Newbie trying to adapt - help me understand my data

Hey, all.

I'm on a CPAP trial - last night was day 9. Diagnosed with moderated obstructive apnea - AHI of 35. Also experiencing noticeable side effects (high blood pressure, lack of focus, and even some endocrine problems which my PCP think might be related to chronic apnea).

I have yet to have a decent night's sleep since being on the machine. Although my quality of sleep seems better, and I do see some daytime improvements (mentally a bit sharper, also my sinuses are super clear in a way that I've never experienced), I'm sleeping just a few hours a night.

I was using a nasal mask until a couple nights ago, which would unseal when I moved while sleeping on my side, regardless of strap adjustments. I swapped it two nights ago for a Respironics Dreamwear under the nose mask, which is better so far. Less leaks, less stuff on my face, less hoses in the way (although hose coming out of the top of my head is still a bit distracting sometimes). Generally, I think this is a good step. Link to mask:
(https://www.sleepapnea.com/products/mas ... lsrc=aw.ds)

Last night, I managed to string together at least 7 hours of actual sleep in a single night, which feels like a real achievement. I did wake up this morning with a moderately bad headache, annoyingly. I also experienced some snoring while drifting off to sleep, and awakening while snoring. In all cases, I'm pretty sure my mouth was closed.

I had a notable experience this morning after waking but still hoping to get back to sleep for a bit: several times in a row, I could feel my epiglottis flapping closed, arousing me and causing me to not sleep. It seems to me that the times I woke up last night as a result of snoring are related to this problem.

Here's my chart from last night's sleep - overview: Also, a zoom in on the time I'm describing (falling asleep, epiglottis collapsing & rousing repeatedly): Any advice is appreciated. I've done a fair bit of reading here and elsewhere, have watched videos on interpreting Sleepyhead output, etc., but I don't feel like I know nearly enough to actually interpret data and my experience and understand what (if any) actions to take.

Another specific question - I haven't been using anything to track my sleep, but now am interested in looking at actual sleep data, not just breathing, as I manage my situation. Any advice on equipment/apps to augment this data? I'm looking in another tab right now at pulse oximeter-equipped trackers. Thoughts?

TIA.
sal

Just wondering if you actually need the ramp at all with such a low min. pressure - let alone for 20 mins... do you have trouble adjusting to the air going in? Most don't bother with it unless their min. pressure starts out really high and/or they do have trouble just putting on the mask and going straight to whatever min. pressure is set to. For those 20 mins, you aren't getting the full benefit of even the low setting of 5 until the ramp is done. And you'd likely have fewer snores if that 5 were to be raised to e.g. 7 - still a relatively low min. as things go.

So, by the numbers, you're doing good... However, I think you could be doing better. Your pressure line is pretty active, and that means that you're having a fair number of breathing events that probably still disturb your sleep.

I'd start by bumping your min pressure to 7, to see if we can't prevent a lot of those, and give you a more even sleep.

While the settings reflect the ramp settings...with Respironics machines just because the settings are in the clinical menu doesn't mean it is necessarily being used.
For Respironics machines for whatever ramp settings to engage the user has to engage/push the ramp button when they start the machine. Totally separate button pushing requirement.
I see no evidence of ramp being used on this report above.
The setting minimum is 5 cm and that's right where the machine goes first thing.
So while ramp is available...it isn't being used.
Kinda hard to not use something that is already not being used.

And yes..I do agree that a small increase in that minimum pressure is worth doing.

Thanks for the advice. I set min pressure to 7 just now and gave it a 5 minute trial. I'm surprised at how different 5 and 7 feel, but I think I can adapt. Will try for a couple nights, and report back.

I am curious how you know it is your epiglottis collapsing. Did you have some special testing that revealed this? Seem to remember reading of a situation on here where someone had issues with their epiglottis collapsing and that factor was taken into consideration in handling their sleep apnea.

Under 'Machine Settings' down on the left it says 'Ramp time 20 mins". Does that mean something different?

Julie wrote: ↑

Sun Feb 17, 2019 3:34 pm

Under 'Machine Settings' down on the left it says 'Ramp time 20 mins". Does that mean something different?

All it means is IF the person pushes the ramp button that's what they get for ramp. The ramp button is a separate button on the front of the machine and it has to be pushed for ramp to happen.
If they don't push the button...ramp doesn't happen.
This is the way it is with Respironics machines.

Now ResMed...that's different...you get ramp if it is turned on in the setup menu area because there is no separate ramp button to push when you start the machine.

We can tell by looking at the statistics (and the pressure graph) that in the report above that the ramp button was never pushed.
Statistics say the minimum pressure was 5....if ramp had been used it would say 4.
Also the pressure graph shows the machine starting out at 5 cm ...if ramp had been engaged then you would see a small increase from the 4 cm starting point up to 5 over 20 minutes.

He's not using the ramp at least on this report.

popijininsky wrote: ↑

Sun Feb 17, 2019 2:48 pm

Thanks for the advice. I set min pressure to 7 just now and gave it a 5 minute trial. I'm surprised at how different 5 and 7 feel, but I think I can adapt. Will try for a couple nights, and report back.

It is a bit of a change, but it's not as high as you're pressure's been getting while you're asleep.

Give it a shot, and hopefully you'll get even better sleep.

Thanks for the advice, all - after setting min pressure to 7, I've been able to get two back-to-back nights of about 8 hours sleep.

I've woken up a couple times with my mouth open. Wondering if I should start thinking about chin strap.

Graphs below - any feedback?

Last night - mask slipped off a couple times until I tightened side straps a lot more. I was worried about overtightening, but it's still really comfortable with straps tighter: The prior night:

Also, @kteague - I don't know that what I was feeling is my epiglottis flapping. The feeling is in that area - I guess I should say my airway was closing repeatedly. -s

popijininsky wrote: ↑

Tue Feb 19, 2019 9:04 am

Thanks for the advice, all - after setting min pressure to 7, I've been able to get two back-to-back nights of about 8 hours sleep.

I've woken up a couple times with my mouth open. Wondering if I should start thinking about chin strap.

It's looking pretty good, stay the course for a while and see if things continue to improve.