Mike almost always has his "worst" reports in the wee hours of the morning within a couple or 3 hours of getting up doesn't he? You report that you have checked on him in the wee hours of the morning and you find that he is a lot more restless at that time. Maybe the longer he lays in bed his comfort level decreases maybe he is having some pain from not moving much. It just plain old hurts sometimes to stay in bed. Pain is my main reason (unless the dogs are acting up) for my nights with shorter hours of sleep. I think in this situation that longer hours may causes "restless" sleep and thus increase the chance of having those tossing and turning centrals and such.DoriC wrote:Pugsy, I know you put a lot of heart into your response, probably one of your best efforts so far to help us understand. I really, really get it this time!! I'm going to pick a setting and stay with it and don't panic over "alien" variations. Can I throw 2 more questions at you? If cpap and apap give similar results and all things being equal, are there any reasons to use one or the other except for the comfort factor? Would there be the same variations? Also, a math question, when you throw Hrs Used into the mix, how does that impact the data? Mike usually sleeps about 9 hrs so with both having similar data how would that compare to someone who only sleeps 6hrs? Am I confusing you?
From my own experience the longer I am in bed the higher my AHI. More hours of sleep...more chances for time in REM sleep where I am worse...more changes of my back deciding it doesn't want to lay in bed anymore and give me those "restless" events that aren't real that I am pretty darn sure I have within the last 2 hours of sleep. It's rare that I ever have very much show up on my reports the first 4 to 5 hours of my sleep. Most of the time if I have anything really ugly show up it at the end of the night the last 2 hours in bed.
I don't know if there is any huge glaring reasons to use cpap over apap or apap over cpap unless someone actually has times where significant higher pressures are needed for relatively short periods of time like my 18 cm for maybe 30 minutes maybe 3 times a week. I do it to cover those times. If the pressure variations bothered me I wouldn't do it. I would limit the max and just let those events maybe happen if they are going to. You already use a relatively small APAP range anyway with Mike because you think that the variations are disturbing. It's no where near a wide range.
The comfort of the lower pressures for the bulk of the night is sure sweet though. Of course if someone is particularly sensitive to any changes in pressure no matter how tiny then they should use cpap.
Let me ask you this...going on how you perceive his nights..sleeping and resting and whatever....if you couldn't see the reports...can't cheat and look at the data....can you tell any difference in how he seems to feel? Could you just make note of how he feels or acts for a week and not look at the reports and then go change it maybe to cpap mode...give it another week and only evaluate how he seems to feel (don't cheat and look at the reports)? Then go back and look at your notes and then look at the reports to see if you see a pattern? Would you go into data withdrawal?
I am sorry that I can't really give you a clear cut answer. I did try straight cpap on the ResMed machine. I had to use a pressure of 13 to get my AHI down to where I saw it with APAP. I initially tried cpap at 9 cm. Had a truck load of events show up and I felt them. Using APAP at 10 min was a whole lot easier than cpap at 13 even with EPR helping me out.
It's my preference though. I can't transfer it to Mike. I don't know what he is feeling and you don't either because really can't express it. Really makes it tough to try to figure out what makes him more comfortable. How about a compromise? A really tight pressure range? Not quite CPAP mode but close. Have you ever tried that?
