why do I rip my mask off in sleep and cpap questions?

axxell6307 wrote:Is that any different than the pdf manual from the manufacturer I already have?

I don't know exactly which manual you have.

There are 2 main manuals.

The typical User manual...and the Provider/Clinical manual.
The provider manual has more details and information in it.

So last night I didn't get into bed so early. I watched tv in my chair for a couple hours instead of in bed. I was able to sleep 6hrs on my back with my mask on. Progress.... I still woke up every two hours. I'm thinking I wake up after every rem cycle. It's probably always happened to me because I can always remember my dreams... When I side sleep I fall right back to sleep though. Last night on my back, it took me about five to ten minutes to fall back asleep. I had to take another melatonin after my first arousal. That's still pretty discouraging.

I'm hoping I can train myself to get at least 7hrs sleep and only wake up once. Going to keep working at it, and after I get my new machine and see my stats, I may try a sleeping rx like lunesta. Right now, I only use melatonin.

axxell6307 wrote:So last night I didn't get into bed so early. I watched tv in my chair for a couple hours instead of in bed. I was able to sleep 6hrs on my back with my mask on. Progress.... I still woke up every two hours. I'm thinking I wake up after every rem cycle. It's probably always happened to me because I can always remember my dreams... When I side sleep I fall right back to sleep though. Last night on my back, it took me about five to ten minutes to fall back asleep. I had to take another melatonin after my first arousal. That's still pretty discouraging.

I'm hoping I can train myself to get at least 7hrs sleep and only wake up once. Going to keep working at it, and after I get my new machine and see my stats, I may try a sleeping rx like lunesta. Right now, I only use melatonin.

I also recall that in my sleep studies, almost all of my ahi's occur in non rem. Thus, I think when transistioning from rem to non rem is my problem. Hopefully the apap machine will fix me up.....

Having easy to obtain and review data may help the brain come to grips with things better.
You may be correct about the REM sleep stage wake up. It's normal to wake up after a REM stage but most of the time we go back to sleep and don't remember it.

Once you get the new machine let's see what that data shows. Maybe something is going on in terms off sleep apnea during that REM stage which is making the wake ups worse.
Did you know that it is common for OSA to be worse in REM sleep? My OSA is 5 times worse in REM vs non REM sleep.
Maybe your therapy isn't quite optimal for REM??? Maybe it is sub optimal treatment making for more wake ups.
This is where the data can maybe help us sort out questions.

A word of caution about the goal of only "one wake up". It might not be so easy and it might take a long time or it might never happen for any number of reasons. There's more to wake up causes and good sleep than just OSA.

While I'm here, I have a question for a friend. He's done one night at a sleep clinic and they told him he has sleep apnea and needs to go back for cpap study. However, they are dragging their feet and he's miserable. They also seem very shady. He is thinking of just buying this same dreamstation auto cpap. He has nasal problems so I told him he probably needs full face mask also. Are there any reasons for him not to do this? One thing I was wondering is if he ends up having more than osa, and perhaps mixed apnea, which includes some central sleep apnea. If so, would the Respironics dx500t11 still be an appropriate machine?

Also, what could an auto bipap do that this machine can't? The auto cpap has A Flex, C Flex, C Flex +, and supposed to automatically adjust for your pressure needs on inhalation and exhalation, so I'm unsure what's the difference???

axxell6307 wrote:Also, what could an auto bipap do that this machine can't? The auto cpap has A Flex, C Flex, C Flex +, and supposed to automatically adjust for your pressure needs on inhalation and exhalation, so I'm unsure what's the difference???

2 main differences.
1. Bilevel machines can go to 25 cm. Regular cpap/apap machines go to 20 cm. Only important if someone needs more than 20 cm.
2. Bilevel machines offer 2 distinct pressures...one for inhale and one for exhale and you can set so that the difference between inhale and exhale can be as little as 1 cm or 3 or 4 or 5. Now the cpap/apap has the Flex exhale relief which effectively can create a similar difference with a reduction during exhale but the most a person can get with a Respironics machine is 2 cm. Flex exhale relief is flow based...depends on how forcefully someone breathes but it has a maximum reduction no matter how forceful a person breathes.

BiPap is a Respironics marketing term for a bilevel pressure machine. It sort of has become a generic term but other brands have bilevel machines but they may call them something else.

Pugsy wrote:

axxell6307 wrote:Also, what could an auto bipap do that this machine can't? The auto cpap has A Flex, C Flex, C Flex +, and supposed to automatically adjust for your pressure needs on inhalation and exhalation, so I'm unsure what's the difference???

2 main differences.
1. Bilevel machines can go to 25 cm. Regular cpap/apap machines go to 20 cm. Only important if someone needs more than 20 cm.
2. Bilevel machines offer 2 distinct pressures...one for inhale and one for exhale and you can set so that the difference between inhale and exhale can be as little as 1 cm or 3 or 4 or 5. Now the cpap/apap has the Flex exhale relief which effectively can create a similar difference with a reduction during exhale but the most a person can get with a Respironics machine is 2 cm. Flex exhale relief is flow based...depends on how forcefully someone breathes but it has a maximum reduction no matter how forceful a person breathes.

BiPap is a Respironics marketing term for a bilevel pressure machine. It sort of has become a generic term but other brands have bilevel machines but they may call them something else.

Wow you sure know your stuff. Thanks.

Would like to clarify one thing though. When you say Respironics exhale relief max is 2cm, do you mean that it can only be a 2cm reduction from whatever the inhalation pressure is? Or that it can only go as low as 2cm total?

This is from an older Respironics model manual. I have not seen anything similar in the DreamStation manual but I have no reason to think that Respironics has changed how Flex works. Respironics has done Flex this way since they first offered Flex exhale relief.
The relief is from the inhale pressure and the machine can't go below 4 cm...and in fact Flex isn't even turned on until at least 6 cm is used.
You may need to right click mouse and choose view image to read it all...I can't make it smaller or linked because it is on a different website and I don't have the time to move it to imgur.

Got my dreamstation today and it's all setup. Can't wait to try it tonight....

Couple questions. I've looked and can't find it answered in my manuals anywhere. Is bluetooth REQUIRED or just an option? I connected it to my home wifi and would assume that it will send stats to dreamapper via wifi and I can see them on my app on my phone without bluetooth?.... Also, do you know how soon the data is available? Say I go to sleep at midnight and wake up at 7am, when would it show my stats on the app?

Will there be any problems since I did not enter any provider info. Will it be trying to upload stats to someone?

Do you know if I use my old hose, that doesn't have the same connector, do I lose any features other than heated hose?

I read that the unit has snore detection, however I don't see it in any of the menus anywhere on the unit. Would it just be included as an event and show up in my ahi?

Finally, I'm reading about the periodic breathing. Do most people have zero % of this? I've read your description of it in other threads as Periodic breathing is nothing more than a waxing and waning of the air flow". What exactly is waxing and waning? I'm wondering if I have that. When I first start falling asleep, I immediately feel my airways feel like they narrow and it's a slight suffocating feeling. Is that waxing and waning?

axxell6307 wrote:. . . a waxing and waning of the air flow". What exactly is waxing and waning?

Waxing = increasing; waning = decreasing. The terms are often used when referring to phases of the moon: waxing to full, then waning to new; but they can be applied to other things as well, like air flow.


Jean

I've set my min pressure to 7 and turned ramp time to 0. I prefer not having ramp as I don't put it on until I'm falling asleep. I'm wearing the mask while awake and holding my breath, coughing, and doing other things to simulate an apnea and the pressure is not leaving 7. Is something wrong? Or has the machine just not collected enough data from me yet as I've not slept with it yet...

axxell6307 wrote:Is bluetooth REQUIRED or just an option?

Just an option.

axxell6307 wrote: I connected it to my home wifi and would assume that it will send stats to dreamapper via wifi and I can see them on my app on my phone without bluetooth?.... Also, do you know how soon the data is available? Say I go to sleep at midnight and wake up at 7am, when would it show my stats on the app?

That's the way it works...I don't know how soon the data becomes available though. My suggestion is try it about 30 minutes after getting up and see if it's there...if not try again 30 minutes later...keep trying till it shows up.
If it goes like the past Respironics machines did...it probably will happen around Noon GMT time...not necessarily Noon your time (depends on your time zone).

axxell6307 wrote:Do you know if I use my old hose, that doesn't have the same connector, do I lose any features other than heated hose?

You lose only the heating part of it but just make sure that you have the hose diameter set on your machine to whatever your old hose is.
It makes a difference in your therapy and how the pressure is delivered...so don't have a slim line hose setting with a regular diameter hose.
Now losing the heated hose part affects humidity....with the heated hose you can keep a more consistent humidity delivery.
So there's some advantages to the heated hose besides just helping prevent condensation.
I mention this because the default humidity delivery system on this new machine is totally different from what you used to use (if you used a humidifier) and the settings won't equal the same as what you were getting on your old machine. These newer machines don't put out the moisture that the older machines did...at least in the default setting. So be careful...you could inadvertently really dry out your nasal mucosa.

axxell6307 wrote:I read that the unit has snore detection, however I don't see it in any of the menus anywhere on the unit. Would it just be included as an event and show up in my ahi?

It measures vibrations and shows up in the software reports only. Won't show up anywhere else.

axxell6307 wrote: Finally, I'm reading about the periodic breathing. Do most people have zero % of this? I've read your description of it in other threads as Periodic breathing is nothing more than a waxing and waning of the air flow". What exactly is waxing and waning? I'm wondering if I have that. When I first start falling asleep, I immediately feel my airways feel like they narrow and it's a slight suffocating feeling. Is that waxing and waning?

rise and fall of the respiration pattern.
See the stuff in green...that's PB flagged breathing...and it's barely PB


See the green stuff in this one.. it's barely PB also.....then look at the flow rate that isn't in green..mainly the 2 top rows...that's normal breathing. Don't worry about PB unless you start seeing a lot of it...if you do then we have a more in depth chat about it. It's normal to see a little or none and isn't a problem unless there's a lot of it and it has a more marked waxing and waning pattern. It's unlikely we will need to have that discussion.

Night one:

2.8 hrs used. 100% mask seal. 7.8 ahi. zero periodic breathing. 90% was at 13.

I had my min pressure set to 7. I think I need to raise my min to 9 to try and lower that ahi a bit?

The stats on lcd screen are only thing available now so I can't see my max and min pressures reached yet. So far, pretty happy with it. I'm surprised my pressure need has gone up. In 2008 during my first sleep study, I was at 9.

axxell6307 wrote:I had my min pressure set to 7. I think I need to raise my min to 9 to try and lower that ahi a bit?

Most likely..yes
BUT what is that AHI made up of? If it is mostly OAs and hyponeas yeah, raise the pressure minimum
BUT if mostly Clear Airway events then no...raising that minimum won't help and might make things worse.
Unfortunately the on screen data doesn't tell you what the AHI is made up of and that's why we use the software.

Pugsy wrote:

axxell6307 wrote:I had my min pressure set to 7. I think I need to raise my min to 9 to try and lower that ahi a bit?

Most likely..yes
BUT what is that AHI made up of? If it is mostly OAs and hyponeas yeah, raise the pressure minimum
BUT if mostly Clear Airway events then no...raising that minimum won't help and might make things worse.
Unfortunately the on screen data doesn't tell you what the AHI is made up of and that's why we use the software.

Dreamapper will tell me what kind of apneas I had. However, it still has not updated yet on my app or web browser....

It's 12:15pm my time and i did set the time correctly on my machine. Not sure why it's not updated yet.