One Constant Pressure?

Raheel wrote:Pugsy, Please tell me how can I find when does Rem sleep occur in sleepyhead reports.

Unfortunately there is no clear cut way to see any sleep stages with any software because the machines can't tell tell us and the software can only report what the machine gathers.

Now some people have looked at enough of their flow rate (breathing pattern) to get an idea by comparing flow rate and maybe tidal volume or minute volume. I have never really seen anything that I could point to being an easy way to spot REM. What I do is compare when REM normally would occur and compare that to when I might see the pressure increase.
Remember I had a sleep study done in a lab so I had documented REM stage OSA worse.
When I would look at my reports I would almost always see a significant pressure increase about 90 minutes after sleep onset and that's when the first REM cycle normally happens (approx 60 to 120 minutes after sleep onset)...so I used common sense logic.
For the other REM stages in the night I would compare the pressure changes with a hypnogram which would show me when REM likely would be occurring.
See the hypnogram shown here.
https://en.wikipedia.org/wiki/Sleep#Physiology

As the night progresses we typically have more REM sleep...cycles more frequently and last longer so that means we most often have the greatest amount of REM in the wee hours of the morning.

See this thread for a screen shot showing some clustering in probable REM sleep when I was trying a fixed pressure on a new bilevel machine.
viewtopic.php?f=1&t=88508&st=0&sk=t&sd= ... ster+child

So with time and experience (looking at hundreds of reports) and knowing my own history...I can usually spot probable REM stage sleep if I happen to see pressure increases or a little clustering of apnea events.
It's not something that is always easy to see or clear cut though.

For me, I can tell pretty much exactly when I am in REM sleep. After the machine detects my sleep-breathing pattern, and ramps up, my respiratory rate becomes very steady. All of my rem sleep periods are indicated by a sudden jumping around and generally rising of respiratory rate, and waking is indicated by a slight lowering of the steady state respiratory rate combined with an increase in tidal volume.

Unfortunately, while this is very good for me figuring out when my sleep cycles are, and how many I have, my apnea is well treated in all stages of sleep, and I doubt the pattern would be the same if I was having a lot of events.

Cannuck1, You are absolutely right to experiment with different settings while monitoring the results in Sleepyhead, and I would also make a subjective judgment of how you think you slept and your energy level/sleepiness the next day.

Cannuck 1 wrote: epr@2
I always wanted to have a constant pressure( more natural)

I know I’m not the only one to experiment and asking for insight with one constant pressure.

Now for me, the pressure relief function (your epr@2) is the antithesis of a constant pressure and the antithesis of "natural" breathing. The pressure is going up and down with each breath! I cannot tolerate this.

Compare this pressure relief function to my APAP setting of min 12 and max 20 without pressure relief. I truly get a steady pressure throughout a breath. Any pressure changes happen smoothly over several minutes and the changes themselves do not disturb my sleep.

But, it is up to you to fiddle until you find out what is best for you and you alone.

ChicagoGranny wrote: Now for me, the pressure relief function (your epr@2) is the antithesis of a constant pressure and the antithesis of "natural" breathing. The pressure is going up and down with each breath! I cannot tolerate this.

This is not as absolute a thing for me as it is for you. I find that when I am just waking from sleep, the most natural breathing occurs at constant pressure, but that is because my breathing is slow and rhythmic immediately after I awaken. When I first get to bed, I find the highest EPR available (3) is best for natural breathing as there is no restriction to my normal (fairly random) breathing pattern. This is why I use ramp only EPR and autoramp.