Difficulty getting started

[Atom]

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I know this was only an hour nap, but it is I think it is illustrative of some changes I've made, and I'm hoping for continued improvement. First, I tightened up the straps on my face mask, and I added an improvised chin strap which is just some 1" wide elastic that my wife sewed into a loop. I think this is helping control jaw movement, and I didn't experience any chipmunk cheeks. I also slept soundly for the entire hour and only woke up because I had an alarm set. I still have events, but they are controlled, and my O2 never dropped very much below 90.

The CA events are somewhat puzzling.

I feel like I'm going to get in some solid nighttime rest with this thing on fairly soon. It just takes a lot of adjustments and learning.

Thanks for all the helpful guidance.

[DreamDiver]

screenshot-20200423-164753.png

I know this was only an hour nap, but it is I think it is illustrative of some changes I've made, and I'm hoping for continued improvement. First, I tightened up the straps on my face mask, and I added an improvised chin strap which is just some 1" wide elastic that my wife sewed into a loop. I think this is helping control jaw movement, and I didn't experience any chipmunk cheeks. I also slept soundly for the entire hour and only woke up because I had an alarm set. I still have events, but they are controlled, and my O2 never dropped very much below 90.

The CA events are somewhat puzzling.

I feel like I'm going to get in some solid nighttime rest with this thing on fairly soon. It just takes a lot of adjustments and learning.

Thanks for all the helpful guidance.

Wow! Looks great. Don't worry about the CA, you only had one. I have almost nothing but CA's. Your large leak as zilch (that's good.) Your flow rate looks good. I think you may have actually napped. Flow limitation is managed. Notice how the pressure goes up in response to things like flow limitation, obstructive apnea and hypopnea but not central apneas. This is by design. Your pressure didn't skud the top of your pressure limit, but resolved nicely in the alpine slope fashion...

It looks like you're getting the hang of this. For most of the duration, look how regular your breathing pattern is.

Don't worry too much about AHI. Don't worry about CA's. As you get used to the machine, you'll find the settings that work for you and that will come down naturally.

Looking great!

[Atom]

Lately, I've been having this sensation of phlegm in the back of my throat, which is quite uncomfortable and hinders getting to sleep. I don't notice this during the day when I take a nap with it; just at night. Is this a thing, or just me?

[DreamDiver]

Lately, I've been having this sensation of phlegm in the back of my throat, which is quite uncomfortable and hinders getting to sleep. I don't notice this during the day when I take a nap with it; just at night. Is this a thing, or just me?

You probably need to talk with a GE doc if it's persistent. In the meantime you could try refraining from eating for three hours before sleeping. From my own experience, too much dairy causes phlegm like that. There may be some food that does the same for you.

[Atom]

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This is as long as I ever been able to sleep with the CPAP. This is no improvement over the results I get with no CPAP (based on my recording pulse-oximeter). I'm not sure what to try next.

I had hoped that the CPAP was going to allow me to sleep on my back, but this does not appear to be working.

[Pugsy]

You for sure need more maximum pressure and probably more minimum as well.

[Atom]

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I think this is progress.
1. Raised min pressure
2. Wore homemade chinstrap (I don't think it works without this)

[DreamDiver]

screenshot-20200430-040434.png

I think this is progress.
1. Raised min pressure
2. Wore homemade chinstrap (I don't think it works without this)

Looks like progress!

[Dog Slobber]

I think this is progress.
1. Raised min pressure
2. Wore homemade chinstrap (I don't think it works without this)

Darn right it's progress.

It also illustrates a consequence of increasing the minimum pressure that many don't accept. Increasing your minimum pressure, often reduces the maximum pressure your machine needs to go.

Leave it at minimum 14, for a bit. Good Job!

[Pugsy]

It also illustrates a consequence of increasing the minimum pressure that many don't accept. Increasing your minimum pressure, often reduces the maximum pressure your machine needs to go.

It does indeed and why I don't always jump on the much higher minimum bandwagon unless I just have to.
Some time ago I helped a woman who was consistently seen pretty much pressures around 17 with overall average around 14 all night with a minimum of 5.
We upped her minimum to 9 and her max never gets over 13 now. Most of the time she rarely even sees 12.

[Atom]

I gather that the variation of pressure as well as the amount of pressure is important?

[Pugsy]

I gather that the variation of pressure as well as the amount of pressure is important?

Well....maybe in a backdoor fashion. I personally think that the large variations reflect the coming and going of the apnea events and those apnea events are the problem we want to avoid.
When the pressure line is more stable with less large variations it means the airway itself is more stable and not trying to collapse as often or as much.
The whole idea of auto adjusting pressures is to prevent the airway from collapse in the first place and not try to be continually trying to fix the problem when the machine reduces the pressure down to the level where the airway tends to collapse.
We want a good stable baseline pressure that does the bulk of the work holding the airway open and can get to (increase) for the times we need a bit more pressure for whatever reason.
People often complain saying that the variations in pressure are disturbing their sleep...I tend to think that the sleep disruptions are more likely from the apnea events themselves that occur when we see wide variations in pressure usually when the minimum is a lower number.

[DreamDiver]

I gather that the variation of pressure as well as the amount of pressure is important?

For many of us, pressure needs can change during the night. Exposure to allergens, sleeping position, flow limitations, what or when we ate or drank last... Any number of influences can affect your AHI. An auto machine provides the flexibility to adapt to those influences in a way that straight CPAP cannot, within the parameters set on your machine.

What's nice about auto's is that your pressure will resolve gracefully to the lowest setting necessary if no new events trigger a pressure rise. For instance, if your AHI is lower when you're on your side, but you've turned onto your back, the pressure will likely increase to where it's better for when you're on your back. When you turn back to your side, events resolve, so the pressure reduces to your preferred lower pressure. It's more organic and I suspect it just feels better for most people than straight CPAP. EDIT: That said, some people really do seem to perform better with straight CPAP -- no pressure changes at all. We're each of us unique.

Chris

[Miss Emerita]

Just wanted to note that your flow limitations were considerably reduced with the higher minimum.

[Atom]

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This looks like progress! Nearly 7 hrs- that's a very long sleep for me under any conditions. I think the chinstrap has been very helpful for keeping my mouth closed. My lowest SpO2 was 86%.