How can it be?

sweetdreams · Post by **sweetdreams** » Sun Apr 08, 2007 5:33 pm

How can the lowest AHI I've had (usually avg 5-7's) last night be 2.4 when I feel like it was one of my worst nights for sleeping and waking up to many leaks and very sleepy today. The leaks were higher than normal (2 weeks with using encore software have been high at 38 and 42 avgs for the Optilife mask (that I'm struggling with). Then last night the leaks were max leak 111, 90% 64, Ave 47, avg time in large leak 28 min. Avg time in apnea 7 minutes. The pressure settings are 10-15 and most of the night was at my titrated 13. I use the Remstar auto with c-flex and trying to make the Optilife work.

So I'm confused, most time at my titrated level I got my loweest AHI, but if leaks affect AHI, how can my AHI be at the lowest?....and just when I thought I was beginning to figuring it out.Any info would be appreciated.

Thanks.

CollegeGirl · Post by **CollegeGirl** » Sun Apr 08, 2007 5:45 pm

Sweetdreams,
When you are in large leak the machine cannot succesfully read or treat apneas, so any apneas you had during that time period cannot be scored. This often results in a lower-appearing AHI. You cannot successfully determine anything using data obtained from a night when you had leaks of that quantity.

NightHawkeye · Post by **NightHawkeye** » Sun Apr 08, 2007 7:25 pm

The other thing that can happen, which I see in my own data, is that you might not have gotten much REM sleep. If your apneas are occurring mostly during REM, which is common, then not getting much REM can make the data look good, whereas the lack of REM can make you feel subpar during the day.

Regards,
Bill

hairnet · Post by **hairnet** » Mon Apr 09, 2007 9:38 am

Can you tell me how you determine if you are in REM sleep? I have the Respironics Auto with CFlex and the encore pro software. I have my auto set at 6-10. Lately my AHI has been getting higher, especially the week in Denver, CO. Maybe the altitude change from Texas. However even at home the AHIs seem to be getting higher. Seems most of my apneas and hypopneas occur at around 8 to 9. Maybe someone can give me some advice.
Thanks.

Wulfman · Post by **Wulfman** » Mon Apr 09, 2007 10:10 am

NightHawkeye wrote:The other thing that can happen, which I see in my own data, is that you might not have gotten much REM sleep. If your apneas are occurring mostly during REM, which is common, then not getting much REM can make the data look good, whereas the lack of REM can make you feel subpar during the day.

Regards,
Bill

Bill,

I'm having the opposite "problem"(?)
I've been feeling like ALL (or at least alot) of my sleep is REM......(for months, now) and my AHI is generally very low (like alot of 0.3's but ranging up to 1.1). To me it seems paradoxical as REM is supposed to be where most of the events (typically) take place.
I look for the "flat lines" in my leak chart to try to determine when my REM possibly occurred. (REM paralysis?)

I've always had dreams, but since XPAP it seems to have shifted to "Overdrive".....
Don't know how good that is.
On the nights when my AHI is a little higher (almost all hypops), I think I got some deeper sleep.

Den (sometimes wondering what's going on in that oxygenated brain of his)

Slinky · Post by **Slinky** » Mon Apr 09, 2007 11:33 am

Well, what I was told when I was seeing a sleep neurologist some 10 years ago when I asked about dreaming was that when we remember a dream it was because we were in REM whilst dreaming and woke up during REM. If we leave REM w/o waking we won't remember the dreams.

CollegeGirl · Post by **CollegeGirl** » Mon Apr 09, 2007 11:51 am

Right, Slinky. This has been my experience. When I had severe untreated apnea, I had lots and lots of dreams - but I remembered up to a dozen a night. This meant that I was fully awakening a dozen times per night, not just a little, but enough to think about my dream, and remember it in the morning. Now that I'm on CPAP, I know I'm still dreaming (because I am when my alarm clock goes off in the morning, usually), but I don't remember any of my dreams at all, except for whichever one I am awakened during. This is significant progress, in my book.

Slinky · Post by **Slinky** » Mon Apr 09, 2007 11:58 am

Giggle. When I opened this post and got down to reading your post, CollegeGirl, it so happened that Tom T Hall was singing "A Week In A Country Jail" from the 1970s. And your little penguin of yours was dancing right in rhythm to Tom T and the music.

NightHawkeye · Post by **NightHawkeye** » Mon Apr 09, 2007 12:27 pm

hairnet wrote:Can you tell me how you determine if you are in REM sleep?

By association, really. The common pattern for REM I've seen is three, four or five REM intervals of increasing length during the night, with the REM interval increasing throughout the night until REM occupies about 50% of sleep time near the end of a night's sleep. I see a similar pattern of apnea in my Encore Pro data, hence, the association. Also, it's fairly common for OSA to worsen or to only show up during REM.

wulfman wrote:I've always had dreams, but since XPAP it seems to have shifted to "Overdrive".....
Don't know how good that is.
On the nights when my AHI is a little higher (almost all hypops), I think I got some deeper sleep.

It does sound like you must be waking up a lot, Den. Of course, depending on the dream, that might not be all bad. .

Slinky wrote: . . . Tom T Hall was singing "A Week In A Country Jail"

Wish I could remember all the words to it. He never did claim innocence to the speeding charge though, as I recall . . .

Regards,
Bill

Wulfman · Post by **Wulfman** » Mon Apr 09, 2007 12:53 pm

NightHawkeye wrote:
hairnet wrote:Can you tell me how you determine if you are in REM sleep?
By association, really. The common pattern for REM I've seen is three, four or five REM intervals of increasing length during the night, with the REM interval increasing throughout the night until REM occupies about 50% of sleep time near the end of a night's sleep. I see a similar pattern of apnea in my Encore Pro data, hence, the association. Also, it's fairly common for OSA to worsen or to only show up during REM.

wulfman wrote:I've always had dreams, but since XPAP it seems to have shifted to "Overdrive".....
Don't know how good that is.
On the nights when my AHI is a little higher (almost all hypops), I think I got some deeper sleep.
It does sound like you must be waking up a lot, Den. Of course, depending on the dream, that might not be all bad. .

Slinky wrote: . . . Tom T Hall was singing "A Week In A Country Jail"
Wish I could remember all the words to it. He never did claim innocence to the speeding charge though, as I recall . . .

Regards,
Bill

Since I'm a side-sleeper, at least every time I turn over. SOME/MOST dreams ain't half bad. Some seem to go on and on and on.

Yup. Tom T. got pretty fond of the "hot bologna, eggs and gravy" by the time he got out.

Den

Here's the lyrics:

One time I spent a week inside a little country jail
And I don't guess I'll ever live it down
I was sittin' at a red light when these two men came and got me
And said that I was speeding through their town

Well, they said,"Tomorrow morning you can see the judge then go."
They let me call one person on the phone
I thought I'd be there overnight so I just called my boss
To tell him I'd be off but not for long

Well, they motioned me inside a cell with seven other guys
One little barred up window in the rear
My cellmates said if they had let me bring some money in
We ought to send the jailer for some beer

Well, I had to pay him double 'cause he was the man in charge
And the jailer's job was not the best in town
Later on his wife brought hot bologna, eggs and gravy
The first day I was there I turned it down

Well, next morning they just let us sleep but I was up real early
Wonderin' when I'd get my release
Later on we got more hot bologna, eggs and gravy
And by now I wasn't quite so hard to please

Two days later when I thought that I had been forgotten
The sheriff came in chewin' on a straw
He said, "Where is the guy who thinks that this is Indianapolis?
I'd like to talk to him about the law."
Well, I told him who I was and told him I was working steady
And I really should be gettin' on my way
That part about me bein' who I was did not impress him
He said, "The judge'll be here any day."

The jailer had a wife and let me tell you she was awful
But she brought that hot bologna every day
And after seven days she got to lookin' so much better
I asked her if she'd like to run away

The next mornin' that old judge took every nickel that I had
And he said, "Son, let this teach you not to race."
The jailer's wife was smilin' from the window as I left
In thirty minutes I was out of state

blarg · Post by **blarg** » Mon Apr 09, 2007 12:56 pm

And I never dreampt before CPAP, and now I remember one dream when I wake up sometimes. I dunno how good "overdrive" would be though.

sweetdreams · Post by **sweetdreams** » Mon Apr 09, 2007 5:26 pm

Thanks College Girl and Nighthawkeye. That makes a lot of sense. What else can I do but try to stop leaks? I tried a different size pillow again for the Optilife last night and adjusted the headgear which seems to crawl. I'm almost at the end of my 30 days with the Optilife and as much as I like the lightweight, can wear my glasses, sleep on side, I just can't keep it sealed when I move around. Don't mind the mouth taping either. So, I might try a trade but I don't know what to try.

Can you tell when you are in REM on the reports? I seem to dream clearly about 1-2 hours before I wake up. Is that the gauge?

Would changing pressure help with the leaks? Titrated at 13 and 90% is more often at 14. Would lowering the max to 13 help with leaks and be therapeutic if I'm at 14 so often?

Thanks again.