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

Imgur has been messing up lately when Large thumbnail is selected...it kicks to another image...so maybe it wasn't you.

I didn't even look at the data or I would have caught the fact it was an old report.

Glad you are feeling better today...let's hope we have more of these type of days.

Its bizarre that with almost identical AHI's there can be such a difference in how I feel...I'd love to be able to understand what the difference is...

AHI numbers simply don't always tell the whole story. We would like for them to but they don't.
They are a useful tool to help us evaluate things but they simply don't tell the whole story. Like that time my AHI was 10.3 and I felt amazing that day. Go figure.

There's more to getting good restorative sleep than just apnea events or lack of.
We can have an AHI of 0.0 and not have good quality sleep for some reason (known or unknown) and still feel like total crap.
I always say that a nice low AHI only guarantees a good math score...nothing else is guaranteed.
In some situations I think a really low (or 0.0) AHI means a person didn't get much sleep or maybe their OSA is worse in REM and for some reason they just didn't get much REM so the 0.0 might mean no REM and we need REM.

Pugsy wrote: There's more to getting good restorative sleep than just apnea events or lack of.
We can have an AHI of 0.0 and not have good quality sleep for some reason (known or unknown) and still feel like total crap.
I always say that a nice low AHI only guarantees a good math score...nothing else is guaranteed.

YES, YES, and YES.

When dealing with not feeling rested upon waking, we have to remember (in the words of Sludge and his various incarnations): CPAP does NOT fix bad sleep. All CPAP does is fix OSA. If there are any other factors contributing to the bad sleep in addition to OSA, then CPAP is a necessary part of getting a good night's sleep, but it is not sufficient to guarantee a good night's sleep.

Ok, been busy but wanted to post another nights. This was last night but I feel pretty much as I have for the last week...Which is, still fatigued. some days slightly better than others.

Any input? Thanks!

another night of data. Last 3-4 days no sugar (no sweets, desserts etc) and no night caps to try and isolate variables .I excercise daily so I'll keep that up...AHI keeps creeping up but I feel about the same as always...Fatigue but with a glimmer of hope...still not jumping out of bed (which is how I am when I have a 'great/miracle' night).

Looks like the machine is trying but not really keeping up with all of the hyponeas...Crazy how many I'm having...

SleepyMcgee wrote:Looks like the machine is trying but not really keeping up with all of the hyponeas.

It doesn't look to me like it is trying very hard if it were we would see the max pegged out at 13 and the highest it every goes is 10 and then only short term.

I don't know if we are dealing with REM or supine sleeping or both.
I know that the machine isn't responding as I would expect...don't know why and I guess it doesn't really matter why.

Feel like making a big jump just to see if it changes anything markedly?
I propose minimum of 9. Leave the max where it is...the machine is unlikely to go there anyway.
For some reason the slower gentler response is letting hyponeas slip past the defenses...so let's see if higher pressures all the time will prevent them.

Normally I wouldn't go with a 2 cm jump so fast but there comes a time when sometimes we just want a drastic change and see what happens...you can always go back down if needed. Your trending AHI isn't reducing...it's increasing and that's the wrong way.

Pugsy wrote:

SleepyMcgee wrote:Looks like the machine is trying but not really keeping up with all of the hyponeas.

It doesn't look to me like it is trying very hard if it were we would see the max pegged out at 13 and the highest it every goes is 10 and then only short term.

I don't know if we are dealing with REM or supine sleeping or both.
I know that the machine isn't responding as I would expect...don't know why and I guess it doesn't really matter why.

Feel like making a big jump just to see if it changes anything markedly?
I propose minimum of 9. Leave the max where it is...the machine is unlikely to go there anyway.
For some reason the slower gentler response is letting hyponeas slip past the defenses...so let's see if higher pressures all the time will prevent them.

Normally I wouldn't go with a 2 cm jump so fast but there comes a time when sometimes we just want a drastic change and see what happens...you can always go back down if needed. Your trending AHI isn't reducing...it's increasing and that's the wrong way.

I'll crank it up...Why not. Its crazy though...I had nights with 4 as my MIN that had 1/2 as many apneas...But as you said, maybe I've been sleeping on my back or whatever lately...

SleepyMcgee wrote:Its crazy though...I had nights with 4 as my MIN that had 1/2 as many apneas...But as you said, maybe I've been sleeping on my back or whatever lately...

Well....something is changing and since we don't know what it is nor can we likely prevent it then might as well try to ward it off...whatever it is.
It's not like we're looking at pressures in the upper teens here anyway..your pressures are relatively low and you have considerable room for increasing before it's likely to get too uncomfortable.
Might as well use a pressure that probably some nights isn't needed but on the other nights do a better job preventing.

In theory the APAP function should take care of that for you but for some reason the criteria, normally seen in conjunction with those hyponeas for causing pressure increases and staying up there,...isn't being met and the machine isn't changing pressures well enough for your situation.

Now if using higher minimum starts creating a problem the maybe we start digging deeper as to what might be changing to cause such a difference in pressure needs sometimes.

Cranked it up to 9 last night...Not sure what happened but I woke up middle of the nigth without the mask on. Looks like it was off for 1.5 hours or so...Also interesting...Looks like many of the events were directly preceded by a pressure spike...especially the RERA's...Thoughts? Feel about the same today.

You slept without the mask for about 90 minutes...I would expect you to not feel so great for that reason alone.
You can't really measure last night very well because you have one big variable there.

Those pressure probes..they look like spikes but they aren't really that much of a spike...they didn't happen nearly as fast as it looks like...zoom in on the pressure graph and look at the pressure line...it goes up gradually and comes down gradually.
Now does little slow change in pressure maybe disturb sleep? Dunno...maybe...maybe not.
I think at some time you might want to use a fixed pressure just to see if it helps or not. Some people say that they feel they sleep better at fixed pressures.

Your AHI is lower and there is really not much going on of any great significance...if you think you are going to try to end up with a totally blank events graph...don't go there in your thinking. It's unlikely to ever happen even if you cranked the pressure up to 20 cm. If nothing else the machine will flag some SWJ during a minor arousal and give you a few flags that aren't necessarily "real".

I throttled my pressure down to 8.5 from 9. I think the jump from 7-9 may be the culprit for me yanking the mask off the other night. Either way, mask stayed on last night. I feel meh today. Kind of a 'normal' day for me. Better than yesterday but certainly no improvement over how I had been feeling. Hyponeas continue at same levels...Frustrated. Full weekend of kids stuff ahead of me and I'm zombie dad. Good for halloween I suppose but a crappy way to exist.

I don't know if the varying pressures are contributing to maybe some low level arousals that might be impacting your sleep or not...they sure aren't varying all that much but it's worth considering going to a fixed pressure to see if it helps or hurts.
Just set the minimum to equal maximum and the pressure won't change. Don't go over to cpap mode..you lose FL flagging in cpap mode even though you really don't seem to be having a FL problem I wouldn't want to lose the FL flagging.

If you do this you are going to have to use a higher pressure..
Not sure how much but probably up between 9 and 10 or even a little more...I think I would start with 9.5 if it were me.

Just found this conversation - very informative and helpful process. You are so great, Pugsy. What a wonderful resource you are

Also I am super jealous of your sleep data that you put up!!!

One question for SleepyMcgee, just curious: about how long are your hyponeas? ie., 1 - 2 seconds or 3 - 4 seconds or what?

emmagoldman44 wrote:Just found this conversation - very informative and helpful process. You are so great, Pugsy. What a wonderful resource you are

Also I am super jealous of your sleep data that you put up!!!

One question for SleepyMcgee, just curious: about how long are your hyponeas? ie., 1 - 2 seconds or 3 - 4 seconds or what?

Agree on Pugsy +1000.

Not sure on my hyponeas. Will need to dig into them. What I do know if that there doesn't seem to be a connection between pressure and AHI so it's perplexing. There also doesn't seem to be much of a connection (for me) between AHI and how I feel the next day.

Living life as a zombie SUCKS but having a forum like this and people like pugsy is a good thing. Can't imagine going through this 50 yeas ago. Hell, 20 years ago.




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