What do clumps of A & H events mean?

RMinOntario · Post by **RMinOntario** » Mon Jul 27, 2009 9:04 am

Well, I know 1 night doesn't make a trend but ....
I lowered my pressure from 14 to 12 and changed the EPR from 3 to OFF. I didn't find exhalation as comfortable and I nearly put the EPR to 1, but persevered & it turned out okay. My AI was 1.1 and HI was the lowest since I started getting data July 2, at 4.4. I understand since this is a Resmed it is equivalent to about an HI of 2.2, so for the first time my AHI is below 5! I stayed on my side (best as I can tell using the body pillow) for all but the last hour. The last hour on my back was a reward for staying on my side the rest of the night.

Also I noticed at the early part of the night I kept curling my head down toward my chest, so I resurrected a teddy bear to cuddle and his head propped my chin up. I guess I could have used a pillow although it didn't occur to me at the time.

Thanks for the suggestions and help over the last day or two.

I keep an Excel sheet of lights out/on, pressure, AHI etc, etc and just realized that even w/o adjusting the Resmed HI values by half, my AHI was 5.5. That was the lowest for me in a month. Yes!!

Wulfman · Post by **Wulfman** » Mon Jul 27, 2009 9:18 am

Congratulations!

Glad to hear something (or some things) may be working.

Den

Pugsy · Post by **Pugsy** » Mon Jul 27, 2009 9:26 am

One night doesn't make a trend but it sure makes a good start. Good job. It does take a bit of work but a person can get used to exhalation without EPR. I believe I would much prefer that option as opposed to cranking up the pressure more to allow for the reduction that EPR gives. Then you would still end up adjusting to a higher pressure anyway. Hmmm 15 cm with EPR at 3 means still exhaling against 12 cm, or bite the bullet and just do the 12 to start with.

How about the headaches? Did one night give you a no headache night? Don't be disheartened if it didn't. They seem to occur despite the best of numbers sometimes.

I had AHI of 2.7 last night but woke up with headache...Looked at my data and I did really well until the last couple of hours and I spotted a nasty cluster that occurred about an hour before awakening. So at least I have something to apply the blame to.

Good job, keep us posted. I love to read the updates.

jdm2857 · Post by **jdm2857** » Mon Jul 27, 2009 11:56 am

I'd like to see your data from last night to see if you had more events during that last hour on your back.

And you probably look cuter snuggling that bear.

RMinOntario · Post by **RMinOntario** » Mon Jul 27, 2009 3:14 pm

Hi jdm,
I'm really excited at how few apneas & hypops I had last night. It's the cleanest looking graph I've had! I never had any apneas in the last hour.
Here's the graph:

Pugsy · Post by **Pugsy** » Mon Jul 27, 2009 5:18 pm

I see only one break in therapy. Bathroom break again? If so, one is better than 3 breaks that the other report showed.

I would say last night's experiment was a success. Keep up the good work.

tattooyu · Post by **tattooyu** » Mon Jul 27, 2009 5:19 pm

Keep that up, RMin! I noticed an immediate improvement when I switched my EPR from 3 to 1. I'm using 13.6 pressure and an EPR of 1. I may try turning EPR off to see if my numbers improve. Keeping the chin up was vital for me. I just hug a pillow. I'd hug my wife, but she doesn't like a faceful of air.

jdm2857 · Post by **jdm2857** » Mon Jul 27, 2009 5:29 pm

Get a teddy bear!

AS for the data, the last hour looks good, too. Maybe (just maybe) sleeping on your back isn't a big problem.

RMinOntario · Post by **RMinOntario** » Mon Jul 27, 2009 5:31 pm

Pugsy wrote:I see only one break in therapy. Bathroom break again? If so, one is better than 3 breaks that the other report showed.

I would say last night's experiment was a success. Keep up the good work.

I agree. I am pretty happy. Quite a way to go yet, but that's okay as I am very determined. And only one bathroom break to boot.

tattooyu wrote:Keep that up, RMin! I noticed an immediate improvement when I switched my EPR from 3 to 1. I'm using 13.6 pressure and an EPR of 1. I may try turning EPR off to see if my numbers improve. Keeping the chin up was vital for me. I just hug a pillow. I'd hug my wife, but she doesn't like a faceful of air.

Wulfman suggested eliminating the EPR and that sure seemed beneficial. He also recommended not bending my head into my chest. The teddy bear was my workaround - and he didn't complain about the air.

RMinOntario · Post by **RMinOntario** » Mon Jul 27, 2009 5:35 pm

jdm2857 wrote:Get a teddy bear!

AS for the data, the last hour looks good, too. Maybe (just maybe) sleeping on your back isn't a big problem.

I guess I'll experiment with sleeping on my back over the next while. I think tonight I'll try mostly staying on my side again just to see if I can reproduce the results. And I will keep my teddy bear.

jdm2857 · Post by **jdm2857** » Mon Jul 27, 2009 5:39 pm

The teddy advice was for Tattooyu.

Hawthorne · Post by **Hawthorne** » Mon Jul 27, 2009 6:52 pm

I have Rheumatoid Arthritis and have had it since way before I was diagnosed with sleep apnea. Because of this I have slept on my back for years. It is the only pain free position for me.

I have continued to sleep on my back for the 7 years I have been on cpap. In February of 2008 I bought an auto (after using straight cpap for 5+ years after my PSG showed severe sleep apnea in 2002) and have it set at a narrow range. My 90% pressure is 12cm but I spend by far the largest part of the night at 11 cm. My average cpap pressure is usually 11.1/2. My AHI is below 1 almost every night. I can't even remember when my AHI was last more than 2. I use a contour pillow which seems to keep my chin up and my airway fairly open, with the help of the machine. My leak line is generally right on for my mask and pressure.

I would guess that I do not have positional sleep apnea, given the facts. You may not either so, if you sleep better on your back and your numbers are fine, go ahead and sleep on your back.

Some people of course, who have positional sleep apnea couldn't do this. I'm not advocating back sleeping but it's the best ( and only possible) position for me and does not cause excessive events of any kind. You may be able to sleep in any position you want!

I think I'll get my Teddy Bear though!

Pugsy · Post by **Pugsy** » Mon Jul 27, 2009 7:03 pm

The Teddy Bear thing has got me to thinking. I think I "scrunch" up when I try to sleep on my side, very much like the fetal position. It eases my lower back and pelvic pain for a while BUT I have this 4 inch long plate in my cervical spine and I think I probably tuck my chin somewhat when I am on my side. So.... I guess I will make an effort to keep my chin extended a bit more and maybe open my airway a bit more. Bret's buckwheat pillow supports things great but I may be inadvertently curling up in a ball.

Good thing I have a king size bed. I have pillows made into a wall against my back to keep me on my side and now something else to keep in front of me. I am fast running out of room for my poor little pug dog.

RMinOntario · Post by **RMinOntario** » Mon Jul 27, 2009 7:05 pm

Hawthorne,
That pillow you mention might help if I could keep my head straight. I found that on my side, (without my T. bear) that my head curled down to my chest. On my back, I tend to bend my head towards one of my shoulders. I don't think that creates as much of a kink as down to my chest tho'. I seem to not want a straight head / neck line. I'm sure it's probably not good for my neck to bend like that.

I didn't know about positional apnea until recently. I still will have to do more testing for me.

Your numbers are great! Someday I'll get there.

jdm2857 · Post by **jdm2857** » Mon Jul 27, 2009 7:05 pm

Can you snuggle the Pug under your chin?

What do clumps of A & H events mean?

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