Last Night Was First Night

[Iancdub88]

Some people get their sleep disturbed by pressure changes, and do better when their pressure is fixed.
I'm one of them.
Looking at you charts, I think it's worth your while to try a fixed pressure at 10.4 (you're spending half you time there or above it as it is).
If 10.4 it to dramatic to start with, do 10.2 for a few days, then 10.4 and maybe even a bit more.
The reason i suggest you aim for a bit higher is that you still have residual snores, and more importantly, flow limitation that seem to appear when ever the machine is going down to 10.
On second thouth, since flow limitations can be sleep disruptors too a - so it may be a moot point whether its the flow limited breathing or the pressure changes waking you up.
At any rate, whether fixed pressure or APAP, you may be sleeping better if the fixed or minimum pressure is higher than 10.

I had wondered this as well. So you think CPAP mode at 10.4? I think I'll try this tonight and see how it goes.

Also, I messaged my psychiatrist and will have an appointment with him next week. However, Kaiser hasn't even assigned me a sleep doctor yet so I will be trying to figure that out in the coming days.

[Iancdub88]

And please forgive my ignorance but can someone explain flow limitations to me?

[Iancdub88]

Last night. I switched to a fixed pressure of 10.4. I only remember waking up twice which is a big improvement. How does this look? https://sleephq.com/public/5bcff00a-bb2 ... 4a4f28a5be

[ozij]

Last night. I switched to a fixed pressure of 10.4. I only remember waking up twice which is a big improvement. How does this look? https://sleephq.com/public/5bcff00a-bb2 ... 4a4f28a5be

How it looks is less important than how it feels and "a big improvement" sounds promising - stick to this setting for a few days and lets see how you feel.

[Iancdub88]

How it looks is less important than how it feels and "a big improvement" sounds promising - stick to this setting for a few days and lets see how you feel.

Sounds good. Thank you for all your help!

[vandownbytheriver]

And please forgive my ignorance but can someone explain flow limitations to me?

FL is a distortion of the breath waveform... the machine is constantly doing math on your breathing. When it detects things it thinks can be helped with more pressure it flags those periods as FL's on the graph. See the peaks of your breath waveform at 12:30? See it changed (rounder) at 12:32? You had a micro-arousal looks like, at 12:31:30, and changed position or etc. FL's are one of the things (with Snore, OA, H) that would drive APAP pressures higher.

Your graphs look great, you're doing great, keep it up.

[Iancdub88]

FL is a distortion of the breath waveform... the machine is constantly doing math on your breathing. When it detects things it thinks can be helped with more pressure it flags those periods as FL's on the graph. See the peaks of your breath waveform at 12:30? See it changed (rounder) at 12:32? You had a micro-arousal looks like, at 12:31:30, and changed position or etc. FL's are one of the things (with Snore, OA, H) that would drive APAP pressures higher.

Your graphs look great, you're doing great, keep it up.

Thank you! I had quite a few more flow limits last night - https://sleephq.com/public/a9caf6db-be9 ... ee61b52003

I'm wondering if upping the pressure to 11 maybe in a couple days might be a good idea. I'm still tired during the day but it's definitely improved from a week ago,

[vandownbytheriver]

Thank you! I had quite a few more flow limits last night - https://sleephq.com/public/a9caf6db-be9 ... ee61b52003
I'm wondering if upping the pressure to 11 maybe in a couple days might be a good idea. I'm still tired during the day but it's definitely improved from a week ago,

Not sure why your machine settings are not showing up... best to leave the card in for a while (30 seconds is what I do) before yanking it out, maybe.

You popped a zero! If you're doing good just cruise for a while. Plenty of time to get pressure-happy later on... let it ride, I'm saying.

[Iancdub88]

Thank you! I had quite a few more flow limits last night - https://sleephq.com/public/a9caf6db-be9 ... ee61b52003
I'm wondering if upping the pressure to 11 maybe in a couple days might be a good idea. I'm still tired during the day but it's definitely improved from a week ago,

Not sure why your machine settings are not showing up... best to leave the card in for a while (30 seconds is what I do) before yanking it out, maybe.

You popped a zero! If you're doing good just cruise for a while. Plenty of time to get pressure-happy later on... let it ride, I'm saying.

It could also be that my trial ran out yesterday and I didn't upgrade to premium.

And awesome! Sounds good to me!

[ozij]

Thank you! I had quite a few more flow limits last night - https://sleephq.com/public/a9caf6db-be9 ... ee61b52003

I'm wondering if upping the pressure to 11 maybe in a couple days might be a good idea. I'm still tired during the day but it's definitely improved from a week ago,

In a few days. Give yourself about a week to get used to this fixed pressure, see how you feel, and then review how you feel and what the results show.

[Iancdub88]

The last couple of nights haven't been as good. Last night had some snoring and flow limits. I'm thinking of upping the pressure.

https://sleephq.com/public/4a75f88e-f6b ... 57d1194d87

[ozij]

The last couple of nights haven't been as good. Last night had some snoring and flow limits. I'm thinking of upping the pressure.

Makes sense.
Can you be more specific about what was not "as good"?
Can you keep a sleep log that you fill after waking up, and before you look at the data?
Both are important, but keeping them separate is helpful.

[Iancdub88]

Makes sense.
Can you be more specific about what was not "as good"?
Can you keep a sleep log that you fill after waking up, and before you look at the data?
Both are important, but keeping them separate is helpful.

Basically, I feel like I'm awake too often, switching sleeping positions, etc. And I've still been tired during the day. Not like I was two weeks ago, but I still haven't felt totally rested since starting this therapy.

I definitely do need to do the sleep log.

[Iancdub88]

Last night, I tried upping the pressure to 10.6 and it felt a bit too intense so I went back to 10.4. The flow limits seem to be getting worse so I don't know what that's about.
I remember tossing and turning probably around midnight, 3am and 5am. I woke up tired again. I know I'm sleeping but it feels pretty fragmented. Here is last night's chart:

https://sleephq.com/public/4a75f88e-f6b ... 57d1194d87

I had my first follow up with a sleep doctor yesterday and she wasn't super helpful. She told me I don't need to keep the mask on all night and it's okay to sleep without it. She said my numbers look great but if I can't sleep well, we might have to look at other treatment options. That was frustrating because I feel like I'm so close.

I don't know, overall I'm happy that I can keep the mask on all night and at least sleep some but I'm also frustrated and worried that I won't figure out how to just sleep through the night. Any help or encouragement is always appreciated. Thanks so much.

[ozij]

Last night, I tried upping the pressure to 10.6 and it felt a bit too intense so I went back to 10.4.

Try 10.6 some time before you go to bed. Decide you will give it about 30 minutes or so - and just breathe and relax. Commit yourself only to that, don't even think of using it when you try to sleep.
See what happens after 30 minutes.
An altenative is to go back to APAP, leave your minimum at 10.4, which you're familiar with, but let the machine add pressure when events start happening.

She said my numbers look great but if I can't sleep well, we might have to look at other treatment options.

Is she aware of the medication you take? Did you ask her how they may impact the quality of your sleep?

I think you're facing a number of issues:
You're not sleeping well - part of that is caused for sure by breathing obstructions, but possibly only part.
You're worrying about it - another cause for not sleeping well
You're taking medications that may impact your sleep quality.

All in all, not an easy situation to be in. But that doesn't mean it's hopeless.