Switching CPAP to APAP for diagnostics,....

I have been running 7cm with EPR of 2 the vast majority of the time since I have been on CPAP. Lately I have noticed a very slight uptick in 'obstructive' events, and I think I know the reason why.

My Cardiologist told me to start drinking a glass of dark red wine nightly to see if it would help raise my HDL levels along with fish oil. Being that I am not a drinker to begin with,.... I think that glass of Cabernet is having a bit of an impact on my sleep pattern.

I was thinking of changing my machine to Auto mode and setting a min/max of 6/12 with the same EPR of 2 to do a bit of investigating without making tiny changes every few nights.

Just wondering if those are good APAP settings to accomplish my goal, or if the experts here have any better recommendations. Thanks as always!

I don’t drink at all, for more than one reason, but what’s not stated is how aware your cardiologist is to you having sleep apnea, combined with how far before bedtime you are drinking it: knowing alcohol greatly affects sleep and sleep apnea, it seems reasonable that if you are going to drink, it should be done as long before bed as practical to minimize the chances of disrupting your sleep.

Another thing to check out is if there are supplements (resveritrol, IIRC) you could take to get the active ingredient(s) that are beneficial without the alcohol that disrupts.

If any doctor told me to start drinking--I would have some serious questions.
Substitute dark red or purple juices to get a similar benefit.
Obviously this doc would have a line out his door in Utah.

chunkyfrog wrote: ↑

Sat Jun 09, 2018 12:37 pm

If any doctor told me to start drinking--I would have some serious questions.
Substitute dark red or purple juices to get a similar benefit.
Obviously this doc would have a line out his door in Utah.

Everyone in Utah are Mormons: Mormons, Jack Mormons, and Non-Mormons!

The middle and last group wouldn’t get concerned about drinking beyond medical results.

On your planned auto settings I would set the minimum at 7 since that is what you are running now and are still having events. The top setting really doesn't matter since the machine will not increase unless it feels you need it. If you want to limit it to 12 and see if you even reach that pressure that's ok but if you see the pressure riding at the top of the graph you can increase it then. The minimum setting is the factor most important in controlling the events.

Now if these are central events due to the sedation, pressure increases will not help.

He is aware of my mild apnea, and it's not like he suggested becoming an alcoholic. He simply said I could 'try' drinking a small glass of wine several times a week, to nightly if I so desired until my next blood work is done. Absolutely no reason to 'suspect' my doctor at all,...he is extremely highly rated, and people travel for hours to see him.

My slight changes are in obstructive events, no change in centrals. Thanks for the info that has relevance to my question.

I would try the 6 minimum and 12 maximum if it were me.

Is it possible that you are ending up on your back more now than you used to?

Very small difference between 6 and 7 and with the machine allowed to raise if needed 6 might do the trick. You never know until you try and see the results. At least you know what needs to be increased if after a few days the events aren't lowered.

Pugsy wrote: ↑

Sat Jun 09, 2018 1:40 pm

I would try the 6 minimum and 12 maximum if it were me.

Is it possible that you are ending up on your back more now than you used to?

No Pugsy,.....I have spent about 85/90% of my sleep time on my back for quite a few years. My back is pretty bad, and that is surprisingly the most comfortable position for me. If I sleep too long on my sides, my low back and hips kill me when I get up. Stomach sleeping is not an option for me as it causes intense pain.

I thought I had read you mentioning the 6/12 setting for newbies previously, so that's where I figured I would start. Thanks for the verification.

Here is last nights chart with the new Auto settings. I have no idea why SH shows the pressure as 7cm under machine settings when it clearly shows Min 6 Max 12 at the top. It also shows the humidifier set at 4 when it was really 5, and it shows ramp off when it's set on auto. Oh well, must just be bugs in the software.

It knocked my obstructive events down nicely, and it only took a small amount over my usual setting of 7cm to do it. I assume that if I wanted to , I could just bump my setting to 8 or 9cm and go back to CPAP mode, or maybe I should leave it here for awhile,......possibly permanently? The machine didn't do anything that bothered me set this way.

The major leaks showing are mouth breathing. I already knew I had one of those nights when I woke up with very dry mouth at my 5am bathroom break. It's not very common for me, but last night I slept propped up due to what I had for dinner, and my GERD. Obviously your mouth is more prone to flop open that way.

That first central is SWJ for sure, and also not certain about the last two. The second one appears authentic to me based on a close up of the graph. I also noticed a spike on the snore graph which is rare for me, as that graph is usually flat lined. Judging by the pressure spike at the same time, it looks like the machine stopped an obstructive event like it's meant to.

As far as the 'centrals' go, there is nothing I can do about them,...if they are even real. Mine are always 10 to 15 seconds as a rule, and with them not stacked behind one another that's nothing of concern anyway.

Any input is welcome.

Machine setting statistics...buggier than all get out.
Disregard. Mine tells me the humidifier is disconnected....and of course it isn't.
That particular area of the statistics is well known to be buggy.

An occasional "real" central is actually normal to see and not a big deal. It's when we have a truckload of them that they are a problem and even if all your centrals were "real" there's still not enough to qualify for being a problem..

Your choice on how you want to proceed with your settings. If it were me I would give it at least 2 weeks just for my own education if nothing else. See what trends or patterns develop. I have nights where I barely see much of an increase in pressure needs but I do have some nights where the pressure wants to increase substantially for some reason. Since the varying pressures don't cause a problem with me in terms of sleep or aerophagia or whatever....I leave it in auto mode and trust the machine to sort it out and not worry about it.

Pugsy wrote: ↑

Sun Jun 10, 2018 9:55 am

Machine setting statistics...buggier than all get out.
Disregard. Mine tells me the humidifier is disconnected....and of course it isn't.
That particular area of the statistics is well known to be buggy.

An occasional "real" central is actually normal to see and not a big deal. It's when we have a truckload of them that they are a problem and even if all your centrals were "real" there's still not enough to qualify for being a problem..

Your choice on how you want to proceed with your settings. If it were me I would give it at least 2 weeks just for my own education if nothing else. See what trends or patterns develop. I have nights where I barely see much of an increase in pressure needs but I do have some nights where the pressure wants to increase substantially for some reason. Since the varying pressures don't cause a problem with me in terms of sleep or aerophagia or whatever....I leave it in auto mode and trust the machine to sort it out and not worry about it.

Since Auto mode didn't cause me any issues either, I think I will leave it as is for awhile, and see what develops as you say. If nothing changes much, I might just keep it here permanently since it let me spend most of the time at a slightly lower pressure than normal.

These type of pressure ranges are no big deal, but I don't know if I would be able to handle some of the high pressures I see used here by some members. I would almost certainly have to use a Bi-Pap if my pressure needs were to ever increase above say,...15 most likely. I am a 'light' breather when asleep, and I don't believe I could handle an EPAP of 12 or more.

Hopefully that never happens!

chunkyfrog wrote: ↑

Sat Jun 09, 2018 12:37 pm

If any doctor told me to start drinking--I would have some serious questions.
Substitute dark red or purple juices to get a similar benefit.
Obviously this doc would have a line out his door in Utah.

A lot of studies have shown that a moderate amount of alcohol consumption (not just 'red wine') (2 'drinks' a day) can have a variety of health benefits.

Agreed.
But to have a doctor say it seems a little . . .unusual.

chunkyfrog wrote: ↑

Sun Jun 10, 2018 2:06 pm

Agreed.
But to have a doctor say it seems a little . . .unusual.

.... enlightened.