Sleepheros sleep-improvement Thread

[RRR]

Thanks Hosecrusher - It appears Fitbit analyzes sleep stages with a combination of movement and heart rate variability. It sounds like using a beta-blocker would alter heart rate variability and make the analysis inaccurate.

Thanks,
RRR

[sleephero]

Looking better....now tonight try 11 minimum with the 20 maximum...probably will need around 12 finally but lets see what 11 minimum does.

Ok, here is the result.

[Pugsy]

The idea was to bust up the clusters...and that happened but not as much as I wanted or hoped.
Some parts of the night you need a lot more pressure than other parts of the night. When we see this happen there are usually 2 potential suspects.
REM stage sleep pressure needs and/or sleeping supine or maybe a combination of both to give a person the double whammy.

How did you sleep last night and how do you feel today?

[sleephero]

I wouldn’t say it was a restful sleep. I ate some air that produced some gas in the morning.
Also the mask needs to be tighten a lot to have it leak free - that is also not comfortable.
I know that the Fitbit is only a inaccurate tool but it shows that I not had a lot of Rem and deep sleep.
In the Initial SL diagnosis they diagnosed with me with REM worsened OSA. I also know that sleeping supine is a problem for me as I have already tested it out with a T-shirt with airpack. My problem is I can’t wear it all night
As i get some back pain in the morning.
I was maybe also thinking if I should get such neck bracelet or head strap to keep my mouth shut and not falling down when I am in back sleeping position.
We could try the T-shirt this night again to see what’s happening since I used it last in December I was doing some muscle build up so maybe I can sustain the T-shirt now the whole night. I also have this other mask here now to test (amara view).

Also we can exchange the pillow I am using the Resmed Cpap Max contour pillow.

[sleephero]

Here is the result from last night. I was wearing my backpack T-Shirt.
Woke up around 4am-5am and needed to move position.

[Pugsy]

Just how comfortable is this TShirt you fixed up?
How'd you sleep in general last night and how do you feel?
I have been doing some experiments to keep me on my side lately. Not because of the sleep apnea stuff but because of pain stuff.
I cannot imagine wearing something that causes me more discomfort so I have been using a buckwheat hull pillow placed behind my spine to keep me on my side more. Decent enough results depending on where I put the pillow (lower spine vs higher up).

I see a therapy break at 00:20......were you asleep prior to that break?

[sleephero]

Just how comfortable is this TShirt you fixed up?
How'd you sleep in general last night and how do you feel?
I see a therapy break at 00:20......were you asleep prior to that break?

The T-Shirt itself is not an issue right now. It may be an issue during summer time when it is getting hotter.
The problem this night was that around 4-5 I woke up because of pain from side position which forced me to sit up and turn to the other side
If i could sleep completely through the night it may be better.
How did I sleep ? To be honest I don’t know. Is there an improvement? I would say yes but it’s really hard to quantify. I don’t want to do jumping jacks in the morning and generally my mood isn't "happy". Let’s say I would expect much more from this therapy.

Yes I was asleep at 22:30. I have no idea what happened at 00:20. It happened in the past that when my wife came into the bedroom that I got awake accidentally and thought because of the low pressure that the machine is not activated and then I am turning it off. But my wife assured me that she came at 23:20 into the bedroom.
(and no, there is no day-light saving shift, the times look all right in the graph).
Maybe the Wifi turned off during that time and and so the Toshiba Flashair got stuck for a while ?

Probably this night I will try to fall asleep on the "other side" (no doors reference here ) then last night and see what's happening.
The next day I probably will start exchanging my mattress through the other in my home. Maybe there is one that fits better to me and thus allow me
to sleep side position the whole night without getting pain.

[Pugsy]

Were you by chance hoping that using cpap would let you feel 30 years younger with better sleep and more energy and fix all your aches and pains? I know that is what I was hoping would happen and it was a bit of a disappointment to me to realize that it wasn't going to happen. Not all our sleep problems come from sleep apnea. Not all our other health issues are related to sleep apnea. Not everything can be fixed with cpap and nice pretty low numbers.

I got maybe 5 hours of sleep last night....short night but not related to cpap or sleep apnea at all. I feel sort of "okay" I guess but far from wanting to kick ass and take names that I want to feel like.
I don't feel like I want to run a marathon but at least I don't feel like I just ran that marathon and got run over by a bus at the end of it.

It's been coming on 10 years now that I have been using cpap and my sleep quality is still fragile but I accept it and realize that not all my problems can be fixed by the cpap. So I just keep working on sleep quality as best as I can.
I have to take meds that mess with my sleep but if I don't take those meds then other stuff messes with my sleep...damned if I do and damned if I don't kind of thing so I have to choose which one is worst.

[sleephero]

Generally speaking you are right.
Now at the end of the day I think I felt better today compared to the day I wrote I feel like sh/t.(ahi 12.)

BUT

I am not giving up so fast.

I know that I have a long journey in front of me as well as I have already a long journey behind me.

Just a few things that I already „fixed“ since my „I have to change my life otherwise I will end as my father day“:
- lost 30kg in last 3 years (15kg still to go)
- had low vitamin D and iodine issue - fixed
- had high Cholesterol values - fixed by diet
- reduced my blood pressure pills significantly (2.5mg Ramipril left, I am sure end of year I get rid of it)
- Improved general fitness by weight and cardio training

So the only thing left is the sleep. My main wish is that the concentration and mood(stay relaxed with the kids) over the day should improve.
I know it can happen as I at least experienced it a few times since I have the Cpap stuff.
Also the kids recognized it that sometimes I was more „relaxed“ during the day.

I know things can’t be fixed in one night but for sure I will be patient and continue with trying to get it solved and always be open to ideas.
(I am still hoping that it is getting really better when I get rid of the last 15kg)

That being said, today is backpack sleeping on left side and I need to move my wife’s pillow to the end of the bed as she is complaining about the airflow from the mask.

At least that is easily Solveable

[sleephero]

Ok, here we go for last night experiment.
I slept on "left side" until the restroom break after that I continued on "right side".
I already had some gas during that break and some burping.

I also saw an improvement in the fitbit recording that I had a pretty long time in the beginning with very few arousals during "left sleep".
Usually my whole sleep time is fragmented with many arousal lines. For me that counts already as an improvement.

The first OA happening this night (green marker) is 59seconds long, I wonder if I should increase the min pressure to 12 or 13.

I see many flow limitations where no OA/H are happening, can I assume that those are the places
where the machine is doing its job correctly ? e.g. 3:20 to 4:10

Unfortunately sleeping only on one side is creating back pain for me, therefor I am going to try another mattress tonight and a side-sleeper pillow.

[Pugsy]

Your flow limitations are driving those pressure increases....note when you see more flow limitations you see more pressure increases.
The flow limitations aren't growing up to become full fledged OAs or hyponeas though.
Flow limitations are the earliest of warning signs that the airway is trying to collapse and those FLs are specifically marked for killing in the auto adjusting algorithm with more pressure. Trying to prevent further airway collapse to the point of earning a flag.

And I fully understand that sleeping only in one position often causes problems. Been down that road myself so I fully understand it.
For this reason I often suggest that people just set the pressure minimums high enough to deal with any sleeping position issues and let the machine sort it out and not worry about position when doing something special in terms of the position causes problems.

Your choice if you want to increase the minimum a little more. Just be careful as more minimum might feed the aerophagia monster so if that happens go up slowly.
While it is technically possible those FLs you see are causing some of your sleep quality or fragmented sleep issues...it is also possible that pain or something else is also at play here.

[sleephero]

Initially after the SleepLab in November I got CPAP 12mBar with EPR-3 as standard setting. I found out soon that
with CPAP 13mBar and EPR-1/2 I got much "better" results. I got pretty fast adopted having 13mBar the whole
night. I don't know why after the second SleepLab they gave me 7-16 and not having a higher starting value.
So I am not afraid of increasing minimum pressure a bit. I think that the APAP algorithm can kick in faster when FL happens.

Coming to this night I "unfortunately" changed many things compared to last night:

- Used side sleeper pillow
- Increased min. Pressure by 1
- Exchanged the mattress
- Had my weekly weight training during the day
- Ate less "volume" for dinner.

I still used the balloon T-Shirt (I wrote backpack in previous posts but its actually a balloon). My urge to sleep in supine position is really strong I woke up a few times in 45-degree
position sleeping on the balloon. My wife already had shrinked the T-shirt by sewing the sides tighter but it seems it needs to be even more tighter. Maybe I go for a smaller size.

In the morning I woke up a bit too early, guess due to some gas. Also had the usual back pain.

ANYHOW,
I got the best result I had EVER.

My wife asked me how I slept. I said "engineering wise" best sleep since therapy start. "Quality wise" things need improvement. Still feel a bit tired, sluggish today.

But I think this is a point where I can start working on.

[sleephero]

Hi I just wanted to come back shorty and give an update how my story continued.

I am using now a soft cervical collar every night and my AHI Values have dropped to <0.5 consistently every night.
The pressure range is now 9-13.

Feeling much better and sleep better.

[Bookit]

That's great! Thank you for coming back and posting an update. It's encouraging to see another success story.

[seattlepap]

No I can't change anything it's hospital locked.
The only thing I can change is to turn off/change the ramp, turn off EPR and change humidity level (currently 6).
I remember the last night in the hospital reading secretly the instructions for the night team "start at 8 go up to 11, max12". Maybe they never tested me for higher values ? (I don't know unfortunately as I forgot to ask for copies of my results and have to wait until they send me the summary).

You were inpatient in a hospital or do you mean that the clinic was located in a hospital. If they're not working with you to fine tune your therapy, start calling other sleep offices that are highly rated. Most clinics will prefer you to not mess with your settings, but they WILL work with you on them and they want to partner with you to get a good night of sleep. There's definitely something not how it should be in your story here.