Need Help understanding results

[ebuck11]

n

[tan]

My third night last night. Best so far, however i still wake every two hours all night. I notice on my sleep tracker that i'm getting hardly any REM. Do you think that me waking every two hours is linked to the sleep cycles? Apart from that i feel mostly good. By night time i feel old fashioned tired, not 'i want to scream angry' tired...

Usually sleep cycles are about 90mins. But how do you know that you wake up every two hours? If you check your clock, stop doing that. You should remove all light emitting electronics from your bedroom. Alternatively, if you wish a sleep record, then upon awakening you can stop and then start your machine. Those will be recorded as different sessions.

Also you should install this software:
https://www.sleepfiles.com/OSCAR/

and share some pictures from OSCAR with us. Explained here (a link to be provided)

It will be easier for us to understand what your issues might be.

[ebuck11]

n

[slowriter]

AirCurve 10 machines don't seem to flag RERAs at all.

Early models of the AirSense 10 AutoSet didn't either but I think that all AutoSet models released now flag RERAs....both for Her models and regular models.

Just for the record, both of these are true, but I'd rather have a machine (the VAuto) that better treats the RERAs, than one that Resmed claims to report RERAs but, in my experience at least, doesn't do so very well.

When I had a "for her" model trial, it never confirmed any RERAs; the only thing that did was another sleep study, which confirmed I needed a bilevel.

In short, I don't think RERA-reporting should be a feature that people worry about.

[slowriter]

Here are some screen shots of my data. This was a relatively good night for sleeping, but i felt pretty tired all day.

Can you not format them as outlined here (not sure if there's a better link)?

[Pugsy]

AirCurve 10 machines don't seem to flag RERAs at all.

Early models of the AirSense 10 AutoSet didn't either but I think that all AutoSet models released now flag RERAs....both for Her models and regular models.

Just for the record, both of these are true, but I'd rather have a machine (the VAuto) that better treats the RERAs, than one that Resmed claims to report RERAs but, in my experience at least, doesn't do so very well.

When I had a "for her" model trial, it never confirmed any RERAs; the only thing that did was another sleep study, which confirmed I needed a bilevel.

In short, I don't think RERA-reporting should be a feature that people worry about.

And I pretty much totally agree with you.
I have always taken any RERA reporting by a machine with a grain of salt since to really know for sure if a RERA happened we need to know sleep status and of course these machines can't do that.
At best what they tell us is that our respiration pattern "looks like" the respiration pattern of a RERA but it's sort of an educated guess I suppose.
What we can assume though is if we see a lot of RERAs then the sleep quality was in the toilet but the absence of RERA flagging doesn't necessarily mean much. The sleep quality could still be in the toilet for any number of reasons and that includes airway related stuff that just didn't "look like" it was airway related.

[ebuck11]

n

[slowriter]

How about trying a min pressure of 7, which is the minimum that would give you the full benefit of the EPR?

You may need more than that, but we can see how you do with this step.

[Pugsy]

If you aren't hitting max 7 cm now and you never do then there isn't much chance of needing more than 7 cm minimum.

Are you comfortable with the 5 cm starting pressure?

I see no need to change anything at this time unless you are feeling air starved at the low pressures.

The bulk of your AHI is CA/Centrals and they won't respond to more pressure.

You are very new to cpap therapy. I would concentrate on just adjusting to sleeping with the mask and machine on....and give yourself some time.

Those people that get an overnight miracle....actually very rare. I sure didn't have one.

[ebuck11]

n

[Pugsy]

It's normal to have a few central apneas here and there....so there is no need to "fix" them unless they are present in large numbers or causing problems.....you are a long way from having enough centrals for anyone to worry about.

It's normal to have sleep onset centrals for one thing....during the transition from wake to asleep.
It's normal to wake after each REM cycle briefly and while most of the time we don't remember it...we still wake up for a short period of time. Any time you wake up and go back to sleep you stand the chance of having a sleep onset or sleep stage transition central apnea and those are normal and to be expected and we just ignore them.

Now if you start seeing 5 central apneas per HOUR, every hour, every night....then we start worrying. You are a long, long way from that point.

[ebuck11]

n

[palerider]

Here are some screen shots of my data. This was a relatively good night for sleeping, but i felt pretty tired all day.

http://cpaptalk.com/wiki/index.php/Oscar:organize

Just one screenshot per night.

[slowriter]

If you aren't hitting max 7 cm now and you never do then there isn't much chance of needing more than 7 cm minimum.

Here's why I suggested it:

• OP has been diagnosed with UARS, where RERAs are the primary problem
• the machines aren't that good at detecting and responding to RERAs, so the likelihood is reasonably high they're getting them now
• pressure differential (EPR or PS) tends to help resolve RERAs
• they won't get the full 3cm of EPR unless they start at 7
• 7 is a pretty low pressure anyway

[Pugsy]

If you aren't hitting max 7 cm now and you never do then there isn't much chance of needing more than 7 cm minimum.

Here's why I suggested it:

• OP has been diagnosed with UARS, where RERAs are the primary problem
• the machines aren't that good at detecting and responding to RERAs, so the likelihood is reasonably high they're getting them now
• pressure differential (EPR or PS) tends to help resolve RERAs
• they won't get the full 3cm of EPR unless they start at 7
• 7 is a pretty low pressure anyway

And OP has been on cpap a grand total of 3 nights now...maybe 4.
Way too soon to be talking changing pressures before we know if what she is using now is doing a good job or not.

Which is why I said there was no real reason to go changing things right now.
Her FL graph....is better than mine is. I can tell that without even seeing the FL graph.
I see nothing on the report to suggest increasing the pressure at this time.

I would never suggest someone go changing things unless there is a proven need to go changing things ...
Let her get used to cpap first and see how things go...might get lucky and all they need to resolve any UARS issues is what they are using now.
I never suggest changing pressures after only 3 or 4 nights of using the machine unless there is an urgent need....and I don't see it here and I am not hearing it from her at this time.

I didn't say never change things....I said wait and see how things work out with these settings. Get used to using the mask and machine and sleeping decently with it and then see how they feel.