zackds wrote: ↑Sun Jul 22, 2018 11:03 am
i dont know if its normal to stop breathing for 9 seconds even when awake though
It's normal to do a lot of weird breathing stuff while awake and we simply don't realize we are doing it.
For our sleep problems to be related to breathing and sleep...we gotta be asleep and if we are awake any of that weird breathing stuff simply doesn't count.
Now figuring out the why for being awake...not always so easy to do. There's lot of stuff that can cause us to wake up and it doesn't necessarily have to be related to our breathing. The machine can only fix problems related to the breathing problems though. It does nothing for fixing a problem causing arousals that aren't related to breathing issues.
I will repeat what I have said before...pick a pressure number that seems to work and just use the machine for a period of time with no willy nilly changing of anything. Pick a pressure that you used one of those nights where you didn't have to pee during the night and you felt decent during the day with a minimal number of wake ups during the night.
Then be prepare to use it for a month...keep a log as to how you feel or sleep and the pee breaks.
Accept the limitations of the data from your machine...it is what it is. Learn to recognize arousal/awake/post arousal breathing event flags and be prepared to mentally remove them from any evaluation except the fact that the arousal breathing means poor sleep quality for some reason.
I don't know that the gentle waxing and waning that you see means much one way or the other. Even if it did I don't know what you can do about it. The only machine that will smooth that out is one of the ASV machines and it will make the flow rate nice and pretty but no guarantee that it will mean you will sleep any better and you can't afford one of those machines anyway.
If this UARS you have going on...I told you a long time ago that there were no quick fixes and you need months of use to figure out if it helps or not because the improvements are so very gradual and small and take a long time to realize that things are getting any better.
And back to your original question in this thread...can you maybe use a pressure that is making things worse?
Maybe but really only if the more pressure causes comfort issues which in turn affect sleep quality. I don't think more pressure causes centrals in your situation. I think the bulk of your centrals are related to SWJ. An occasional real central is normal and not a worry. So the higher pressures might cause comfort issues (aerophagia or just high enough to not be comfortable exhaling) but otherwise more pressure doesn't really hurt anything.
You have some crappy sleep issues...now why your sleep is crappy we can't really know for sure. About all we can do is try stuff and see if we can maybe get lucky and figure out a cause and a solution.
But at some point you have to quit dial a wingin and pick something that can work and give it an extended trial.
It's hard...I know that we want to try to adjust something based on last night's results but we simply don't sleep the same each night. Get close and then give it time.
Some time back when I got a bilevel machine I had to come up with some sort of settings. My nightly results were sort of all over the place...some really good and some not so good and some even down right horrible.
What I did was pick some settings that could give me decent results and then I prepared myself to use those settings no matter what the nightly report showed and not go changing things willy nilly. My AHI was running in the 3 ish category...some good nights sleep and some not so good but remember I have some sleep maintenance insomnia issues related to pain and/or the medication I take for the pain.
At first the results were all over the place...mostly not so good but with an occasional good night but over time (I did this experiment for 6 weeks where I forced myself to not change anything because I knew that the settings could work) everything improved without my changing anything. Hours of sleep improved...awakenings became less numerous...AHI reduced and how I felt in general during the day improved.
My AHI was cut in half at the end of the 6 weeks. My hours of sleep increased to somewhere around 45 minutes to an hour more sleep and that extra time asleep has always been critical in how I felt during the day. Slowly the "good" nights became the majority of what I saw instead of in the beginning the "good" nights were in the minority.
I am not a very patient person. I am one of those people that wants immediate marked relief...the hardest thing I have ever done was not change anything those 6 weeks but it was one of the best experiments I ever have done. There is some truth to the "give it time" thing because the body and the brain needs to adjust to the settings.
Your AHI is never going to be a good measuring tool because your AHI is primarily SWJ and all it really tells us is that when we have more SWJ we have more crappy sleep. You are going to have to rely on how you feel and that's really hard to do because we want to look at numbers or the flow rate and see a problem so we can fix the problem. Unfortunately the data from the machine can't always give us what we need in that regard.
I would also like to see you try a fixed pressure or a really tight apap range...just to eliminate any pressure changes as being a factor in the arousals. Since your machine won't flag FLs in fixed cpap mode...I suggest keeping it in apap mode and make the minimum equal the maximum. It will work like cpap mode but you still have FL flagging.
That's what I would have you do if you were a family member of mine. It's not perfect but given what we have to work with and your limited budget...about all we can do.
The fact that the nocturia has improved at times...that alone is worth continuing the experiment.
I may have to RISE but I refuse to SHINE.
