Length of Time of Obstructive Apena

fdw wrote:Lately I've been have periods of time in which my Obstructive Apena have lasted nearly a full minute.......Is a pressure increase necessary?

How often do you see those "clusters"? Was this an isolated incident or are they frequent?

I'm still thinking they're "positional" unless you can confirm they're not.


Den

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From 2008, but still true, I believe:

"Patients with congestive heart failure . . . are not currently candidates for APAP titration or treatment."

http://www.ncbi.nlm.nih.gov/pubmed/18220088

This discussion is turning into an autopap vs cpap discussion. Know that on autopap mode, the machine will not ramp up for approx. 10 seconds when an apnea is detected. This is to prevent the machine from chasing moments of holding your breath, a yawn, burp, etc... That means you will experience an apnea event for up to 10 seconds before the machine starts to treat it. I would bump your pressure up a .5 for a week or so. I like the cpap mode because I like idea of my windpipe being opened all night. It doesn't prevent me from having apnea events (I'll average about 2 or 3 per night). I feel much better in cpap mode. Somewhere down the line I would suggest switching over to autopap mode to see how you feel and see what your numbers are like. To me, I'll go with whatever makes me feel better during the day.

Sheriff

Sheriff Buford wrote:This discussion is turning into an autopap vs cpap discussion.

The value of APAP is well known to most of the regulars on this forum.

Sheriff Buford wrote:I like the cpap mode because I like idea of my windpipe being opened all night.

APAP settings will keep the airway open just as well as CPAP mode with the added advantage of running a lower average pressure.

jnk... wrote:From 2008, but still true, I believe:

"Patients with congestive heart failure . . . are not currently candidates for APAP titration or treatment."

http://www.ncbi.nlm.nih.gov/pubmed/18220088

Yeah. I found the long form of that publication in my archives.

http://www.ncbi.nlm.nih.gov/pmc/article ... .1.141.pdf


Den

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Wulfman... wrote:

jnk... wrote:From 2008, but still true, I believe:
"Patients with congestive heart failure . . . are not currently candidates for APAP titration or treatment."
http://www.ncbi.nlm.nih.gov/pubmed/18220088

Yeah. I found the long form of that publication in my archives.
http://www.ncbi.nlm.nih.gov/pmc/article ... .1.141.pdf
Den
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Interesting. Thanks to you both, I was not aware. One would think this would be included in the manufacturer's (in my case ResMed) statement of contraindications.
Here's a pretty good (I thought) overview of CPAP vs APAP. It is fairly recent and does mention patients with CHF as possible non candidates for APAP.
http://respiratory-care-sleep-medicine. ... etter.aspx

Last nights results using APAP

Really? Where are they?

Julie wrote:Really? Where are they?

Sorry about that....

fdw wrote:Last nights results using APAP

And.........?

( how do you feel? or, how did it feel when you woke up? )


Den

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Wulfman... wrote:

fdw wrote:Last nights results using APAP

And.........?

( how do you feel? or, how did it feel when you woke up? )


Den

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Worn out...I didn't get enough hours of sleep. Just one of those bad nights. I thought I'd share last nights results

OK. Just wondering. It appears that the Flow Limitations are what's driving the pressures.
If you find the pressure changes may be wearing you out or keeping you from feeling rested, you know what to do.
It would appear from that report that you'd also do well at a straight 13.
Is EPR set at "3"? You might even try experimenting with different settings there, too.


Den

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Wulfman... wrote:OK. Just wondering. It appears that the Flow Limitations are what's driving the pressures.
If you find the pressure changes may be wearing you out or keeping you from feeling rested, you know what to do.
It would appear from that report that you'd also do well at a straight 13.
Is EPR set at "3"? You might even try experimenting with different settings there, too.


Den

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Actually lowered EPR to 2 from 3, two days ago.

I don't think 13 fixed would be high enough, could be wrong. I will give it few more nights in APAP

Actually last night looked really good, however feel a little groggy..tired..this morning.

Not sure if the 2 wake ups were due to APAP of not?

fdw wrote:

Wulfman... wrote:OK. Just wondering. It appears that the Flow Limitations are what's driving the pressures.
If you find the pressure changes may be wearing you out or keeping you from feeling rested, you know what to do.
It would appear from that report that you'd also do well at a straight 13.
Is EPR set at "3"? You might even try experimenting with different settings there, too.


Den

.

Actually lowered EPR to 2 from 3, two days ago.

I don't think 13 fixed would be high enough, could be wrong. I will give it few more nights in APAP

Actually last night looked really good, however feel a little groggy..tired..this morning.

Not sure if the 2 wake ups were due to APAP of not?

For the vast majority of the night, it's not going over 13........except when you have a cluster of flow limitations and then the pressure bumps up.......and then you wake up.
So, that was the reasoning for my previous comment about 13 cm., and it still showed up in last night's report.
One of the things I look for in reports is the pressure where the least events occur. In my opinion, a few flow limitations are not worth the pressure increases......UNLESS they precede hypopnea or apnea events......which yours typically don't.


Den

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fdw wrote:I don't think 13 fixed would be high enough, could be wrong. I will give it few more nights in APAP

Agreed.

Your chart looks great. Regarding that cluster of centrals around 3:30, do you think you could have been awake or restless at that time?

It takes more than CPAP to get a good night's sleep. Here are some basics.

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps.
- Practice total abstinence of caffeine including sources like chocolate (sigh)
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Use the bedroom for sleeping (and sex) only, and make sure the bedroom and bed are comfortable.
- Optimize emotional stress in your life
- Use CPAP software to make sure your therapy is optimized
- If you still don't feel or sleep well, make sure you have regular medical checkups to confirm there are no other medical problems.

Sorry, if I repeated that.