Last Night Was First Night

[vandownbytheriver]

To be honest, today I'm feeling super stressed about it. I do struggle with anxiety so lack of sleep probably isn't helping. I'm just so paranoid that I'm doing something wrong, making the incorrect adjustments and somehow making things worse.

Anything, literally *anything*, is better than letting the machine take you for a 20cm ride for your first experiences. And 4cm is baby farts, you need at least 7cm to get any good out of it.

My advice is to change your pressure settings to 8cm CPAP and 20min ramp and start slow. My first setting was 10cm, but I am Severe (104 AHI) so going to depend on your situation. Just get some CPAP under your belt and worry about APAP later. Ramp is one of the first things to go once you can handle the pressure. Depending on your results bring your pressure up slowly.

You'll want to monitor your results... best is Oscar (for home use) and SleepHQ (for sharing links)... both are free, Oscar is an application, SHQ is a website 'in the cloud'.

www.sleepfiles.com/oscar
www.sleephq.com

Here's a recent night of mine... note how you can zoom in on breaths and events!

https://sleephq.com/public/700dd744-1fb ... 1d1143571a

Also, if you fill out your machine and mask in your profile we'll know what they are... see mine below. I prefer to see text instead of pictures myself.

[Iancdub88]

To be honest, today I'm feeling super stressed about it. I do struggle with anxiety so lack of sleep probably isn't helping. I'm just so paranoid that I'm doing something wrong, making the incorrect adjustments and somehow making things worse.

Anything, literally *anything*, is better than letting the machine take you for a 20cm ride for your first experiences. And 4cm is baby farts, you need at least 7cm to get any good out of it.

My advice is to change your pressure settings to 8cm CPAP and 20min ramp and start slow. My first setting was 10cm, but I am Severe (104 AHI) so going to depend on your situation. Just get some CPAP under your belt and worry about APAP later. Ramp is one of the first things to go once you can handle the pressure. Depending on your results bring your pressure up slowly.

You'll want to monitor your results... best is Oscar (for home use) and SleepHQ (for sharing links)... both are free, Oscar is an application, SHQ is a website 'in the cloud'.

www.sleepfiles.com/oscar
www.sleephq.com

Here's a recent night of mine... note how you can zoom in on breaths and events!

https://sleephq.com/public/700dd744-1fb ... 1d1143571a

Also, if you fill out your machine and mask in your profile we'll know what they are... see mine below. I prefer to see text instead of pictures myself.

Thank you. This is very helpful. I did have it set to 8 last night which did seem to be the perfect starting point for me so I'm glad you said that. I will try tweaking the other settings you mentioned. I'm scrounging through my house now looking for an SD card I know I have somewhere so I can start uploading data.

[Iancdub88]

Also, if you fill out your machine and mask in your profile we'll know what they are... see mine below. I prefer to see text instead of pictures myself.

Is it not showing up in my signature? It is on my end.

[Julie]

EVEN if you're doing something 'wrong' it doesn't have to be forever and clearly won't kill you while you experiment - so relax a bit which might help overall.

[Miss Emerita]

Good to hear your looking for an SD card to use. That will make it a lot easier for us to help you and for you to learn about this new way to take care of your health.

Your AHI breakdown is very reassuring to me. You're probably having some CAs (central apneas or clear airway events) that are caused by arousals. Arousal breathing tends to be deeper than regular asleep breathing, and sometimes that can briefly reduce by a little bit the time your body wants to take between breaths. Don't worry about this.

Did you turn on your EPR?

[Iancdub88]

Did you turn on your EPR?

Yes, it's at a 3 like you recommended. That is a very comfortable setting. Thanks for that!

[Iancdub88]

EVEN if you're doing something 'wrong' it doesn't have to be forever and clearly won't kill you while you experiment - so relax a bit which might help overall.

Thank you. I'm not sure why I'm all in my head about it.

[Iancdub88]

Okay, night three was okay. I managed to keep the mask on the entire time. I switched between cpap mode at a pressure of 9 with ramp time at 20 and apap mode with a range of pressure from 9-20. I think I prefer the cpap mode for now but there were some other issues. I had the humidity up too high(6) at first and it basically soaked the inside of the mask. I turned it down to 4 which was too low so I think 5 is good. The mask still has a little saturation but my nose isn't clogged.

I also had some leaking issues. I am a stomach sleeper by default so I'm sure that doesn't help keep the mask on when I'm trying to get into that position. I did get the pillow with the indentations for the mask but it didn't make much difference so I went back to my normal pillow.

And worst of all, there were more events per hour last night. It seems as though I wake up as soon as I fall asleep at times. I feel like this is a brain thing maybe? Like i'm subconsciously afraid to fall asleep with the mask on? I don't know. I also had some throat tightness this morning.

Anyways, I was able to post last night's results on SleepHQ and would love your help reading them. Thanks a lot!

https://sleephq.com/public/89731e23-af8 ... ac2d0498b2

[vandownbytheriver]

Anyways, I was able to post last night's results on SleepHQ and would love your help reading them. Thanks a lot!

Man, that's a stormy night! See the section at 0330? That's a good time! Were you asleep? Perhaps not... but that's what we're going for. Looking like 9cm is your magic number.

You have set Ramp pressure the same as your Min pressure... this does no good, all this does is turn off APAP for a while. EPR 3? I believe that's driving your CA's... all that stuff around 1am is when your body doesn't have enough CO2 to keep you breathing steady. See that crazy pressure excursion that woke you at 12:30? You may have rolled onto your back, the Flow Limit graph took you to the Moon.

First thing, lets not make so many changes during the night! Set 9cm CPAP, 0 or 1 EPR, and see how you do for a night. Just turn off Ramp, you don't need it, you're not really using it. Stay off your back if you can, I put a pillow behind me to remind me of this. Good luck, let us know etc.

[Pugsy]

I don't know that EPR is causing your central apneas to pop up. Most of what I saw was arousal/awake related flagged central apneas. I have serious doubts as to whether EPR is a problem for you or not in terms of causing centrals.
We need a LOT more for sure sleep data to know for sure.

This report from last night screams a crappy sleep quality night.
Lots of starts and stops of the machine....screams being awake and with that much arousal/awake breathing then we just have to wonder if you were sound asleep or not when those events got flagged.

Remember your machine only measures air flow and doesn't have any way to know if you are really asleep or not.
Pauses in breathing while awake can cause the machine to flag awake events and they aren't considered therapeutic results except to point to not sleeping soundly at all.

[Iancdub88]

First thing, lets not make so many changes during the night! Set 9cm CPAP, 0 or 1 EPR, and see how you do for a night. Just turn off Ramp, you don't need it, you're not really using it. Stay off your back if you can, I put a pillow behind me to remind me of this. Good luck, let us know etc.

Will lowering the EPR to 1 make it harder or easier to exhale?

[Iancdub88]

Remember your machine only measures air flow and doesn't have any way to know if you are really asleep or not.
Pauses in breathing while awake can cause the machine to flag awake events and they aren't considered therapeutic results except to point to not sleeping soundly at all.

Gotcha! As I said, I was definitely aware that I was waking up about every hour.

[Pugsy]

Will lowering the EPR to 1 make it harder or easier to exhale?

I find that the more exhale relief I have the easier it is to exhale.
So a reduction to 1 would make it harder for me to exhale compared to how it feels with a higher EPR/exhale pressure relief.

If that discomfort with the EPR reduction causes more sleep problems then IMHO that is worse than the centrals popping up because I think that the wake ups are causing the central flags. Reduce the wake ups and I bet the centrals will reduce all on their own.

Your primary job right now......get to sleep and STAY asleep.
Without sleep none of this stuff really matters.

[Iancdub88]

Your primary job right now......get to sleep and STAY asleep.
Without sleep none of this stuff really matters.

This is just something my brain needs to learn, right?

[Pugsy]

Your primary job right now......get to sleep and STAY asleep.
Without sleep none of this stuff really matters.

This is just something my brain needs to learn, right?

Yeah, pretty much.
The brain is a powerful tool but sometimes it causes more problems.

Pick some setting(s) that are totally comfortable for you and don't keep changing stuff willy nilly or nightly.
The brain also needs predictability and consistency so give the brain some time to adjust to this whole new way of sleeping with crap on our face and head.

At least 4 or 5 nights without changing anything unless the results are a disaster.