bjhunt01 therapy help thread

[bjhunt01]

So..."NO NO NO," she screamed hysterically! "You can't take my SnoreLab away from me!!!!" (I bet you still have your SnoreLab )

What's a snorelab? Is that a dog with a respiratory problem? Seems like a SnorePug would be more appropriate...

SnoreLab is an app you can get on the app store. It records every single sound you make all night long. Also the intensity of your snoring. Initially I got it because I was told I talk in my sleep and I wanted to hear what I was saying. (Oh funny stories about things I said!!). BUT I also discovered that I snore like a pig, told my cardiologist a year ago who ordered a home sleep study...and the rest is history. It's really a cool app. You can also pickup when your neighbor starts mowing their lawn as you are trying to sleep and the same time every day a plane flies over and when the heat or a/c goes on. But it's also been a big help in getting the CPAP right.

[Pugsy]

Good job on the recent reports.
So what if you needed some pharmaceutical help....I take some meds every night or else I can't sleep because of the pain.
Sometimes a girl's gotta do what a girl's gotta do.

That one cluster of CAs/centrals at roughly the 09:45 mark....pretty sure just SWJ and I would ignore it. It's so soon after you had the break in therapy that I am reasonably certain you weren't asleep yet.

[palerider]

So..."NO NO NO," she screamed hysterically! "You can't take my SnoreLab away from me!!!!" (I bet you still have your SnoreLab )

What's a snorelab? Is that a dog with a respiratory problem? Seems like a SnorePug would be more appropriate...

SnoreLab is an app you can get on the app store. It records every single sound you make all night long. Also the intensity of your snoring. Initially I got it because I was told I talk in my sleep and I wanted to hear what I was saying. (Oh funny stories about things I said!!). BUT I also discovered that I snore like a pig, told my cardiologist a year ago who ordered a home sleep study...and the rest is history. It's really a cool app. You can also pickup when your neighbor starts mowing their lawn as you are trying to sleep and the same time every day a plane flies over and when the heat or a/c goes on. But it's also been a big help in getting the CPAP right.

I figured it was something like that there's so many apps out there though, it's impossible to keep track.

[bjhunt01]

Good job on the recent reports.
So what if you needed some pharmaceutical help....I take some meds every night or else I can't sleep because of the pain.
Sometimes a girl's gotta do what a girl's gotta do.

That one cluster of CAs/centrals at roughly the 09:45 mark....pretty sure just SWJ and I would ignore it. It's so soon after you had the break in therapy that I am reasonably certain you weren't asleep yet.

I pretty much do try to knock myself out with 1 mg. of clonazepam, an antihistamine (allergic to something in Texas all year long), and up until about a week ago, 6 mg. of melatonin. Same thing happened last night - didn't fall asleep until about 4:30. In order to get myself back to a normal sleep cycle, I may have to take a little extra clonazepam for a few nights AND MAKE MYSELF actually get into the bed instead of being on the computer blue screen thingy and/or watch television. More drugs and more self discipline! As I see my days be so short and not as productive as I would like it is motivating me more and more on the self discipline side. I hope you are feeling better from your mud crawl!

[bjhunt01]

So last night the insomnia demon hit me again and I have a lot of centrals and OA's before falling asleep about 4:40. Then again when I got up and got back in bed about 9:20 to 10:20. My mouth tape somehow broke a hole toward waking up time so I had leaks there.

A weird thing: this screen would not come up on Oscar - just a fraction of it so I tried Sleepyhead and got it.

Not counting insomnia times, I notice that OA's hit at 10.99 pressure so I think I should raise to 11.2 - yes?
Should I raise my minimum pressure too?

[djams]

So last night the insomnia demon hit me again and I have a lot of centrals and OA's before falling asleep about 4:40. Then again when I got up and got back in bed about 9:20 to 10:20. My mouth tape somehow broke a hole toward waking up time so I had leaks there.

A weird thing: this screen would not come up on Oscar - just a fraction of it so I tried Sleepyhead and got it.

Not counting insomnia times, I notice that OA's hit at 10.99 pressure so I think I should raise to 11.2 - yes?
Should I raise my minimum pressure too?

Yes, you could increase pressures (both).

But I wouldn't recommend it right now. You should work on getting back to your normal sleep/wake times first, IMO. Don't let that get out of hand.

When I'm having a hard time falling asleep, laying in bed for hours on end is the worst thing I can do. I'll get out of bed, have a healthy snack, read. Gone for a walk a few times. Cleaned a few times.No phone, no TV. Go back to bed when I feel sleepy. Then I always get up at normal wake time.

[Pugsy]

I wouldn't go increasing the minimum pressure right now.
You have such a tight range as it is that you really haven't been giving the machine much room to roam.
Give it a chance to do it's job first.

[bjhunt01]

So last night the insomnia demon hit me again and I have a lot of centrals and OA's before falling asleep about 4:40. Then again when I got up and got back in bed about 9:20 to 10:20. My mouth tape somehow broke a hole toward waking up time so I had leaks there.

A weird thing: this screen would not come up on Oscar - just a fraction of it so I tried Sleepyhead and got it.

Not counting insomnia times, I notice that OA's hit at 10.99 pressure so I think I should raise to 11.2 - yes?
Should I raise my minimum pressure too?

Yes, you could increase pressures (both).

But I wouldn't recommend it right now. You should work on getting back to your normal sleep/wake times first, IMO. Don't let that get out of hand.

When I'm having a hard time falling asleep, laying in bed for hours on end is the worst thing I can do. I'll get out of bed, have a healthy snack, read. Gone for a walk a few times. Cleaned a few times.No phone, no TV. Go back to bed when I feel sleepy. Then I always get up at normal wake time.

Just reading where you said not to change the pressures. Oops too late. Went to 8.2 and 11.2. It felt good breathing. But I had a total garbage screen because I had a total insomnia night so am going to go out and get some extended release Melatonin from Cooper Clinic. I figure their product has to be pure. Reading usually makes me pass out, but not last night-even doubled the clonazepam. For what it's worth, and probably nothing because of so much insomnia, I'll post full screen, and 3 additional screens where I'm pretty sure I was asleep. And I even went to bed before midnight. For whatever reason, Oscar isn't taking my data for the second night so went back to Sleepyhead.

I think I can only post 3 attachments at once, so will do the last one in another post.

[bjhunt01]

Screen 4 of 4 for last night where I might have been asleep.

[bjhunt01]

I wouldn't go increasing the minimum pressure right now.
You have such a tight range as it is that you really haven't been giving the machine much room to roam.
Give it a chance to do it's job first.

Hi Pugsy: I saw this after the fact. When you say I'm not giving the machine room to roam, what exactly does that mean? I thought it meant raising the maximum to give the maximum room to go as high as it might need to in order to determine what my maximum should be. And that raising the minimum reduced obstructives. Can you educate me please? Thanks! Barbara

[Pugsy]

The minimum pressure is increased once it has been determined that it is so low it can't get to where it needs to be quickly enough...and when you only have 2 or 3 cm for it to go up to...it really doesn't have a chance to try to get to where it needs to be to even see if just letting it do its job might work.

I use 7 minimum (with EPR 3) ...max of 20...and sometimes it goes to 12 or 15 or maybe 18...but it gets there and I don't have a bunch of obstructive stuff flagged. My AHI is usually less than 1.0. It gets to where it needs to be quickly enough or I would have a bunch of clusters of OAs ....which I rarely have and when I do it's maybe 2 OAs in a minute and if that happens the machine gives me a new minimum anyway in the for Her mode.

Right now we have no proof that the minimum pressure just has to be increased because you haven't been giving the machine a chance to do what it is designed to do in auto mode. A range of 2 or 3 is an extremely limited range and sometimes that's what we have to use but in your case it hasn't been proven that you just absolutely have to increase the minimum and we already know that increasing anything feeds the aerophagia monster.

Let the machine do its job without tying it's little hands.

And the nights you don't sleep well....the data can't be trusted because I bet a lot of the OAs and hyponeas are also SWJ.
You can't base pressure needs on a night with 80% SWJ flags.

[bjhunt01]

The minimum pressure is increased once it has been determined that it is so low it can't get to where it needs to be quickly enough...and when you only have 2 or 3 cm for it to go up to...it really doesn't have a chance to try to get to where it needs to be to even see if just letting it do its job might work.

I use 7 minimum (with EPR 3) ...max of 20...and sometimes it goes to 12 or 15 or maybe 18...but it gets there and I don't have a bunch of obstructive stuff flagged. My AHI is usually less than 1.0. It gets to where it needs to be quickly enough or I would have a bunch of clusters of OAs ....which I rarely have and when I do it's maybe 2 OAs in a minute and if that happens the machine gives me a new minimum anyway in the for Her mode.

Right now we have no proof that the minimum pressure just has to be increased because you haven't been giving the machine a chance to do what it is designed to do in auto mode. A range of 2 or 3 is an extremely limited range and sometimes that's what we have to use but in your case it hasn't been proven that you just absolutely have to increase the minimum and we already know that increasing anything feeds the aerophagia monster.

Let the machine do its job without tying it's little hands.

And the nights you don't sleep well....the data can't be trusted because I bet a lot of the OAs and hyponeas are also SWJ.
You can't base pressure needs on a night with 80% SWJ flags.

I'm sure you have shut down for the night by now but here's a question for tomorrow night based on what you've said: what numbers would you recommend I set the minimum and maximum at now? Thanks!

[bjhunt01]

The minimum pressure is increased once it has been determined that it is so low it can't get to where it needs to be quickly enough...and when you only have 2 or 3 cm for it to go up to...it really doesn't have a chance to try to get to where it needs to be to even see if just letting it do its job might work.

I use 7 minimum (with EPR 3) ...max of 20...and sometimes it goes to 12 or 15 or maybe 18...but it gets there and I don't have a bunch of obstructive stuff flagged. My AHI is usually less than 1.0. It gets to where it needs to be quickly enough or I would have a bunch of clusters of OAs ....which I rarely have and when I do it's maybe 2 OAs in a minute and if that happens the machine gives me a new minimum anyway in the for Her mode.

Right now we have no proof that the minimum pressure just has to be increased because you haven't been giving the machine a chance to do what it is designed to do in auto mode. A range of 2 or 3 is an extremely limited range and sometimes that's what we have to use but in your case it hasn't been proven that you just absolutely have to increase the minimum and we already know that increasing anything feeds the aerophagia monster.

Let the machine do its job without tying it's little hands.

And the nights you don't sleep well....the data can't be trusted because I bet a lot of the OAs and hyponeas are also SWJ.
You can't base pressure needs on a night with 80% SWJ flags.

I'm sure you have shut down for the night by now but here's a question for tomorrow night based on what you've said: what numbers would you recommend I set the minimum and maximum at now? Thanks!

I lowered my minimum to 7 based on your feedback about giving the "room to roam". Had a leak toward the end as the tape was getting wet. So removed mask as the leaks were causing chubby cheeks and waking me up. I went back to sleep without the mask for about an hour. I'm still tired. The CA's at 8:15 and 9:45 are me making adjustments to the cold packs on and under my head as I've started getting headaches again. Here's my screen. What do you suggest I set my minimum and maximum at if not these? Thanks!

[Pugsy]

I wouldn't change the settings at this time.

The bulk of the AHI is central/CA and very likely there's a lot of SWJ false positive flagging going on because of the very obvious awake times and multiple starting and stopping of the therapy. We can't do a damn thing about the centrals with this machine anyway...there are no pressure tweaks that can fix SWJ stuff. We have to fix the poor sleep quality first and it isn't necessarily something that a tweak in the pressure settings will fix.

I don't like to try to base pressure needs on awake false positive SWJ stuff. Awake stuff doesn't count.
Instead I would work on trying to fix whatever is messing with the sleep and causing the awakenings ...as best I could.

Remember how the For Her mode works....if you get 2 OAs within a minute...it will automatically increase your minimum pressure for you and it will keep it until you turn the machine off. So it will give you a new higher minimum if it thinks you need it.

Your primary problem right now is sleep quality and leaking....things that are unfortunately sometimes extra difficult to get under control.

I understand your desire to what to "change something" so things will be better but there is some truth to the "give it time" thing as well and you are simply not giving anything any time.
A minor 0.2 or 0.6 setting change somewhere....is not going to fix your problems. Heck, not even a big major change will help.

Sleep quality, leaks and comfort....those are your biggest problems right now. We really can't evaluate pressure needs until you have some prolonged blocks where you were sound asleep and not having SWJ false positive flagging mucking up things.

[bjhunt01]

I wouldn't change the settings at this time.

The bulk of the AHI is central/CA and very likely there's a lot of SWJ false positive flagging going on because of the very obvious awake times and multiple starting and stopping of the therapy. We can't do a damn thing about the centrals with this machine anyway...there are no pressure tweaks that can fix SWJ stuff. We have to fix the poor sleep quality first and it isn't necessarily something that a tweak in the pressure settings will fix.

I don't like to try to base pressure needs on awake false positive SWJ stuff. Awake stuff doesn't count.
Instead I would work on trying to fix whatever is messing with the sleep and causing the awakenings ...as best I could.

Remember how the For Her mode works....if you get 2 OAs within a minute...it will automatically increase your minimum pressure for you and it will keep it until you turn the machine off. So it will give you a new higher minimum if it thinks you need it.

Your primary problem right now is sleep quality and leaking....things that are unfortunately sometimes extra difficult to get under control.

I understand your desire to what to "change something" so things will be better but there is some truth to the "give it time" thing as well and you are simply not giving anything any time.
A minor 0.2 or 0.6 setting change somewhere....is not going to fix your problems. Heck, not even a big major change will help.

Sleep quality, leaks and comfort....those are your biggest problems right now. We really can't evaluate pressure needs until you have some prolonged blocks where you were sound asleep and not having SWJ false positive flagging mucking up things.

OK. I was asking about the pressure because I wanted to check with you to see if after moving the minimum back down to 7 when you talked about room to roam, do I now have them where they are in that "room to roam" area, i.e., if my current settings now at 7 and 11.40 is enough room to roam? (Another member once suggested minimum at 10 and maximum at 20 so I'm asking about pressures so as to get the those settings at room to roam numbers.) I do understand that my Centrals are at the going to sleep, or going back to sleep after getting up to use the restroom, or having to mess with cold packs so I am not worried about their appearance on the screen. After moving to blue tape and scuncis, generally I have had better leak rates. Last night I started a delayed release Melatonin so I can sleep better. I can work on leaks and sleep and stop focusing on pressures as long as I know they are in the room to roam place. I had been getting feedback that each time I raised the maximum, I was still bumping up against that so continued to raise it a little. So: final question: are you good with 7 and 11:40 as giving me enough "room to roam?" If so, I will keep them there or if I need a little more room than that, where would you suggest I put the minimum and maximum and leave it and then focus on leaks and sleep quality? Thanks!