Brand New and Have Questions

Goldsmoke97 · Post by **Goldsmoke97** » Sat Nov 02, 2019 8:48 am

Thanks Pugsy, I did some research on the EPR, after you mentioned it, and I am curious if you could explain a bit more to me? Mainly if its strictly a comfort setting how could it be having that large of an impact on my qualify of sleep?

Pugsy · Post by **Pugsy** » Sat Nov 02, 2019 9:03 am

Total time in apnea....assuming those centrals are real and not awake breathing flagged by mistake....not good.
Central apneas are unwanted when present in large numbers and your AHI is primarily composed of central apneas.
They can disturb sleep as much as obstructive events can disturb sleep. They can cause desats just like obstructive events.

There is a very small subset of people who use cpap that going bilevel actually can trigger central apneas when there wasn't a real problem with centrals to start with.
Using any form of exhale relief creates a bilevel situation....so to see if you happen to be a member in that very small subset of people we reduce or eliminate exhale relief (EPR on a ResMed machine).

Goldsmoke97 · Post by **Goldsmoke97** » Sat Nov 02, 2019 9:14 am

Ok that makes sense, thanks for the explanation.

Goldsmoke97 · Post by **Goldsmoke97** » Sun Nov 03, 2019 9:18 am

Just went to check my data from last night and there was now information from that night and yes I did have the SD card in the cpap machine. I'm checking the Oscar trouble shooting page now. But anyone of any ideas

Goldsmoke97 · Post by **Goldsmoke97** » Sun Nov 03, 2019 9:33 am

Got it, I was having trouble getting to sleep with the 8 pressure and now erp, so I lowered the min to 6 and placed erp to 1 instead of zero. Should I make sure to set the ERP to 0 tonight to get some better info?

Pugsy · Post by **Pugsy** » Sun Nov 03, 2019 9:43 am

Were you awake when that cluster of centrals happened around the 09:00 time frame?

Did you have very many awakenings during the night? Spend much time awake with mask on?

Goldsmoke97 · Post by **Goldsmoke97** » Sun Nov 03, 2019 10:24 am

yes i believe that I was awake during that 9:00 stretch of time and I did wake up around 5 time during the night , outside of the final hour I don't think that I spent much time in awake with the mask on

Pugsy · Post by **Pugsy** » Sun Nov 03, 2019 10:48 am

I think a crash course in awake vs asleep flagging is in order
http://freecpapadvice.com/sleepyhead-free-software
Anything flagged while awake simply doesn't count except to make us wonder why so much awake time.

I wish you hadn't made 2 changes....the attempted EPR reduction and the lowering of the minimum pressure at the same time.
Makes us wonder which might have caused what result.
The centrals didn't reduce in number with the reduction in EPR like I had hoped but the awake times and potential false positives flagged makes us wonder just how many of those centrals are real asleep centrals and how many we can ignore because you were awake.
I would rather have seen you try 8 minimum with the reduction in EPR being the only change.

Awake/arousal or post arousal breathing is very irregular when compared to asleep breathing and these machines can't tell the difference.
The don't measure sleep status at all. They just measure air flow and irregular breathing can and will cause false positive flags to happen.
Not just in the central/CA category either. There can be false positives in all categories.

Take a hard look (or try to) at what may have contributed to the awakenings because if you remember at least 5 or so...I am betting there were more you don't remember. We only remember the ones that we were awake long enough to form a memory. Others can happen that we don't remember. The awakenings need to be minimized so that we can evaluate the asleep results more effectively to know if we need to be concerned about something or not.
I am concerned about the central numbers but only if you were really asleep when they were flagged.
Awake flagged stuff I am not so worried about except for the worry about why you had so much awake time.

Goldsmoke97 · Post by **Goldsmoke97** » Sun Nov 03, 2019 11:26 am

thank you for the link, I make sure my machine is set for 8 an 1 erp tonight and I try to notate times that i wake up tonight

Pugsy · Post by **Pugsy** » Sun Nov 03, 2019 11:32 am

Don't stress out too much about remembering the awake times...all it does is foster more awake time which is the last thing we want.
Instead when you wake up and have enough presence of mind to think "I am awake" just reach over and push the button to turn the machine off and then immediately push the button to turn it back on again. Takes a couple of milliseconds.
Then on the software reports those breaks in therapy will show up easy to spot and you don't have to worry about trying to remember when or why.
Makes it real easy to then do the zooming in to see if you were awake or not when something got flagged because you have a known awake time as a reference point (which is the break in therapy line).

Goldsmoke97 · Post by **Goldsmoke97** » Mon Nov 04, 2019 8:03 am

Thanks again Pugsy, it seems that when I wake up its to change positions. I'm pretty elevated on my back and I'm use to sleeping on my side. Also, it feels like I'm waking up every 60-90 mins, or at least I was more aware of it when I was rolling over to flip the machine on and off. I'd close my eyes dream for a little bit then I would be up again. A big part of me just wants to rip the mask off and try a night with out it and If I'm not working all I do is wait to fall asleep since I feel to tired to do anything but watch TV. But last night I turned the ERP off and the min pressure was 8.0 max was 20.

Pugsy · Post by **Pugsy** » Mon Nov 04, 2019 8:08 am

If you prefer to side sleep and that's what you have done for a long time why are you trying to stay on your back and elevated?

Goldsmoke97 · Post by **Goldsmoke97** » Mon Nov 04, 2019 8:17 am

I've been finding it very difficult to find a comfortable position to sleep with the full face mask. I even bought a special pillow with the edges cut off. I guess I just though it would be easier for me to try and learn how to sleep a different way. The reason for the elevation is that I'm not sure the cpap is doing anything so I try to sleep as if my apnea is not treated. This was my first night with the machine and tried to just sleep on my back

Pugsy · Post by **Pugsy** » Mon Nov 04, 2019 8:24 am

Sleeping with all this "new cpap stuff" is difficult enough without adding in trying to learn a new sleeping position.

I know full face masks can present some extra challenges because the mask can get in the way but people even sleep successfully with a FFM and on their stomach. It can be done...just some extra challenges getting there.

None of this cpap stuff matters much if you are waking a gazillion times during the night.
We gotta get good solid sleep first and foremost to stand any chance in hell of feeling decent and having the restorative powers of sleep work their magic.

Back sleeping is worse for OSA anyway...even elevated back sleeping can't prevent the airway from collapsing. I have fallen asleep sitting totally upright (without cpap) and snored and woke myself up and hubby laughing his ass off at me.

How come the FFM? Chronic nasal issues or sometimes nasal issues?

Goldsmoke97 · Post by **Goldsmoke97** » Mon Nov 04, 2019 12:10 pm

I sleep with my mouth open, I’ve been thinking of getting nasal pillows and getting a mouth guard or taping my mouth shut

Brand New and Have Questions

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