newbie problems

[stege]

Hello all , I'm a newbie to cpap talk and have read up on what I should and shouldn't do but honestly this is the first time I've ever posted anything so this could be "messy" .

I have been using my cpap machine for a little over a year and have had mixed results . I seem to have come to a point where I can't get a consistent AHI reading under 5 . When first diagnosed a clinician set my fixed pressure at 8 which gave me an average AHI of 2.1 .After having a falling out with this respiratory clinic i was unable to attain those AHI results even though using the same settings .I did find what seemed to be a sweet spot of 10cm and had an average AHI of 3.79 over a period of 188 days , then another period of 74 days averaging AHI of 3.46 . Recently my AHI numbers have been climbing for whatever reason and I have no idea how to get back to a reasonable number .I do have Sleepyhead but am afraid I just don't know how to read it properly . I have tried 10.5 and 11 cmh20 with poor results and am now "experimenting" with 9.5 . Any help would be appreciated .ps this is the first time I have seen any vs2 problems ..

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[jnk...]

Have you tried running that puppy in APAP mode to see what happens? Or were you given some reason (something beyond OSA) not to do that?

[stege]

Hi jnk , the last time I tried APAP mode min 10 -max 17 got an AHI of 11.05 then min 10- max 14 got AHI 14.7 that sort of scared me off . I didn't try lower minimums so maybe that would help .

[Pugsy]

How's your overall sleep quality been?
I see one break in therapy where you turned the machine off briefly so we know you were awake then.
Do you have very many other awake times where you wear the mask with the machine on?

Awake breathing irregularities can cause the machine to flag awake/arousal breathing by mistake and make the AHI look bad but awake flagged events don't count.
While these videos are targeting central/clear airway apneas....false positives aren't limited to just centrals.
http://freecpapadvice.com/sleepyhead-free-software

In CPAP mode the Flow Limitation flagging is turned off.....so we don't know if you had many FLs or not.

My suggestion...change to apap(auto) mode and lets try a modest range and just see what the machine wants to do and we can also monitor the FLs.
Like minimum of 9.0 and max of 15 and Flex of 2 or 3 (whichever feels the best).

Clear Airway/central apneas we really can't fix with pressure changes on this type of machine but OAs, hyponeas, snores and FLs should reduce. Though your snores aren't enough to worry about.

[stege]

Hi Pugsy , I believe overall I sleep well but I regularly wake up once a night to use the washroom usually between 2:00 and 4:00 am . I also change positions 3 or 4 times per night , I guess this would be considered waking but have no problem falling back to sleep .I do feel my sleep quality may suffer because I worry about waking up to a bad AHI number in the morning .

I will try the APAP tonight at 9.0 to 15 with 2 flex as you suggest .

Thanks so much .

[Okie bipap]

I do feel my sleep quality may suffer because I worry about waking up to a bad AHI number in the morning .

The number you see in the morning is from the past, and there is nothing you can do about it. We all have bad nights, and most of us have learned to accept that fact. As long as the good nights out number the bad, you are on the right track. We do the best we can to get things set to where we think they will give us a good night's sleep and hope for the best. If things are not going as well as you like, make changes based on trends (several nights data), not one night results.

[stege]

Hi all , I was going to ignore last nights chart because I had a lot of trouble sleeping and didn't think much could be gained from it but then decided it would be best to get your opinion .

I woke up at 1:25 am then for a bathroom break at 2:30 . I was pretty much awake from then until 5:30 , no problem with breathing just too much thinking going on .

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[jnk...]

pretty much awake from then until 5:30 , no problem with breathing just too much thinking going on .

Thinking is highly overrated.

But if it has to happen, be very strict with your brain about not doing it lying down on your bed in your bedroom.

Go to another room in another position (sitting or standing) to do your thinking, if at all possible. Then tell your brain that it has done its thinking for the night now and that if it starts that thinking nonsense again in the bed, you promise you will drag it right back to that other room in that other position and will make it read the warranty for the refrigerator for 20 minutes.

That kind of threat can often scare brains to the point that they realize you mean business.

[Pugsy]

You have to just ignore all the stuff that is flagged when you know you were awake.
You know you were awake but the machine doesn't have any way to know if you are awake or asleep.
It only measures air flow and our awake air flow is much more irregular than asleep breathing air flow...and the machine will flag those irregularities as some sort of apnea event.

Up until you woke up at 2:30...actually a very decent report.
If you want to see what the AHI for that part of the night is you can turn off the second session. Just go over to the left side of the report and scroll down below the statistics until you see the sleep sessions and just click on the session that starts later so that it shows red instead of green. Then the report graphs on the right will only show the first part of the night.

[stege]

So much great information and encouraging thoughts . I'm sure you've heard it before but I'm so happy to be able to share my situation with people like you who understand what's going on .

I'll continue to use APAP 9 to 15 and keep an eye on the awake portion of the graphs since as you say they can distort the total AHI number.

[stege]

Hello everyone , It's been about a week since setting apap to 5-15 and I feel things are going well . All but one night ( 5.4 ahi) have been below 5.0 so is fairly consistent and I think that's a good sign . These are screen shots from last two nights and are fairly typical , what do you think ?

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[palerider]

Hello everyone , It's been about a week since setting apap to 5-15 and I feel things are going well . All but one night ( 5.4 ahi) have been below 5.0 so is fairly consistent and I think that's a good sign . These are screen shots from last two nights and are fairly typical , what do you think ?screenshot-20200131-131138.pngscreenshot-20200131-124755.png

I think you should be aiming for under TWO, Five is a crap target.

Also, you're at 9-15, set it to 10-20

[stege]

Right 9-15 , sorry about that .

[squid13]

Like palerider suggested set your top number to 20 and then all you have to play with is the bottom number. Just because it's set to 20 doesn't mean it will go there,it will only go as high as it needs to.

[stege]

Thanks for the help I'll make adjustments .