Newb needs help. Exhaling issues

[Dog Slobber]

The Flagged apneas on the SleepHQ graphs have been shifted forward exactly one hour on the Flow Rate.

This is a bug in SleepHQ, or data corruption in the communication from the CPAP to Sleep HQ.

We can safely presume the SleepHQ rendering is incorrect compared to OSCAR because:

• The location of the events on SleepHQ doesn't make sense, it is within the a time frame the machine is off
• In the AHI trace on SleepHQ the AHI timeframe is correct. This suggests a bug in SleepHQ and not data transfer corruption.

[Pugsy]

Thank you DS....that makes sense.

Too bad because I suspect the cluster of flagged crap is probably SWJ stuff but I can't prove it unless I had OSCAR zoomed in reports to see.

[Brad S]

Holy crap!
How can you have all those apneas in the middle when you don’t even have the mask on according to the chart? I don’t understand. Or am I reading it wrong?
I hope someone here can help you!

This is an Oscar shot of that specific 13 minute time in the middle you are talking about. The time on the Oscar chart is correct. Every night as I put the mask on, I take a screen shot of my phone. It captures the time and I can then check that with Oscar in the morning to make sure the times are the same. I adjusted the time on Oscar a few weeks ago and it has been right ever sense.
I honestly don't remember what was going on at that time. I do know that I frequently partially wake up either feeling like it is hard to breathe- in and/or out. The air in my mask is too warm or just fidgeting around.

In answer to your question if my mask was on, I do believe it was. I think the chart is correct of the middle time.
Last nights time line-
I put my mask on at 10:13 and started to doze off and something agitated me and I took it off at 10:26
I again put the mask on at 10:28 to 1:11AM
I took of my mask at 1:11 and put it back on at 1:33 to 1:46 (the time of the chart below)
I put it back on at 2:03 until I woke up at 6:21.

I think that during the gaps that you are asking about, my mask was off....

[Brad S]

Thank you DS....that makes sense.
Too bad because I suspect the cluster of flagged crap is probably SWJ stuff but I can't prove it unless I had OSCAR zoomed in reports to see.

I know how to zoom in on specific time frames, but how on earth could I possibly show all of these areas zoomed in without it being dozens and dozens of pages?
I don't know how to, but I would be more than happy to share any info or access to Oscar
I can send my SleepHQ login if it would help make this easier or figure this out.

Thank you to all of you for your interest in this.

[Pugsy]

I know how to zoom in on specific time frames, but how on earth could I possibly show all of these areas zoomed in without it being dozens and dozens of pages?

Well there is a way to share your OSCAR data/SD card contents without involving a gazillion screenshots.
One of the reasons I like sleephq....I don't have to use OSCAR to scroll through a night.
Problem is that it involves my getting a copy of your SD card and finding the time to install it in my OSCAR and then go searching and I have had a family emergency going on right now and I simply don't have the time.
Plus I pretty much expect to see nothing but flow rate riddled with arousals and awake flagged stuff which is really nothing any different from what we can see now using sleephq apart from the time glitches.

It won't tell us the "WHY" behind the crappy sleep. It will just reaffirm what we already know and that is the fact that your sleep quality is a lot less than desired. Between leaks, problems exhaling with pressure and simply a lot of wake ups...we can see the symptoms but we can't see the actual cause.

You already sort of zoomed in on the time frame from 1:33 to approx 1:45 and it's zoomed in enough that we can see nothing but SWJ or arousal/awake breathing flagged events. You weren't asleep.
Now why you weren't asleep....we don't know the answer to that question.

I suspect that the majority of any night with any flagged events you will find that the flagged events are a symptom of the problem of crappy sleep but not necessarily the cause of the crappy sleep.

[ozij]

I suspect that the majority of any night with any flagged events you will find that the flagged events are a symptom of the problem of crappy sleep but not necessarily the cause of the crappy sleep.

In this specific example, we can also see the machine is misinterpreting your irregular, wake breathing and driving the pressure up because it thinks you're having obstructive events. No wonder you feel you have trouble exhaling.

I've read the AS11 has "Autoramp" which identifies when you're asleep, and will only start raising pressure at that point. The first thing I'd do is to setup the machine for Autoramp - that way it won't be driving you crazy by raising pressure when you're awake.

[Brad S]

In this specific example, we can also see the machine is misinterpreting your irregular, wake breathing and driving the pressure up because it thinks you're having obstructive events. No wonder you feel you have trouble exhaling.
I've read the AS11 has "Autoramp" which identifies when you're asleep, and will only start raising pressure at that point.

The first thing I'd do is to setup the machine for Autoramp - that way it won't be driving you crazy by raising pressure when you're awake.

@ozij- THANK YOU THANK YOU THANK YOU for the suggestion.
I tried auto ramp when I first started therapy and I was given advice to not use it. I believe that advise was correct and well justified at that time based on the information I was able to supply.
I think in my specific case, at this time, and also this is based on last night only, autoramp worked! I am thinking you are absolutely correct, the constant steady pressure of the autoramp let me go to sleep and then the machine was able to take over.

At this point I am so desperate for sleep I would try just about anything friends here suggest.
I set the autoramp to auto and not a specific time. 5, 10, 15 minutes etc. I first set it for a starting pressure of 7.

I am posting a link to SleepHQ below because I am not home today and don't have access to my Oscar chart right now. The time on the sleephq chart is slow by about 1:45 but I don't think the exact time matters for this.

The first time the ramp was set to start at 7. I could not go to sleep I felt I was just not getting enough air. I took off the mask and reset the ramp to start at 8 and went back to bed. I think I should have started it at 9 which is my minimum pressure, but I believe it worked! I fell asleep and I can see in the SleepHQ where it changed. I put the mask on at 10:14 (Actually 11:59) and at 10:21 my breathing changed and at 10:24 the pressure increased to 9. I feel I slept really well. Not long enough but I feel better today. I had to get up early to go to work.
I also got a travel neck pillow and also two small travel pillows yesterday which I will post about in more detail later.

I wanted to come on here and say I can't thank you and everyone else here enough for taking the time to read my posts and make suggestions. I appreciate every single one of you.

Tonight I am going to set the autoramp to 9 and I am very hopeful that this will be the change I am looking for.

https://sleephq.com/public/9bd93a7b-675 ... d5f0ad6633

[ozij]

[lynninnj]

In this specific example, we can also see the machine is misinterpreting your irregular, wake breathing and driving the pressure up because it thinks you're having obstructive events. No wonder you feel you have trouble exhaling.
I've read the AS11 has "Autoramp" which identifies when you're asleep, and will only start raising pressure at that point.

The first thing I'd do is to setup the machine for Autoramp - that way it won't be driving you crazy by raising pressure when you're awake.

@ozij- THANK YOU THANK YOU THANK YOU for the suggestion.
I tried auto ramp when I first started therapy and I was given advice to not use it. I believe that advise was correct and well justified at that time based on the information I was able to supply.
I think in my specific case, at this time, and also this is based on last night only, autoramp worked! I am thinking you are absolutely correct, the constant steady pressure of the autoramp let me go to sleep and then the machine was able to take over.

At this point I am so desperate for sleep I would try just about anything friends here suggest.
I set the autoramp to auto and not a specific time. 5, 10, 15 minutes etc. I first set it for a starting pressure of 7.

I am posting a link to SleepHQ below because I am not home today and don't have access to my Oscar chart right now. The time on the sleephq chart is slow by about 1:45 but I don't think the exact time matters for this.

The first time the ramp was set to start at 7. I could not go to sleep I felt I was just not getting enough air. I took off the mask and reset the ramp to start at 8 and went back to bed. I think I should have started it at 9 which is my minimum pressure, but I believe it worked! I fell asleep and I can see in the SleepHQ where it changed. I put the mask on at 10:14 (Actually 11:59) and at 10:21 my breathing changed and at 10:24 the pressure increased to 9. I feel I slept really well. Not long enough but I feel better today. I had to get up early to go to work.
I also got a travel neck pillow and also two small travel pillows yesterday which I will post about in more detail later.

I wanted to come on here and say I can't thank you and everyone else here enough for taking the time to read my posts and make suggestions. I appreciate every single one of you.

Tonight I am going to set the autoramp to 9 and I am very hopeful that this will be the change I am looking for.

https://sleephq.com/public/9bd93a7b-675 ... d5f0ad6633

wow!
yay!
Go Brad!
Go Brad!
It’s your birthday!

oh wait nevermind

I hope this is what you’re waiting for. Hopefully you can keep plugging away on those leaks and get it figured out.

[Dog Slobber]

I tried auto ramp when I first started therapy and I was given advice to not use it.

Auto-Ramp has a (incorrect) bad reputation because of timed ramp. Many people attribute some of the negative properties of timed-ramp and apply them to auto-ramp.

Auto-ramp is the one feature I miss from my AutoSet, that's not available on the AirCure.

There are also too many people running around trying to optimize their (and other's) therapy before they've adjusted to sleeping with it yet.

Tonight I am going to set the autoramp to 9 and I am very hopeful that this will be the change I am looking for.

There is no point in setting autoramp to 9 if your minimum pressure is 9. Are you alo intending to increase your minimum pressure?

BTW, looking at your trace, you could use an increase in minimum pressure, but as I alluded to earlier you priority is to get accustomed to the machine and sleep better.

[Brad S]

Auto-Ramp has a (incorrect) bad reputation because of timed ramp. Many people attribute some of the negative properties of timed-ramp and apply them to auto-ramp.

So, am I correct in thinking that auto-ramp is the right way to go for me? It is my understanding that the machine will turn off the ramp when it detects my sleep and not based on a manually preset time?

There are also too many people running around trying to optimize their (and other's) therapy before they've adjusted to sleeping with it yet.

At this point in my therapy, I am grateful for any and all advise and I do completely understand this is a lifelong marathon. I think I am very close to the point where I will be able to settle in now and adjust to let the therapy do it's thing. I am so relieved that I am able to exhale and not wake up in pure panic, feeling like I can't breathe. I know that is in my head, but it is my head and I gots problems in there! LOL
I hope to be coming up to the point that it will only be small tweaks here and there and not grasping for anything that might work to get me through the night.

There is no point in setting autoramp to 9 if your minimum pressure is 9. Are you alo intending to increase your minimum pressure?

I was thinking about this all morning. I like that 8, or less than 9 was the auto-ramp start because I think I can see where my sleep started and the machine took over. Is it reasonable to set the ramp starting pressure to 8.4 (less than 9) so I can identify where the machine takes over when it automatically goes to 9 to begin the therapy?

BTW, looking at your trace, you could use an increase in minimum pressure, but as I alluded to earlier you priority is to get accustomed to the machine and sleep better.

I am sorry and I am not questioning you, only trying to understand. Can you explain trace to me? Is it the line on the pressure graph that shows the actual machine pressure through time? It looks like I spent a lot of time last night in the 9 to 10 range. Is there a reason I would want to raise the minimum pressure?

Tonight is night 42 in my therapy journey. The first 38 have been a living hell. I am determined to get through this no matter how hard it is.
I thank all of you for being here and putting up with my constant whining and questions. I hope I can come back tomorrow with the same positive results.

[Brad S]

wow!
yay!
Go Brad!
Go Brad!
It’s your birthday!

oh wait nevermind

I hope this is what you’re waiting for. Hopefully you can keep plugging away on those leaks and get it figured out.

Thanks Lynn! You are a very big part of my success!

[lynninnj]

wow!
yay!
Go Brad!
Go Brad!
It’s your birthday!

oh wait nevermind

I hope this is what you’re waiting for. Hopefully you can keep plugging away on those leaks and get it figured out.

Thanks Lynn! You are a very big part of my success!

LOL stop.... I'm no Robin.

[Pugsy]

So, am I correct in thinking that auto-ramp is the right way to go for me? It is my understanding that the machine will turn off the ramp when it detects my sleep and not based on a manually preset time?

The machine will suspend auto ramp either when it thinks you are asleep or after 30 minutes...whichever comes first.

Is it reasonable to set the ramp starting pressure to 8.4 (less than 9) so I can identify where the machine takes over when it automatically goes to 9 to begin the therapy?

This is most certainly reasonable if you wish to see when the machine thinks you are asleep and it kicks in to your set minimum pressure. It will be fairly obvious. Setting the auto ramp to 9 and your minimum to 9 wouldn't allow you to see the change because essentially there wouldn't be an easily identifiable change unless the machine decided it needed to immediately go beyond the 9 cm minimum.

As for increasing the minimum above 9 cm...I don't think there is an urgent need at this point and for now we have one night of data where you can say you probably slept and I don't like to go making changes based on one night anyway.
If you did consider doing this...maybe 10 cm minimum would stabilize the pressure a little more but you never even hit 12 cm last night. A 9 to 12 pressure line isn't an awful lot of movement and it's not impossible that the times where you are getting close to 12 is maybe REM stage sleep related anyway. In REM it is common for OSA to worsen and/or need substantially higher pressures so I don't know that increasing the minimum at this point is all that critical.

At some point you could try more minimum....like maybe 10 cm minimum just to see what happens but there isn't any urgent need that I can see at this point based on last night's report. I would want to see more night's data to be sure though.

[Brad S]

LOL stop.... I'm no Robin.

Batgirl?