Inconsistant results - stymied - venting

[tuzacat]

I spent yet another night wide awake until about 4 am when I finally dropped off to sleep. I have been trying some experiments with settings and masks on the weekends so last night was basically a result of that - totally my fault. What I don't understand is why I have such a variation in results when keeping everything the same. For instance, recently I had a 0 AHI and a 3.8 AHI at the same settings, same mask, same everything. Over the course of the week the AHI went from 0 to .1 to .3 to 1.1 and kept working it's way up. Why would it be so different with no change in variables? Maybe I should just keep that one setting for a couple of weeks and see if it settles down? The reason I am still experimenting is because I still have grunting issues some nights even with the Wisp ( which is the one mask where most nights there are no grunts). I am also trying to have what is on my face be more comfortable. I prefer a nasal pillow mask (Swift FX) to everything else but I have yet to find a setting where I do not grunt when using it so it keeps me awake. I don't really expect a response here since I haven't posted any charts - to be honest I'm too tired right now to deal with that since it takes me forever to jump through those hoops but maybe later on this week when the dust settles a bit. The grunting started with the ASV pressures; I didn't have them on Bipap but I did have a bunch of centrals on Bipap...seems like I'm trading one issue for another...thanks for listening...
Tuza

[Wulfman...]

I spent yet another night wide awake until about 4 am when I finally dropped off to sleep. I have been trying some experiments with settings and masks on the weekends so last night was basically a result of that - totally my fault. What I don't understand is why I have such a variation in results when keeping everything the same. For instance, recently I had a 0 AHI and a 3.8 AHI at the same settings, same mask, same everything. Over the course of the week the AHI went from 0 to .1 to .3 to 1.1 and kept working it's way up. Why would it be so different with no change in variables? Maybe I should just keep that one setting for a couple of weeks and see if it settles down? The reason I am still experimenting is because I still have grunting issues some nights even with the Wisp ( which is the one mask where most nights there are no grunts). I am also trying to have what is on my face be more comfortable. I prefer a nasal pillow mask (Swift FX) to everything else but I have yet to find a setting where I do not grunt when using it so it keeps me awake. I don't really expect a response here since I haven't posted any charts - to be honest I'm too tired right now to deal with that since it takes me forever to jump through those hoops but maybe later on this week when the dust settles a bit. The grunting started with the ASV pressures; I didn't have them on Bipap but I did have a bunch of centrals on Bipap...seems like I'm trading one issue for another...thanks for listening...
Tuza

Could you elaborate a bit more? What are ALL of your settings?
We don't sleep the same night after night, so our "numbers" can vary quite a bit.
You may need to post some reports so some of our ASV users can give their opinions.


Den

.

[kteague]

I saw that in the past you've described snores, but this grunting you mention sounds quite distinct. Maybe if that word were in the title someone who relates might see it. While your numbers aren't fluctuating widely, since they concern you, maybe a few nights wearing a backpack to keep you off your back could show if position is much of a contributor. Also, how are your leaks looking? I think my greater concern would be why you don't fall asleep until 4am. Any idea what is keeping you awake? If you do decide to check your data, it would be interesting to see how many of your events are recorded during the time you say you were awake vs when asleep.

[tuzacat]

Hi, Den and Kteague, I will post some data this week for sure. It's kind of beyond me today. I have stopped sleeping on my back since I started ASV because of the grunting, but really, I'm a side sleeper anyway - I used to start out on my back to relax and then turn as I was going to sleep. The reason I was awake last night until 4 is I was trying to see if I could get to sleep with the FX instead of using the Wisp. I have decided to experiment on the weekends so if it doesn't work out then it doesn't matter so much the next day if I'm sleep deprived. My settings with the Wisp were Epap11-12; Ipap 17 max 25. Mostly I don't grunt when I use the Wisp at this setting but once in a while I do. At those settings I grunt like crazy when I drop off to sleep with all of my other masks except for the F10 where I snore up a storm. You would think that the issue was the Epap setting which was initially set from 8-12 but really it almost never goes above 11.5. I bumped it to 10-12 for a while and then to 11-12. I have been wondering if the Ipap was too low because almost invariably the PS which is set to 6 rises to above 8. I understand that fooling around with the settings on ASV can be tricky so I didn't want to mess around with it too much on my own. Last night I tried an Ipap of 18 when I used the FX but I still grunted. If the grunting is because of not enough pressure on Inhalation why wouldn't I have grunted at a steady pressure of Ipap13 on Bipap? The grunting is definitely some sort of collapse going on because it happens while I am awake and I can feel it. Last night I grunted while awake and the machine recorded some of those grunts as CA's. I don't think I am having a leak issue _ I have never had large leak recorded although once in a while I see my total leak is too high. This usually happens when I loosen the mask on nights when it's driving me crazy or if I use too much thick padding to keep my nose comfortable. Thanks for your thoughts! I keep thinking I am not quite at my optimum pressures yet even with the Wisp and certainly not with any other mask.

Best,
Tuza

[BlackSpinner]

In all this there is one variable you can't control which is life and your body.
Food, when we eat, stress, alcohol, coffee, weather, activity will all affect our body and there by our sleep.

Your AHI is low and the variations are minimal.

[Tatooed Lady]

I have no clue what your age is...but either your cycle, menopause or just plain Mother Nature could be partly to blame.

[tuzacat]

Hi, Tattooed Lady and Black Spinner, I am 60 and past menopause. Stress in my life, hopefully, will go down this summer when I retire. I wouldn't care what my AHI is except I have noticed I don't always feel that great when it is much over 1. Like the rest of us I am trying to get comfortable enough to sleep restfully consistantly. I have been on cpap of some sort or another for 5 years now and have yet to find the perfect mask for my therapy but I'm still trying. I keep thinking if I can find the right pressure to eliminate the grunts then I will have more options for masks and more nights of restful sleep. Wishful thinking, I know. It seems a lot of people on here have issues with leaks but, sadly, mine are with grunts. My doctor looked at me like I have two heads when I talked to him about it. He doesn't know what they are. This week I am going to go back to stay with the settings that produced the 0 AHI (apparently, accidentally) and then post some charts at the end of the week. I have a bunch of flow limitations as well.

Best,
Tuza

[M'ohms]

Tuza,

I am 60, on ASV, and have experienced the grunts that you describe.

I found that I grunted when I was being lazy--waiting for the machine to initiate a breath for me. The machine blowing in my face made me grunt when I finally started to inhale. I decided that I needed to "jump the gun" on the machine-breath, still relaxed; just inhale sooner. This has become a habit now that I have been on the ASV for 8 months now. Every now and then, I catch myself making a little "moan kind of a sound" and I pick up the pace on inhaling and it goes away. I have found that pressure changes have not affected my grunting situation one way or the other.

[tuzacat]

Oh, thank you, M'ohms! It's interesting you say that because on my most successful nights my breaths per minute are 14 and on the least successful nights they are lower. I will try your idea although I think it's going to be a learning curve - I tend to breathe much slower than the machine. I always feel that it wants to hurry me along and that I'm breathing much faster than is natural for me. Yes, sometimes it seems like a sigh. sometimes a grunt, have been trying to figure out if it happens on the inhale or on the exhale. It always happens when I'm drifting off and then it wakes me up. I'm not sure how I am going to be able to keep pace with the machine and relax into sleep at the same time but I will try. I take it from what you say it has become a habit with you. Thank you so much for providing a clue! I still think I may need to tweak my settings because of the flow limitations but we'll see what happens this week.

Best,
Tuza

[M'ohms]

That's when I had the same problem. Just as I would fall asleep, the grunts would begin. It was almost comical. I also felt rushed with my breaths until I tried to beat the machine. Do you have the timed breaths set to auto? I do, and still feel rushed sometimes. I usually average 13 bpm myself. I guess it has taken me about 2-3 months to conquer the grunts without thinking about it anymore. Occasionally I'll notice it again, though, so I pick up the pace once again.

[tuzacat]

M'ohms, I tried an experiment last night - used the Wisp turned the Epap down down to 10.5 -12 and, sure enough, there came the grunts. Then I turned it back to 11-12 - the grunts disappeared. So at present I am sticking to that pressure for the Wisp = AHI was 3 but my tape came loose last night so I suspect that was the issue. What is really weird is at that same pressure I have copious grunts using the Swift FX. At that pressure with the F10 I don't have grunts but I snore like a bandsaw. Not really sure what's going on. I'm going to stick to the Wisp for a while and see if I can get it back down - will post some data when I have a couple of days where I stay taped. The timed breaths are on auto. I tried to be aware of breathing faster last night but didn't have an issue once I put the pressure up again.

[M'ohms]

I'm glad you have landed on a tangible solution. I hope you can adapt this to any mask that you are wanting to use. I rotate between the Quattro FX, the Airfit F10 and the Hybrid. They behave the same for me!