New user, need sleepyhead help....PLEASE!!!

Actually I was thinking maybe 7 min and the 12 max.

I wish that there was something out there that was highly reliable in terms of accuracy to tell us sleep stages but there isn't really anything. The Zeo had some success but even it wasn't perfect.
Most of the other stuff now that say they can do sleep stages are using accelerometers (sp?) which just measures movement and movement or lack of doesn't equal sleep. I just don't have any faith in them.

Besides...even if you knew exactly what sleep stage you were in would it change anything?
Other than scratching a curiosity itch (which I admit feels good to scratch) how would it change anything? I have yet to come up with anything it would actually change in terms of what I did if I knew exactly what sleep stages I went to and how long, etc. What would I do different? How would I do anything different?
I did get a chance to use a Zeo once for about a week. It wasn't entirely accurate for one thing...gave me more awake time than I had but other than scratching an itch I didn't change anything or do anything different because of the data it gave me. We have zero control over sleep stages...so unless medications are involved there's not a damned thing we can do to change sleep stages nor really do we want to go messing with the normal cycles anyway. We need those normal cycles for the restorative magic powers of sleep to work their magic.

When you look at all the gadgets out there that claim to tell you how you slept...stop and think about how they work and what they measure and then step back and ask yourself "how can that really tell me what sleep stage I was in if it never even touches me".

Now I did use a Fitbit for a while (it up and died) and it wasn't all that far off in terms of restless sleep or not (wore it on my wrist so it uses an accelerometer) but it was easily fooled. It told me I did 7,700 steps when I mowed the yard on my riding lawn mower. The model I used didn't tell me sleep stages...just sleep or not.
When I would have a restless night (like from back pain) the Fitbit would show a few awake times...but then I already knew I had them because I woke up often from the pain. The Fitbit didn't really tell me anything I didn't already know.

So I don't have much faith in all those gadgets but if it feels good to scratch that curiosity itch then sometimes it's worth it.
Even if the poster above who was trying to guess sleep stages by respiration rate was right...what would we do with that information? How would it change anything?

The reason for the minimum of 7 thoughts...it's a small increase show shouldn't cause any problems in terms of comfort and I would be curious as to what might happen if the airway was maybe just a little better held open to start with. The max of 12...probably would be fine. I doubt you would ever go anywhere near it so it sort of becomes a moot point anyway.

Figured.

I guess I'm just wondering if there is a sleep issue besides (*potentially) sleep apnea...Its nuts because I feel like I sleep like a baby most nights only to wake up not feeling refreshed. Ok. Well, I'll crank pressure to 7 and 12 and see how it goes...Weird that last nights AHI was so much higher at a higher minimum AND I dont feel markedly worse than the day before (feel a BIT better actually)

Let me tell you a little story about me.
Back when I first started therapy it took me a few weeks to get the therapy pressure dialed in to optimal. I didn't get a good in lab titration study because I didn't sleep well...didn't get much REM (about 6 minutes I think it was) and REM is where my OSA is about 5 times worse (documented on the first in lab diagnostic sleep study) and I happen to need a LOT more pressure in REM. Both are common...REM worse OSA and need more pressure in REM...I did some experimenting with sleeping position and it was determined that for me sleep position didn't make any difference in the pressures I needed. Not unusual though...not everyone needs more pressure on their back or in REM for that matter.

So once I got the pressures dialed in and the AHI started to drop...the nocturia went away and the waking with the morning killer headaches went away but I still wasn't sleeping so great nor was I waking up a bundle of energy ready to take on the world (in all honesty I never did because I am not a morning person).
So I knew cpap therapy was working (because the nocturia and the headaches were gone) but the daytime energy level thing was elusive.
One day I woke up and felt a lot better for some reason and felt even more better as the day went on. This was about 3 months into my therapy. I felt really good. Back then I didn't look at the AHI from the previous night until the next evening. I didn't want to "cloud" how I thought I felt by seeing the numbers ahead of time.
So I went about my day thinking how good I felt and I just knew that my AHI was going to be real close to 0.0. I would have bet my last dollar on it. Then the evening came and I pulled the card and checked the software results...AHI of 10.3 yep...10.3 and I felt amazing all day. Go figure that one.
I had the "miracle" and AHI in double digits...made zero sense but it happened. I did sleep well that previous night or well for me anyway (other issues unrelated to sleep apnea that mess with sleep sometimes).

It never happened again and the number of "miracle" days I can say I have had in the past 7 plus years can be counted on both hands. A low AHI doesn't guarantee you get the miracle and a high AHI doesn't guarantee you get the crap award.

For years I pretty much accepted that "this is as good as it gets" and to be honest not having the nocturia or the killer headaches was a very welcomed improvement and remember I have other health issues that impact sleep quality so there was a good chance that those other issues also impacted how I felt during the day.
Then one weekend I went on a trip (maybe 4 years into therapy)...flew out to visit my daughter in Las Vegas and forgot to check the travel bag and I had robbed the travel bag of the long hose. Damn....Friday night on a holiday weekend at 11 PM and realized no long hose. No cpap that night.
Horrible night's sleep...woke often...peed often...woke with killer headache and pretty much zero energy and felt like total crap.
Went out and found the only place in Las Vegas open on Sat where you could buy medical supplies that carried cpap hoses...and paid $30 for a normal $6 cheap generic hose....and was happy to pay it.

I got a taste of how bad I could feel without cpap...up until that Friday night I had never gone without cpap unless I was sick with something (usually a stomach bug) so that I could really compare a before and after.
I had improved tremendously in terms of general energy levels....but the improvement had come upon so gradually that I never really noticed the improvement until I had the chance to go without cpap for one night.
Improvements do sneak up on us...so even though my "miracle" nights were few and far between I had been improving all along in areas besides the nocturia and the headaches.

Now I am not advocating that you go without cpap just to see how you feel but there will come a time sometime in the future where you won't use the cpap for some reason or other. You may end up just like me with a realization that you were a lot better off than you thought you were.

You know it can work...as evidenced by the "good" nights/days. We just keep trucking along trying to create more "good" nights if we can.

SleepyMcgee wrote:Adding both 'large' and 'huge' thumbnails as the 'huge' is a comfortable reading size in my browser.

the thing about doing the thumbnails properly is that you can click on them and get the full sized image....
so just do the 'large' one

Ok. Upped pressure to 7 min and 12.5 max. Feel better today than yesterday. Not a 'miracle morning', still a little foggy/fatigued. Data below. I had two drinks while watching the debate (how anyone can watch without a drink is beyond me ) but I understand that introduces another variable and is not considered good sleep hygiene. Without further adieu, heres the data:

Another night where the machine really didn't want to increase the pressure all that much yet we see some stuff we don't like particularly.

The drinks may or may not have played any part in things. A lot depends on how big they were and what time you drank them and your own body's metabolism.
Now the debate on the other hand..... depending on where your loyalties are....just kidding.

Keep these settings for 3 or 4 nights and report each day and lets see if we see any sort of pattern. Some of the clustering last night hints of REM clusters because of when they happen.
First REM is usually about 90 minutes after first sleep onset and then as the night goes on it comes on more frequently and lasts longer with the greatest REM in those wee hours of the morning right before we get up.

Strange for sure. I noticed a few times as I woke briefly in the AM that I was exhaling a bit through my mouth...I wonder if I do that during the rest of the night...I assume the machine would 'see this' and alert me to it in the data? I use nasal pillows....

SleepyMcgee wrote:Strange for sure. I noticed a few times as I woke briefly in the AM that I was exhaling a bit through my mouth...I wonder if I do that during the rest of the night...I assume the machine would 'see this' and alert me to it in the data? I use nasal pillows....

Maybe, maybe not.

To be clearer: It all depends on whether the "exhaling a bit through your mouth" is enough to trigger a larger than expected leak. Your total leak rate (the one in the graph) is just about what we would expect to see with nasal pillows at your pressure setting. So what that means is that your tongue is effectively blocking most of the air from escaping through your mouth, if you are exhaling a bit through your mouth for long periods of time.

To help sort out whether you might be doing a bit of unimportant "mouth breathing" you need to think about the answer to this question: Do you often or frequently wake up with a super dry mouth?

SleepyMcgee wrote:I woke briefly in the AM that I was exhaling a bit through my mouth...I wonder if I do that during the rest of the night...I assume the machine would 'see this' and alert me to it in the data? I use nasal pillows....

It should/would show up on the leak graph if you were doing it very much. Based on your leak graph I don't see it being very much and certainly no where near enough to impact the machine's ability to sense, record and respond.
These machines can compensate for a decent amount of leak no matter where it is from. You never even come close to large leak territory to earn a large leak flag. If you aren't getting a large leak flag then if you are opening your mouth and doing some mouth leaking/breathing it sure isn't very much.

I once did an awake breathing test with the mask and machine on where I breathed gently through my mouth.
I happened to wake up mouth breathing. Not enough to have a tornado exiting my mouth but gentle mouth breathing.
Since it was near time for me to get up anyway I figured it was a good time to do some known awake mouth breathing so I could see exactly what the leak line looked like. It barely made a blip on the leak graph. I have circled the known mouth breathing time on this report below. Not all mouth breathing equals a tornado of massive air pressure exiting the mouth. I had worse leak from some unknown reason earlier in the night ...slept right through it so I don't know what caused it but the for sure known awake mouth breathing at the end of the night showed only a barely seen little blip.

robysue wrote:

SleepyMcgee wrote: Do you often or frequently wake up with a super dry mouth?

never.

Pugsy wrote:

SleepyMcgee wrote:I woke briefly in the AM that I was exhaling a bit through my mouth...I wonder if I do that during the rest of the night...I assume the machine would 'see this' and alert me to it in the data? I use nasal pillows....

It should/would show up on the leak graph if you were doing it very much. Based on your leak graph I don't see it being very much and certainly no where near enough to impact the machine's ability to sense, record and respond.
These machines can compensate for a decent amount of leak no matter where it is from. You never even come close to large leak territory to earn a large leak flag. If you aren't getting a large leak flag then if you are opening your mouth and doing some mouth leaking/breathing it sure isn't very much.

I once did an awake breathing test with the mask and machine on where I breathed gently through my mouth.
I happened to wake up mouth breathing. Not enough to have a tornado exiting my mouth but gentle mouth breathing.
Since it was near time for me to get up anyway I figured it was a good time to do some known awake mouth breathing so I could see exactly what the leak line looked like. It barely made a blip on the leak graph. I have circled the known mouth breathing time on this report below. Not all mouth breathing equals a tornado of massive air pressure exiting the mouth. I had worse leak from some unknown reason earlier in the night ...slept right through it so I don't know what caused it but the for sure known awake mouth breathing at the end of the night showed only a barely seen little blip.

Thanks. Makes sense.

With my 95% being 7.4 last night...Think I should creep up the min to 7.5?

SleepyMcgee wrote:With my 95% being 7.4 last night...Think I should creep up the min to 7.5?

You could but you need to understand what the 95% number really is. It isn't where you spent 95% of the night.
The 95% number is just a number where you were at OR BELOW for 95% of the night. People tend to forget (or don't understand) the OR BELOW part of the definition. The bulk of your increases was simply the pressure pulses and not from the machine wanting to fight anything.

At some point you need to pick a setting and be prepared to stick with it for several nights and not change anything.
It's hard to do ...I know the knee jerk reaction is to keep making changes based on last night's report but we really need to be able to get a good overall feel for what a setting gives us and the only way to do that is to not keep changing stuff.

If you increase the minimum to 7.5...the 95% number will climb because of the law of numbers and not necessarily because the machine feels the need. If you try to use the 95% number as a yardstick as to what you need...it isn't a good yardstick because it is just a number that is a by product of the law of numbers and the machine's way it responds. The more you increase the minimum the more the 95% number will increase.

That said...going to a little higher minimum might be useful in terms of those clusters we see but the problem I have with that is we don't know if last night was a fluke bad night in terms of clusters or if it is something we would see night after night.

It won't hurt to try 7.5...but like I said...you gotta pick something and stick with it to give it a chance to see what it does over several nights. We don't sleep the same each night and unless the results are horrible I don't keep changing things based on last night's results and these results from last night weren't horrible and you have had "better" nights with less pressure...so was last night a fluke or were the better nights at less pressure the fluke?

So if you want to try 7.5...try it but be prepared to stick with it for a few nights unless something horrible happens (which I doubt will happen).

Data for last night. Feel VERY good this AM. Not perfect but pretty damn good. No idea why the key to the charts disappeared...?
EDIT: ARG, uploaded wrong pic. Heres the corrected link. Sorry.

Don't know what key you are talking about.

You reduced the minimum pressure??? I thought you were leaning towards increasing it. I don't really care..but just curious or is SH reporting wrong?

Pugsy wrote:Don't know what key you are talking about.

You reduced the minimum pressure??? I thought you were leaning towards increasing it. I don't really care..but just curious or is SH reporting wrong?

ugh. Wrong upload...Maybe I am still in a fog?!? Updated the link.