Need help, suspect UARS. Want to try APAP - need advice and guidance.

Pugsy wrote: ↑

Fri Jun 01, 2018 4:41 pm

canyouhearmeaya wrote: ↑

Fri Jun 01, 2018 4:29 pm

As i'm going to be using the Airsense 10 Auto For Her, I believe this actually allows you to track RERA... so this should be useful as far as numbers are concerned for UARS shouldn't it?

Maybe...remember anything it flags is going to be what happened and wasn't prevented. There is no way to know how many of anything is prevented. Also remember these machines can't tell if you are asleep or awake so they can't with 100% certainty flag RERAs like can be done in a sleep lab with a tech watching your air flow and sleep status to see if the air flow reduced and you woke up or not.
Instead they measure your air flow and see if it LOOKS like the air flow pattern of a person who wakes up after a flow reduction.
It's a far from perfectly accurate measurement tool since it can't tell for sure if you are awake or not.

RDI of 15 is scored similar to AHI in terms of severity.

https://www.soundsleephealth.com/blog/f ... versus-rdi

http://www.mysleepapneamd.com/what-is-sleep-apnea/rdi

I see, so it's mild/moderate.

I suppose equally it's probably very individual? In that, you could have some with a mild AHI/RDI and seemingly express really bad symptoms, and someone with a severe AHI/RDI and actually potentially present less symptoms.. no?

It always makes me wonder, when you hear about these people being diagnosed with fairly severe sleep apnea, who claim they never had any reason to suspect it other than snoring. You'd assume someone with a condition that bad would be very acutely aware of it because i'd assume they'd feel awful!

So maybe it's very individual.

You are going to find that everything and I mean EVERYTHING that pertains to sleep, snores, sleep apnea, cpap, etc all come with a huge YMMV sticker. Everything highly individualized.
You don't have to snore to have sleep apnea either and snoring all by itself doesn't necessarily mean someone does have sleep apnea either.

Some people are "light" sleepers in that the least little thing disturbs their sleep and others can sleep through a freight train running through the back yard and not wake up. There are people with AHI of 100 and desats really low who say they sleep and feel fine.
We wonder how but that's what they say. There are people with AHI of 10 who feel like they were ran over by that freight train.
Everybody's reaction to everything can vary widely. It is what it is.

People can also just have crappy sleep in general and it not be related to any problem at all with the airway.

Pugsy wrote: ↑

Fri Jun 01, 2018 5:35 pm

You are going to find that everything and I mean EVERYTHING that pertains to sleep, snores, sleep apnea, cpap, etc all come with a huge YMMV sticker. Everything highly individualized.
You don't have to snore to have sleep apnea either and snoring all by itself doesn't necessarily mean someone does have sleep apnea either.

Some people are "light" sleepers in that the least little thing disturbs their sleep and others can sleep through a freight train running through the back yard and not wake up. There are people with AHI of 100 and desats really low who say they sleep and feel fine.
We wonder how but that's what they say. There are people with AHI of 10 who feel like they were ran over by that freight train.
Everybody's reaction to everything can vary widely. It is what it is.

People can also just have crappy sleep in general and it not be related to any problem at all with the airway.

I hear you. I woke up with that freight train feeling this morning!! Well, i'm really looking foward to trying the APAP when it arrives Monday.

Pugsy wrote: ↑

Fri Jun 01, 2018 5:35 pm

You are going to find that everything and I mean EVERYTHING that pertains to sleep, snores, sleep apnea, cpap, etc all come with a huge YMMV sticker. Everything highly individualized.

Some of the wisest words I've seen in a while.

canyouhearmeaya wrote: ↑

Fri Jun 01, 2018 4:49 pm

I see, so it's mild/moderate.

I never like the adjectives that are used. With an RDI of 15, you are being awakened 105 times in 7 hours of sleep. That's not mild/moderate in my book.

ChicagoGranny wrote: ↑

Sat Jun 02, 2018 7:02 am

I never like the adjectives that are used. With an RDI of 15, you are being awakened 105 times in 7 hours of sleep. That's not mild/moderate in my book.

Me either.
It's like being pregnant. You either are or aren't in my book.
But the medical community likes to use adjectives and numbers for whatever.....maybe because people seem to need them for validation of what they either are or aren't doing about something.

Pugsy wrote: ↑

Sat Jun 02, 2018 7:08 am

ChicagoGranny wrote: ↑

Sat Jun 02, 2018 7:02 am

I never like the adjectives that are used. With an RDI of 15, you are being awakened 105 times in 7 hours of sleep. That's not mild/moderate in my book.

Me either.
It's like being pregnant. You either are or aren't in my book.
But the medical community likes to use adjectives and numbers for whatever.....maybe because people seem to need them for validation of what they either are or aren't doing about something.

I agree with you both to be honest lol. That was my exact thought, that if you look at it from numbers, on my sleep test there were over 120 events. In my mind I figured if you can even categorize that stuff, surely that's certainly not mild. But I guess that's how the medical community works, everyone is so hugely different and variable that quantative numbers is the only way they can try and streamline the process (although all too often it doesn't work.)

You see the same in hormone testing.. they use the same range of what's acceptable when testing tesosterone for an 18 year old athlete and a 90 year old diabetic man (which in reality is LOONY). Most doctors aren't even willing to look beyond the numbers (In my experience). But, I guess that's why a lot of people don't get resolve to their health issues. But health is so infinitely complex, the time,care and attention people need to truly be diagnosed individually is too time consuming and therefor expensive.

That's a big reason I have such an approach of 'self diagnosis', which at times may be fooly, but equally no one knows how you feel but you, and if you can tune in to what you're feeling without the clouding of possibly false judgements, it can often be a great method to get closer to the root of the problem.

Thanks for all the support and advice so far all!! Will be sure to keep you all updated with therapy once I started Monday. Hopefully the APAP will be a healer!

Another question I had was:

My sleep efficiency on the study showed as 89%..
My sleep artchitecture I believe is good? 30.04% REM, 50.53% Light, 19.43% Deep.

RDI 15, Total RDI for the night was 129, and on that night I had 9 wakes recorded. Sleep latency 21 minutes, REM latency 69 minutes.

Is it possible to still have high effiency and good archiecture, and yet still bad quality sleep?

The Airsense 10 Auto For her has arrived! Exciting.

I just plugged it all in, set it up, chucked the mask on and it started lol! Certainly felt a bit off, inhaling was nice, but exhaling felt a bit difficult, only had it for a minute or so. Then realised how to get into clinicians menu..

So I'm going for Min Pressure 6, Max 10. EPR 3.

Do I want EPR on full time, or ramp only?

And should I leave ramp set to Auto? Also it says 'start pressure' is 4... should I change this up to 6? Or is that the point of ramp?

Also humidfier temp is 27, is that usually a good temperature? Do I literally just chuck water in the tank, fit the tank and then it'll automatically add humidification in?

First impressions, machine seems really good. Nicely made, easy to set up. Nasal pillows felt pretty comfortable, think I might get along with them nicely. Current got the Mediums on, might try the large just to see if it feels any betterr or worse.

On the settings above, min 6, EPR 3, max 10, I even tried setting start pressure to start at 6. Not sure exale feels any easier though.... feels like when I inhale I get a lot of air, but then struggle to breathe enough out, almost giving me the feeling I'm inflating like a balloon lol.

Do I need to try dropping the max pressure? On the screen the pressure doesn't seem to change from 6 at all (where it shows the current pressure), on inhale or exale it's constantly at 6 (whilst I'm sat here breathing normally just watching it.)

Also as I'm using Nasal pillows, is it SUPER important not to allow your mouth to open? Because when I tried it a few times just to see, it felt like the air was leaking out through my mouth, not sure how to explain the senstation but very weird and totally messed my breathing up.. Is that now Central apneas occur? Wondering if I should tape my mouth closed to begin with, as I'd hate to have the happen when sleeping, felt horrible!!!

Edit: Okay the pressure seems to be increasing now...it was 6.3, then 6.6, now its sitting at 6.7..

Also after using it for around 20-30 mins and taking the p10 mask off, it seems there is some moisture build up in the mask, presumebly from the humidifier? Is that normal? It's sat on the inside of the pillows. Is that risky for bacteria?

Turn the ramp off.
You can't feel EPR with ramp on because the ramp starts at 4 cm and the machine can't drop during exhale when it is already as low as it will go.

EPR ....full time

Leave the max setting alone. The machine may not even go there. It has nothing to do with your exhale difficulties.

Don't try taping your mouth right now. Instead try keeping your tongue in the roof of your mouth to keep air from going into the mouth.

The moisture in the pillows...some might be from the humidifier but some is probably from your own exhaled breath.
If you start getting a cold shower of mist out the vent holes you probably need to increase the heated hose air temp.
Slight dampness..no big deal.
Shower of cold mist..annoying but won't hurt you but you don't want it happening in the middle of the night. That's what we call rain out or condensation.

Pugsy wrote: ↑

Mon Jun 04, 2018 5:04 am

Turn the ramp off.
You can't feel EPR with ramp on because the ramp starts at 4 cm and the machine can't drop during exhale when it is already as low as it will go.

EPR ....full time

Leave the max setting alone. The machine may not even go there. It has nothing to do with your exhale difficulties.

Don't try taping your mouth right now. Instead try keeping your tongue in the roof of your mouth to keep air from going into the mouth.

The moisture in the pillows...some might be from the humidifier but some is probably from your own exhaled breath.
If you start getting a cold shower of mist out the vent holes you probably need to increase the heated hose air temp.
Slight dampness..no big deal.
Shower of cold mist..annoying but won't hurt you but you don't want it happening in the middle of the night. That's what we call rain out or condensation.

I dread to think what it feels like without EPR!! I feel like I'm really having to exhale fairly hard conciously to exhale.. I feel like when I'm sleeping i'll be exhaling so lightly I won't even exhale!!

Is this normal?

I've turned ramp off.

canyouhearmeaya wrote: ↑

Mon Jun 04, 2018 9:19 am

Is this normal?

I don't know what you are feeling so I don't know if it is normal or not.
I can't experience what you are experiencing and remember all this stuff is highly individualized in how they perceive something.
I use a starting pressure of 7 with 3 EPR and I don't even feel any work at all when I exhale.
Never have...even when I first started therapy I was using 8 cm with no exhale relief and it was only mildly difficult to exhale. I used to make a game of it as to how long I felt the resistance and it was always maybe 2 minutes tops.

The bigger the difference between inhale and exhale...the easier it is...usually for most people anyway.

With the starting pressure of 6 and EPR at 3 you are really only experiencing 2 cm reduction during exhale because the machine can't go lower than 4. Try 7 starting with EPR at 3 and see if it is any easier or not.

Just play with the machine while awake like reading a book or watching TV when you aren't under any pressure to fall asleep.
Just do it simply to get used to the new sensations that you are feeling.

Pugsy wrote: ↑

Mon Jun 04, 2018 9:38 am

canyouhearmeaya wrote: ↑

Mon Jun 04, 2018 9:19 am

Is this normal?

I don't know what you are feeling so I don't know if it is normal or not.
I can't experience what you are experiencing and remember all this stuff is highly individualized in how they perceive something.
I use a starting pressure of 7 with 3 EPR and I don't even feel any work at all when I exhale.
Never have...even when I first started therapy I was using 8 cm with no exhale relief and it was only mildly difficult to exhale. I used to make a game of it as to how long I felt the resistance and it was always maybe 2 minutes tops.

The bigger the difference between inhale and exhale...the easier it is...usually for most people anyway.

With the starting pressure of 6 and EPR at 3 you are really only experiencing 2 cm reduction during exhale because the machine can't go lower than 4. Try 7 starting with EPR at 3 and see if it is any easier or not.

Just play with the machine while awake like reading a book or watching TV when you aren't under any pressure to fall asleep.
Just do it simply to get used to the new sensations that you are feeling.

Yeah that's true! lool, you can tell the lack of sleep is getting to me.. asking stupid questions!! Thanks for your patience.

Sounds good, I will give 7min 10max a go with EPR 3 as suggested!

When I inhale I can feel some air blowing outside of the mask if I put my hands around it.. but when I exhale there's no air I can feel. Is it acceptable to feel some air? Or is that leak?