Pugsy wrote: ↑Sun Jun 23, 2019 6:41 am
So...the first sleep session where there's not much going on but the ugly flow limitations....you were asleep??? Is that correct?
Then the big section with a truckload of CAs you were awake during that time until the flow limitation graph got ugly and the CAs essentially stopped.
Looks like we can maybe judge awake vs asleep by watching the flow limitation graph....is that a fair assumption?
Heckuva way to tell sleep status.
What I was trying to determine is if there is a real problem with centrals in your situation or not and if what I am think is correct then the centrals/CAs aren't real and other than they reflect poor sleep they aren't a problem in terms of your brain simply not telling your body to breathe.
I still don't know what to make of the sounds that are bugging you unless...and I am going out on a long skinny limb here...they are related to flow reductions evidenced by the ugly flow limitations we are seeing.
I know that higher pressures seem to cause you some
aerophagia issues...but you aren't
sleeping well either which is not good.
At this point if this were my graphs and I was in the same boat with
aerophagia issues and NOT
sleeping so great because of the sounds...I think I would at least let the machine try to deal with the FLs and see if the sounds that are annoying reduce so you can sleep and not invite the
aerophagia monster.
If you look at the times you were asleep....you don't have many OAs or hyponeas so I don't think you need more minimum pressure at this time. We haven't really seen what would happen with the FLs if the machine could go higher. Would they reduce and would the weird noises also reduce.
I would start with small increases in the maximum pressure and see at what point the
aerophagia monster came back.
Maybe revisit more EPR when the point of
aerophagia returns.
And of course try to figure out how to minimize the leak better. The first session...that small amount of leak isn't a big deal unless it wakes you up. The last session...that leak is big and prolonged and could stand some work even if you slept through it if you see this a lot.
Hi Pugsy: I am just now reading this and about to post last night's graph.
To answer your questions:
1. I think my centrals are primarily when I am struggling to go to sleep and/or waking up from or from having to fiddle with the mask or all the cold packs I have to adjust for my aching head. So I don't think I am sound asleep for most of these. I wake up a lot sometimes with mask adjustments, go to pee 2 or 3 times, have to go get colder cold packs, readjust them, my nose gets stuffed, I forgot and took pseudoephedrine hoping like crazy I can breathe but not wake up. But then I do about 5 or 6 and am awake for a few hours when I do that. Trying to spray my nose instead now. So I think your remark about judging awake and sleep times by flow status is on target.
2. Re: the sounds that are bugging me that I hear on the SnoreLab are from the internal jaw drop and tongue leaving the roof of my mouth no matter how well I'm taped. They are motorboating and/or a throat snore like the pig rooting sound. I don't always hear them while
sleeping if I'm really passed out but they cause some arousal and interfere with my sleep being restful. (So Centrals?) Sometimes they do wake me up. I notice that is usually toward the morning after 8 or 9:00 a.m. And then they keep waking me up. The last 2 nights I haven't been able to tape to the max because my face has sores on it so the minimal taping has likely caused more leaks plus I was using a different mask. The weird noises are always on my SnoreLab when my mouth has dropped inside my throat. I can't lay on my sides because of hip pains so I am always on my back. And sometimes my nose gets stuffed at least on one side if not both during the night. Last night I tried the cervical collar. Think that might have helped my scores on all my apps. It could have lessened the chin relaxing and dropping inside my throat thingy.
3. Yes - not
sleeping well most nights and all through the night is a big problem caused by the above things. And that's probably why I seem to need so much sleep is because of all the wake ups. If I could sleep through the night without waking up I bet I would need less sleep/be in the bed less time.
4. Very weird thing about last night: 40+ leaks!!!! and an AHI of 1.62. I totally do not understand how this stuff works.
And speaking of how I don't understand things, you said "you don't have many OAs or hypopneas so I don't think you need more minimum pressure at this time." So am I to understand that those occur at not enough minimum pressure?
5. I was intrigued by you pointing out a few days ago that I am always pushing the max so have been increasing and last night got bold and went to 10.2 all night. As you suggested in this post to me too.
I slept pretty well all through the night because I was so tired from not enough sleep the night before. Only got up once to go to the restroom.
I have also been intrigued by you saying that turning off the EPR, which I tried a few times, seemed to cut the centrals. So last night, I turned it off again.
But since I didn't wake up a lot last night, that would also reduce the centrals.
6. How weird is this that the flow limitations are greater when there were no leaks. And less with all the leaks. Not understanding things, it would seem to me that flow limitations would be higher when you are leaking because it seems your body would have to work harder to get air when leaking. And, with all those leaks, you'd think they'd wake me somewhat and cause Centrals. Could this get any more confusing? To me anyway.
7. I am becoming more and more convinced that I need some kind of mandibular adjustment device that will hold my/force my lower teeth in place and not allow the internal drop. I started with the cervical collar last night but haven't added Scuncis yet ala Zonker's picture. Would hope that they will help so I don't have to do the dental device as they are so uncomfortable.
So...here is last night. Again I thank you for the time you spend in looking at these and advising me and educating me!
