baby dino's casa de los suenos, increasing ahi

Cynmatthes wrote: ↑

Sat Dec 29, 2018 9:49 am

Thanks. I bumped it up to 10 last night and ahi went down the 4 something range. I will post the data a little later. I do not like the higher pressures so when I get used to the 10 I will bump it to 11 and so on. Hopefuly I won't have to go to high.

Sometimes, I've seen it where people have clusters of events even at higher pressures, like you're having, but raising the min pressure has had the effect of, for want of a better term, heading off the clusters, stopping them from getting started.

It doesn't seem to make sense, but it's something I've seen multiple times with people, they're having repeated events around 20-25 pressure, but raise the min enough, and whatever condition is causing those doesn't get started.

Hopefully, the same will apply to you, and you'll get used to the pressure required and be ok with it.

That last chart looks quite a bit better actually,....think you're on the right track.

I just wanted to warn you about the Amara View, at the pressures you seem to require. I tried one, and couldn't get the thing to not leak badly at even my initial 8cm setting. Many others here have had the same experience, so make sure you have the ability to return it if you buy one, or see if you can borrow one again. Don't get me wrong, it's a nice mask, it's just got a reputation as being difficult to control the big leaks.

I used the Amara View for over a year and my pressure runs from 17 to 20 cm. It can be a little hard to adjust for some people, but I really didn't have too much trouble with it.

Thank you everyone. I seem to be geting the issues with the f-30 worked out and I really like that mask it is very comfortable and doesn't wake me up with rude noises it just fits better than the dream wear ever did.

I will try bumping the epap pressure to 11 tonight. My chest was sore this morning from the 10 but it went away fairly quickly.

If pugsy has an Amara view I could try, I might ask her when she is back from the holidays. I still have the N-20 to try at night. I have tested it during the day while I am awake but not at night. I have only 30 days to decide if I am going to keep the F-30 so I want to see if I can get that dialed in first.

Thank you all for the help!

I suspct the sealing of the Amara View depends on the shape of the nose.
Many people use it successfully but I could not get it to seal at a low pressure of 6. I even tried a different sized cushion an i did not help.

And that is why I choose the F-30 to try. My face does not fit the dreamwear and I was afraid the Amara View would be the same.

Bumping up the pressure last night was a disaster. Glad it was the weekend and I could sleep in. I tried 11 epap and couldn't sleep then changed it to 10.6 figured I would try in smaller incriments. That let me fall asleep but the leaks were terrible so I adjusted and adjusted. Finaly got the leaks to stop and fell asleep sometime early this morning. Will have to see if I can isolate that data because over the whole night. I imagine most of it was swj from not really sleeping and sitting up reading when I couldn't sleep.

Cynmatthes wrote: ↑

Sun Dec 30, 2018 11:02 am

My face does not fit the dreamwear and I was afraid the Amara View would be the same.

The DreamWear is really not all that different in terms of overall shape than the Amara View. I have used both and the DreamWear to me was just an improved version of the Amara View...little softer and little less profile.
The Amara View has been out for a few years...the DreamWear released late spring of this year.
The headgear is different but the cushions are very similar. If you don't like the DreamWear cushion...I doubt you will like the Amara View cushion.
And no...I don't have the Amara View available for donation now. I have some cushions but not the other parts needed to make a complete mask.

Amara View on the right


Amara View on the top


Amara View on the top and from the inside which would be touching you skin

Pugsy thanks, that is what I was afraid of with the Amara view. The F-30 just fits my face better, when I get it adjusted right. The higher pressure seems to be jumping up the centrals. It looks like 10 might just be the magical epap number for me and I will have to live with a little bit higher AHI. night before last was the best data I've seen. Last night was terrible

The pattern of your OA/hyponea clustering makes me think of REM stage sleep.
Of course you might be on your back but the pattern sure looks like REM pattern to me.
I see this pattern often myself...documented REM worse OSA...like 5 times worse in REM than the other sleep stages.

Some of the centrals might not be real centrals but instead SWJ centrals caused by arousals from the clustering of obstructive stuff.
So don't assume that it's the higher pressure causing the centrals. They may not even be real centrals.
And double the chances of SWJ flagging if you are waking often with mask leaks or comfort issues.

I think we have had this discussion before....how good are you at figuring out awake vs asleep breathing?
http://freecpapadvice.com/sleepyhead-free-software
I think it was Greek before....any chance less Greek now?

I think its less greek, I look for even breathing before and after?

This would be SWJ?

While this is real?
This started off with a real one and turned into SWJ?

Welcome to the world of "iffy".
Sometimes not always easy to tell the difference between asleep and awake and real events or not.

Top one looks like all SWJ to me.

Middle one looks like SWJ to me also. The big gulp preceding the CA flag...makes me think maybe a turn over in bed big gulp of air and hold your breath kind of thing. Then very irregular breathing preceding the flagged OA...so maybe some sort of arousal that you may or may not remember and then the post arousal flagged OA and you went right back to sleep.

Bottom one...that's the more iffy one to me. Obviously asleep and then some irregular breathing after a little reduction in air flow that didn't earn a flag. Probably didn't last long enough to earn the flag but maybe it still caused an arousal. So the little reduction in air flow preceding the flagged stuff...that might be real and it disturbed your sleep and caused the arousal and thus the subsequent flagged events which also don't look all that real but also not all that awake either.
Interesting to note that it all happens right at the end of a prolonged period of large leak which makes me wonder how much of an impact the leak itself had on the sleep quality....like did the leak cause the arousal????

What you might do is go through each event and make a list...real...not real...iffy
and then see what removing the not reals from you AHI does to the numbers...then also remove the iffy ones and see what that does.
Remember...centrals/CAs we don't even try to fix with more pressure no matter if real or not.
It's only the real OAs and hyponeas that we can try to reduce with more pressure.
I have had nights with the AHI nearly 4.0 and every single event was NOT real. They were all related to either post arousal or awake breathing. The false positives can be in any category and not limited to centrals.

If your AHI of real obstructive stuff (OAs, hyponeas) is relatively low after you removed the SWJ then maybe you simply don't need more pressure but instead just need better sleep. Especially since it seems that more pressure just causes more sleep disturbances can crappy sleep in general.
We have to get the sleep first before any of this other stuff really matters.

Some time ago I had a chance to help out a guy whose AHI was running 20ish...lots of everything going on there and I was sort of at my wits end trying to figure out what to offer until he let it sleep that he was spending LOTS of time laying there with mask and machine on and he was awake. Major insomnia issues going on which presented it's own challenges of course.
Took some work and some meds and finally got him sleeping fairly soundly and his AHI dropped to less than 2.0 and that's with zero changes in pressure. Over 90% of his flagged events were SWJ.

My suggestion to you right now....worry about mask fit and leaks and fragmented sleep first.
Worry about pressure needs later once the other factors are better managed. IMHO you have enough SWJ going on that it is clouding the pressure needs standpoint especially since more pressure seems to make your sleep quality go further in the toilet right now.

Yes, you may need a little more pressure but you also might not and doing more right now causes more problems than it is fixing.

Besides...I would really like to see what your pressure needs are with a nasal interface mask....did you know that often people who go from a full face mask to a nasal interface mask can go with a lower minimum pressure to get the same job done as a higher minimum?
Sometimes as much as 2 or 3 cm difference and that can be huge in terms of comfort and sleep quality.
I can't guarantee it for you but the odds are that if you can use a nasal mask that you could get by with less EPAP minimum. Win-Win.

Ok tonight I will put the pressure back to 10 and see if I can get the leaks adjusted better. Hubby works tomorrow so I won't try the mask switch but he has New Year's day off so I will switch the mask tomorrow and see how that works.

Last night was terrible. I wound up taking off the F-30 and going back to the dreamwear. I couldn't get comfy, couldn't sleep. So this afternoon I took a nap and used the n-20 that pugsy sent me. 0 leaks and 0 ahi. Yay! Will see how it goes tonight when I fall into a deep sleep.

Cynmatthes wrote: ↑

Mon Dec 31, 2018 7:40 pm

Last night was terrible. I wound up taking off the F-30 and going back to the dreamwear. I couldn't get comfy, couldn't sleep. So this afternoon I took a nap and used the n-20 that pugsy sent me. 0 leaks and 0 ahi. Yay! Will see how it goes tonight when I fall into a deep sleep.

Sounds encouraging on the n-20. Best of luck tonight!