures air flow and our awake breathing is very irregular compared to asleep breathing but the machine just does its thing based on what it senses. Sometimes it does its thing wrong because of the awake breathing muddying up the results.

[Cherokee180c]

OK, so if I am hearing you correctly, turn the ramp off as it is really not doing anything right now. I thought for some reason the machine was going to find it's recommended pressure and the ramp was to go from 4 to that recommended pressure. Also I should have pointed out that my dentist had me start wearing a mouth guard as I was grinding my teeth, probably due to the apnea. I slept with the mouthguard in last night as well as the mask. Thinking I should try ditching the mouthguard tonight and hopefully I will get more actual sleep time to evaluate. It looks pretty clear to me though that in a day or so I should call the doctor to have them prescribe the minimum pressure up to 7. My doctor is actually a nurse practictioner who is good, but I am sure not a sleep specialist. They want me to wait a month for a followup, but that is BS if the machine is not set right.

[Pugsy]

Ramp is only for the going to the minimum setting...not necessarily the therapeutic pressure needed.
Now what happens with the Respironics machines during ramp time is IF (big if) the machine senses apnea events happening it will suspend ramp and proceed to the pressure it thinks you need to be at.
So it's not that critical of an issue and is likely why you see the machine increase the pressure fairly early in the night.

I just wanted you to understand the why and what behind using the ramp.

If you ditch the mouth guard tonight...just leave the minimum at 4 and see what happens tonight.
If you find you still go up to 7 ish and stay there or more the bulk of the night then I wouldn't wait for 30 days...I would change it myself.
It's easy to do. At that time you might want or need to have a bit of ramp lower working up to the 7 minimum. All depends on how comfortable you are with starting out exhaling against 7 cm. Ramp is solely for your comfort. Gotta be comfortable to fall asleep and being asleep is the name of the game. Nothing much matters if we aren't asleep.

[Miss Emerita]

Hey, you got a chart up there in record time! A few little tweaks for the next one: try turning off the pie chart so that more of the information on the left will show, and make sure you've zoomed all the way out before you take the screenshot. Sometimes people prefer to review a chart with the VS2 flags turned off; they find that it's unclear what those flags are really for and think that they clutter up the picture of the rest of the events.

You're in good hands with the experts here, so keep the questions coming!

[Pugsy]

To turn off the pie chart.......Preferences/Appearance tab.....remove the check mark for show pie chart.
No need to redo this image though. We can see enough of the statistics for this one.

[Cherokee180c]

2 day was better. I felt like I slept all night and did not get up. A bit less sleep though. Feel really good this morning. I switched to the medium full face mask as I felt that might fit me better. Felt better. Thanks for the advice on the Oscar Pics. Machine seemed to run at a lower pressure last night since I did not sleep with my dental mouthguard.

screenshot-20191023-060412.png (231.87 KiB) Viewed 1050 times

[katebrownell86]

I am using the CPAP mask for more than one month. I think you should consult with your doctor and discuss this report.