First night...

jtech1 wrote:I seem to get clusters of CA and other events around pressure ramp ups.

Are you awake when this happens? If so they don't count. We call them SWJ Sleep/Wake/Junk. Awake events don't count even though they are flagged. Our awake/semi awake breathing is much more irregular than our asleep breathing and these machines only measure air flow (they can't tell if you are asleep or not) and sometimes awake irregular breathing will earn a flag but it's not real.

jtech1 wrote:1) Should I try a constant pressure one night for the hell of it?

Up to you. Typically a person has to use a higher pressure all night instead of part of the night when using fixed pressures to cover the "what ifs" that sometimes happen....like what if I need more pressure on my back or in REM or whatever.
You might like it though. For myself I sometimes need 6 to 8 cm more pressure in REM and I sure wouldn't want to use 15 or 16 cm all night just to cover the REM events. Using auto mode with min of 7 or 8 for the parts of the night not in REM is a LOT more comfortable.
Now you may or may not see wide changes in pressure needs and if you don't then cpap mode might work well for you.

jtech1 wrote:2) Is it possible that some people just do not get enough pressure or flow via nose? I have always had sinus issues... and am wondering if I should try a full face mask for comparison purposes. If face mask may work at lower pressure for me and be more comfortable?

Some people just don't like the air going straight up the nose. Some people don't like the air blowing all over the face that they get with a full face mask.
Sometimes people who use full face masks end up having to use more pressure to get the same job done than what they were using with a nasal interface mask. Sometimes 2 to 3 cm more pressure. Not saying that would happen to you but if it did you would have a lot of company in that regard.
Probably wouldn't hurt to have a full face mask available in the arsenal anyway in case you get a bad cold or something.

In my lab sleep tests (two over 9 years) I had one CA in each. So, I am pretty sure all the Clear Airway flags are either false alarms, pressure rise induced or awake events.

My wife and I are also in the process of replacing our mattress... 8 years ago we bought the top of the line Beautyrest Black mattress... and it was great for a couple years. Then started sagging. We know this is one of the causes of our constant toss and turn and wake-ups. Which then probably lead to the false CA indications and incorrectly high AHI. We are looking at a split king adjustable base and latex foam mattresses... I am hoping that a slight (6") head raise in the bed will help with sleep, reflux, etc. and also help to reduce wake-ups. So many inter-related factors!!!

I greatly appreciate everyone's input and experience here.

We have had an adjustable bed for ten years. We have the split queen size. We have a memory foam mattress that is reversible with one side medium and the other firm. We have always used the medium side. We are beginning to think about a new mattress for our bed. We will probably go with the memory foam again when we get the new mattress.

Very interesting development last night... I change the pressure to min and max of 9.0 as an experiment. I also put the Flex back to 2 (it was at 1).

When I woke up I glanced at the display and it said 5.6, so I assumed it was business as usual and no change from my average. Although I felt strangely better this morning... I popped the card into Sleepyhead and was amazed to see that I had only 3 CA, 1 OA and 1 Hyp all night with AHI 0.89! Then I went back to the CPAP and realized that when I woke up I was looking at the HOURS screen! (I know.. I need to get that closer to 8... First night I have ever been below 5.7 AHI.

I has 17 VS2 events. Only 2 RERAs.

I want to understand more about the 9 pressure pulse events and 6 periodic breathing events... although I don't think they are anything to be concerned about.

Setting the Flex to 2 also helped me feel more comfortable.

Trying to understand the smart ramp setting. I set min and max to 9. I also turned smart ramp off. And left mode in Auto. Does smart ramp ONLY come into play if I press the ramp button on top? Does the leaving the mode as AUTO with the same min/max do the same thing as changing the mode to CPAP? Or does that do something more? I want to make sure I completely understand what caused the significant difference in my AHI last night... if it was more than just disabling pressure changes.

jtech1 wrote:Does smart ramp ONLY come into play if I press the ramp button on top?

Yes

jtech1 wrote:Does the leaving the mode as AUTO with the same min/max do the same thing as changing the mode to CPAP? Or does that do something more?

It functions like cpap mode but in auto mode the Flow Limitation flagging is turned on....in cpap mode FL flagging is turned off.

Pressure pulses are just the machine sending little puffs of air to help it decided if the apnea event it senses happening is central or obstructive in nature. Pressure pulses may or may not end up resulting in some sort of flag. It might be wondering about something and send a pulse and then the apnea event not progress and meet criteria for a flag and nothing gets flagged. That's why people see pressure pulses when no even flag is around.


Periodic breathing is just a waxing and waning of the air flow that lasts for at least 2 minutes. Most of the time it means not much of anything.
It all depends on the wave form and are any events stuck in the middle of the waveform.

If it is short lived and looks like this...nothing to worry about.

OK. Learning every night... last night I tried the Bedvida. I do like the extra comfort at the nose compared to Dreamwear pillow, BUT, I was awake over 10 times struggling with the hose... and woke my wife up twice also... not good.

My AHI went back up to 5.26, but one thing I am noticing, is that I only had events at 3 times... with hours in between that were clean. At the event cluster times, my inspirations were much longer... so I have to assume I was awake at those times, because I do tend to breath longer when I am awake to get that filled lung feeling. So, it seems my numbers are directly related to how often I wake up... regardless of reason. I am going to search for some threads on hose management and see if I can get the Brevida to work for me. It was a little quieter than the Dreamwear pillow, but the main things I liked were a bit more comfort and NO annoying air stream in the front and back... but the hose issues with Brevida woke me up much worse than the air streams... but at least I should be able to fix the hose issues.

Tidal volume also seems to correlate well with when I an awake or asleep... and for how long. Do other people see this same correlation? ie. very short regular breaths when I am asleep... a spike or two when I roll over or have a brief awake moment, and a cluster of long breaths when I am fully awake for a while.

In fixed mode, I see that I only get VS2 numbers. I can't find any threads on what VS2 is detected by on Dreamstation... are they real snores or just internal vibrations that would have lead to snoring if I did not have the CPAP on?

VS2 is a mystery
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