Anyone got a clue on this one

roadwarrior · Post by **roadwarrior** » Tue Aug 08, 2006 7:05 am

I realize I'm flying a bit blind wiithout the help of the Encore to reveal something here, but I'm curious to hear some input of ideas. I noticed, after setting my limits of my REMstar Auto at 8-15 that of course it starts out at 8, but when I awake in the morning I've been looking at the pressure it is settled upon at that point. It has varied anywhere from 9 to 10 to 15. I've been fighting off some kind of cold or respiritory thing so my sinuses were less than perfect last night. However fairly open as I did the saline spray and some Zicam to ward off any potential virus (it has worked for me over the last few years). It was on 15 this morning. Any ideas as to why it will go so high like that? I was originally titrated at 9 as the high point of what was necessary to avoid apnea events. Just curious to hear some input here our ya'lls experiences.....

oldgearhead · Post by **oldgearhead** » Tue Aug 08, 2006 7:09 am

Body sleep position comes to mind. For me, the pressure delivered on my back is about 3 cm/H2O higher than on my side...

Wulfman · Post by **Wulfman** » Tue Aug 08, 2006 9:52 am

roadwarrior,

Is it chasing your snoring?
On your charts, do you have snore "ticks" at about the point that the pressure goes up? That's what mine was doing.

Den

Goofproof · Post by **Goofproof** » Tue Aug 08, 2006 9:57 am

My guess would be leaking and snoring, congestion triggered. A FF Mask by-passes most problems. Jim

Snoredog · Post by **Snoredog** » Tue Aug 08, 2006 10:33 am

I agree with Wulfman, probably chasing snores.

Sometimes the snores seen are NOT the type that precede an apnea event such as nasal or palatal snores which can occur with just the air moving over it.

Snores can be ignored in a PSG if they are not causing arousals where your 9cm was found. I would limit your Max. to 10cm if it is waking you. No reason to let it run to 15cm. If your original titration was 9cm, you would probably be better using a range of 7cm to 11cm.

roadwarrior · Post by **roadwarrior** » Tue Aug 08, 2006 12:40 pm

My wife tells me I no longer snore at all. I am using a nice tight ResMed Sullivan chin strap that has been great for me. NO slack whatsoever. As for the pressures, I think I'll go ahead and try the 3 below and 3 over idea (in my case 6-12) for the pressure settings and see how that goes. Experimentation is the name of the game when not using the software anyway. I can't wait to get that going however just so I"m not playing such a guessing game.

Wulfman · Post by **Wulfman** » Tue Aug 08, 2006 1:40 pm

roadwarrior wrote:My wife tells me I no longer snore at all. I am using a nice tight ResMed Sullivan chin strap that has been great for me. NO slack whatsoever. As for the pressures, I think I'll go ahead and try the 3 below and 3 over idea (in my case 6-12) for the pressure settings and see how that goes. Experimentation is the name of the game when not using the software anyway. I can't wait to get that going however just so I"m not playing such a guessing game.

OK.....but what does Encore Pro tell you? Encore Pro listens to you all night, your wife may not be able to. It could be killing the snores that it THINKS it hears, but is still bumping up the pressure in the process. See what I'm getting at?
Many people say that just the chin straps don't keep you from mouth leaking, either. It could also be bumping up the pressure because of mouth leaks. You may not know unless you tape, Polident strips or full face mask it.

I wouldn't mess with the pressure for the time being, unless you want to lower the top number a notch or two.

Anyway, keep an eye on your software.

Best wishes,

Den

linda b · Post by **linda b** » Tue Aug 08, 2006 1:52 pm

It is my understand that the auto will raise the pressure to whatever pressure (within the set range) is necessary to stop an apnea/hypopnea and then stay there for a little while before coming back down. Could it be that you had an apnea occur just before you woke up or even that the apnea itself woke you up?

Moogy · Post by **Moogy** » Tue Aug 08, 2006 3:08 pm

I was titrated at 15 cm, but there are many nights that EncorePro shows me running at 19 or 20 cm for a long time, usually later in the night to early morning. However, if I stir in bed for a while, the pressure will show a drop, probably because I am mostly awake for a bit before taking off the mask.

My own high pressure does NOT seem to be related to snoring, an issue mentioned by other posters.

My guess is that I actually NEED that much pressure sometimes, esp. during deeper sleep. During the titration, they only tested me for about 5 hours, then woke me up to leave, so they never got to the really late part of my sleep period. I think the auto can regulate my pressure better than a one-time sleep study. The high pressure doesn't bother me, possibly because I have a BIPAP, so there is substantial pressure relief on exhale.

I do have EncorePro and MyEncore, so I can tell that the auto feature is working for me.

Without software to record your pressure, it is hard to say whether your own pressure is running high for a long time or a short time, regularly or just once in a while. I recommend that you get the software and track your own therapy.

Just my own opinion and experience, take it or leave it. .

Best Wishes,
Moogy

Wulfman · Post by **Wulfman** » Tue Aug 08, 2006 3:39 pm

Sorry about that roadwarrior.....I either didn't read your FIRST sentence or not well enough.

My bad!

Den

roadwarrior · Post by **roadwarrior** » Tue Aug 08, 2006 4:31 pm

Yes well.....as I said as soon as financially possible I will ante up for the software and card reader. Until then I am a bit of shooting in the dark. However one thing that has been brought to light here is that indeed I have been doing a LOT of dreaming lately RIGHT before I find myself getting up for the morning (around 6-6:30am) so indeed there is a strong possibility I am having a apnea attack at around that time and the machine is kicking it up a notch. Only time (and the software) will tell I guess. In the mean time I'm still waiting for someone to try that darn new Mojo FF mask so I can see what mask I'm buying next.

elliejose · Post by **elliejose** » Tue Aug 08, 2006 5:32 pm

roadwarrior,

I am not sure why it happens, but like you and Moogy, my pressure goes up higher in the early morning (like between 2:30 am and getting up time.)
Some nights my 90% pressure is 19 or 20 and nights when I go to bed fairly rested and with no allergies my 90% may just be 12 - 14. That was on Remstar Auto /c-flex. Had a new titration study and got my new bipap yesterday. Not what I wanted but all I could get at the moment. (Bill My Insurance checked with my insurance and I cannot get it thru them - I must rent for 10 months to own.) Got a Bipap Plus /Biflex set at 15 ipap, 11 epap. Don't see one of those for sale on any sight, but that is what it is. Anyway, what I am getting at is that I woke this am about 3:30 starved for air. Sucking for some air that wasn't there. I finally just took my mask off because I could not get enough air to return to sleep. I don't think I can do it this way. However I will give it a few more nights. My problem and reason for switching to bipap was aerophagia and so much trouble exhaling when my pressure was higher. So do be thankful, that you have the auto; I may have to switch back to mine if the same thing happens tonight.

As Moogy said, as soon as you can, get the software. IMHO it is money well spent. Like you, I would like to know the reason for the pressure going up, but what Moogy says makes sense -- deeper sleep in the am. However, mine also sometimes only rises after I am awake in the am. If I lie in bed hoping for another nap, frequently mine will rise to 20. Now I really don't have an answer as to what may cause this.