New user greeting and some doubts

[Txaka]

Hello all,

I have just joined, and did my best to read all the FAQ and newbie info. Thanks everyone for the help!

I was diagnosed back on October with severe obstructive sleep apnea. I am 40 years old, and I suspect I've had it for all my adult life. In the test I came up with 77 events per hour.

Eight days ago I got a CPAP from the NHS, a ResMed Airsense 10 one, and my events are down to an average of 9.6 in these 7 nights. Yesterday I got 8.08, according to OSCAR. 6.73 were Hypo, 0.86 OA and 0.49 CA. On the days before, I got 6.12 and 6.67, both with 0.5 CA so I think I am improving (Before that were 3 days over 10, that is why the average of the 7 nights is 9.6).

I was kind of misled by the Resmed site, and I thought I was doing good, but I have learned that not so much. I checked, and these days my pressure was Auto, min 4 max 20. I have now increased the min to 6, I hope it helps me get better results since the vast majority of my events are Hypo.

I am very happy to be here, and thank you all beforehand for your help and effort. If anyone could provide any tips, I would be happy to try and get that AHI even lower. 77 to 8 sounds good, but it is not enough. Also, for some reason, today I feel way more tired and sleepy than the past 6 days.

[Pugsy]

Welcome.

[palerider]

Here's a 'how to'. wiki/index.php/Oscar:organize

[Txaka]

Welcome.

Where are you located?

I am in sunny Scotland, in Edinburgh!

Here's a 'how to'. wiki/index.php/Oscar:organize

Thanks! I have attached a screenshot of it.

[Pugsy]

No attachment seen.
You probably tried but with the attachment storage at capacity you missed the error message.

See this.
viewtopic/t183806/Attachment-storage-is ... MENTS.html

See what happens with your recent increase in the minimum pressure to 6 from the 4.
Might be enough to greatly reduce those hyponeas....might not but worth trying.

[Miss Emerita]

Welcome! The web site has exceeded its attachment limit, so could you put your screenshot on an image-hosting site like Imgur? I'm betting once people can see it they'll have some suggestions for you to try out.

[Txaka]

Welcome! The web site has exceeded its attachment limit, so could you put your screenshot on an image-hosting site like Imgur? I'm betting once people can see it they'll have some suggestions for you to try out.

Thanks! Yup, edited now.

No attachment seen.
You probably tried but with the attachment storage at capacity you missed the error message.

See this.
viewtopic/t183806/Attachment-storage-is ... MENTS.html

See what happens with your recent increase in the minimum pressure to 6 from the 4.
Might be enough to greatly reduce those hyponeas....might not but worth trying.

Yup! Thanks, I have edited the post with a link to imgur Will post here after tonight and see how it goes with the new min pressure.

[Pugsy]

Probably won't see much of a change in AHI with the slight increase in the minimum given that your machine is essentially setting a new minimum for you once you go to sleep and that seems to be around 12 ish and that's not enough to prevent the hyponeas.....this is seen on the report you shared.
You most likely will be needing a minimum up around 12 and that's a big jump all in one bite. You may need to work up slowly.

Are you having much (if any) nasal congestion?

If going higher with the minimum setting is difficult you might want to add in some exhale relief...EPR on your machine.
Will make exhaling easier and adding it may help reduce the flow limitations which your machine will want to kill by increasing the pressure. Using EPR sometimes helps reduce FLs and also makes it easier to breathe with the machine at the higher pressures you are apparently going to need.

The minimum setting for pressure is your most important setting. It does the bulk of the work holding the airway open and preventing the collapses which can show up flagged as OAs or hyponeas.

[Txaka]

Probably won't see much of a change in AHI with the slight increase in the minimum given that your machine is essentially setting a new minimum for you once you go to sleep and that seems to be around 12 ish and that's not enough to prevent the hyponeas.....this is seen on the report you shared.
You most likely will be needing a minimum up around 12 and that's a big jump all in one bite. You may need to work up slowly.

Are you having much (if any) nasal congestion?

If going higher with the minimum setting is difficult you might want to add in some exhale relief...EPR on your machine.
Will make exhaling easier and adding it may help reduce the flow limitations which your machine will want to kill by increasing the pressure. Using EPR sometimes helps reduce FLs and also makes it easier to breathe with the machine at the higher pressures you are apparently going to need.

The minimum setting for pressure is your most important setting. It does the bulk of the work holding the airway open and preventing the collapses which can show up flagged as OAs or hyponeas.

Thanks for the informational reply!

I am having a bit of nasal congestion at the moment. Had one of those silly colds that stays and will not go away. Not really sick any more, just some congestion and cough in the mornings.

I will check my machine for EPR and see if I can enable on it. I will start tonight at 6 and work my way up in the minimum pressure, and see how I do.

[palerider]

Welcome.

Where are you located?

I am in sunny Scotland, in Edinburgh!

Here's a 'how to'. wiki/index.php/Oscar:organize

Thanks! I have attached a screenshot of it.

Well, you're suffering from the dreaded 'incompetent provider' syndrome, where they think "it's an auto machine, it'll do all the work" and then you get that really ragged pressure curve all night long, with repeated breathing events because they didn't even bother to set any pressures for you, just leaving it at the factory defaults, which are good for almost nobody.

If I were you, I'd set the minimum pressure to 14, and see if we can keep your airway open more

[palerider]

I will check my machine for EPR and see if I can enable on it. I will start tonight at 6 and work my way up in the minimum pressure, and see how I do.

You're already hovering around 14 all night. setting the machine lower than that just causes more breathing problems.

If you have trouble while awake with that pressure (and remember, 14 is just 14 centimeters of water, so like sticking a straw 14 centimeters into a glass and blowing through it, that's breathing out against 14cm of pressure.) then turn on the ramp, and let the machine build up to the pressure.

[Julie]

Also, side sleeping may help to lower the hypopneas a lot (it usually does) and if you need tips to not flip overnight we can help there too.

[Miss Emerita]

Next time you post a chart, I’d love to see your flow limitation graph. The numbers in the side panel suggest FLs are a potential problem for you.

Do you have a stuffy nose?

Raising your minimum, as others have suggested, is a good change to make. I think you might also benefit from EPR, which can sometimes help with hypopneas and FLs.

[Txaka]

If I were you, I'd set the minimum pressure to 14, and see if we can keep your airway open more

Well, I did just that, and I got much better numbers I think. And I feel much better, too.



The weird CA at around 2:00 is because I woke up and was turning around for about 40 minutes or so before I was sleeping again, I think. I did not activate EPR this night, just increased the minimum pressure to 14 (One thing at a time). I think that, all in all, much better than before, so I have to thank this forum for this improvement!

I think that the graph says that, apart from waking up at 2:00, my AHI is around 2.5 or so.

Also, side sleeping may help to lower the hypopneas a lot (it usually does) and if you need tips to not flip overnight we can help there too.

Thanks! I have no problem with that, I think. I always wake up lying on one side.

Next time you post a chart, I’d love to see your flow limitation graph. The numbers in the side panel suggest FLs are a potential problem for you.

Do you have a stuffy nose?

Raising your minimum, as others have suggested, is a good change to make. I think you might also benefit from EPR, which can sometimes help with hypopneas and FLs.

Thanks! Flow Limitation added for more info.

I do have a stuffy nose, getting better as I get out of this annoying long cold.

I will also activate EPR tonight to see how it goes.

Overall, what do you think of tonight's graph?

[Pugsy]

Overall, what do you think of tonight's graph?

I am more impressed with..

I feel much better,

Best numbers in the world don't mean much if we feel like crap.

What setting on your humidifier are you using?
Are you battling congestion during the day as well as at night? Is night worse? Lets see if adding in some EPR helps..or not...reduce the activity on the FL graph.