New (UARS) -- lots of questions

did you sleep study give an rdi?

miner49er wrote: ↑

Tue Dec 10, 2019 3:21 pm

did you sleep study give an rdi?

I have yet to go back to the sleep center and get a copy of my report -- I don't have much mobility since I'm busy with school and don't have a car. So, no. I'm working off of subjective symptoms for now.

zan wrote: ↑

Tue Dec 10, 2019 3:24 pm

miner49er wrote: ↑

Tue Dec 10, 2019 3:21 pm

did you sleep study give an rdi?

I have yet to go back to the sleep center and get a copy of my report -- I don't have much mobility since I'm busy with school and don't have a car. So, no. I'm working off of subjective symptoms for now.

i remember school with sleep problems. stay up all night studying cuz i cant sleep and forget it the next day, but not before i take the test. managed to get a 3.7 but i dont remember a thing i learned

zan wrote: ↑

Tue Dec 10, 2019 3:16 pm

Will do; I like PS 7 right now since I'm sitting upright and awake but you're both probably right that it would work much differently when I'm asleep. I'll try 4-5 cm tonight.

Sounds like a plan.

Typical starting point is 4.

Another thing I'm going to try for the next few days is going off of Trazodone. I've been using it spottily since the sleep study (I was required to stop all medications for three days prior to the study, and discovered that my dependence on Trazodone was partially psychological) but would like to stop taking it entirely, because I'm assuming that most of my sleep-onset insomnia is due to my body associating sleep with continued/heightened CNS arousal....? Hopefully some time on bilevel can retrain my body to actually expect sleep. I'll still be taking Trazodone and melatonin as needed.

I've been wearing the machine for about two hours now, these are the settings I've settled on for tonight:
MaxIPAP: 25
MinEPAP: 8.0
PS: 3.0
Trigger: Very High
Cycle: Med

Everything look OK here?

zan wrote: ↑

Tue Dec 10, 2019 3:43 pm

Another thing I'm going to try for the next few days is going off of Trazodone. I've been using it spottily since the sleep study (I was required to stop all medications for three days prior to the study, and discovered that my dependence on Trazodone was partially psychological) but would like to stop taking it entirely, because I'm assuming that most of my sleep-onset insomnia is due to my body associating sleep with continued/heightened CNS arousal....? Hopefully some time on bilevel can retrain my body to actually expect sleep. I'll still be taking Trazodone and melatonin as needed.

I've been wearing the machine for about two hours now, these are the settings I've settled on for tonight:
MaxIPAP: 25
MinEPAP: 8.0
PS: 3.0
Trigger: Very High
Cycle: Med

Everything look OK here?

That's fine.

Wherever you start on PS, give it a few nights at that stable setting and report back.

Do note that PS 3 is equivalent to EPR 3, so you're not getting any benefit from the bilevel above the APAP at that setting.

slowriter wrote: ↑

Tue Dec 10, 2019 4:00 pm

zan wrote: ↑

Tue Dec 10, 2019 3:43 pm

Another thing I'm going to try for the next few days is going off of Trazodone. I've been using it spottily since the sleep study (I was required to stop all medications for three days prior to the study, and discovered that my dependence on Trazodone was partially psychological) but would like to stop taking it entirely, because I'm assuming that most of my sleep-onset insomnia is due to my body associating sleep with continued/heightened CNS arousal....? Hopefully some time on bilevel can retrain my body to actually expect sleep. I'll still be taking Trazodone and melatonin as needed.

I've been wearing the machine for about two hours now, these are the settings I've settled on for tonight:
MaxIPAP: 25
MinEPAP: 8.0
PS: 3.0
Trigger: Very High
Cycle: Med

Everything look OK here?

That's fine.

Wherever you start on PS, give it a few nights at that stable setting and report back.

Do note that PS 3 is equivalent to EPR 3, so you're not getting any benefit from the bilevel above the APAP at that setting.

Right. And how will I know if my settings are inadequate? I imagine it'll take several days just for me to process the newness of being on the machine.

Like I said earlier, I'd start at PS 4.

And then see what the machine reports, particularly with CAs.

Well, first night was garbage, but I suppose that's not surprising given how long it takes most to acclimate to wearing the mask. OSCAR isn't allowing me to import my new data since the last time I imported was yesterday around 3pm -- OSCAR says this is because ResMed machines split days at noon. I guess I won't be importing any of last night's data until tonight. Sorry for the delay!

Settings: 8cm MinEPAP, 25 MaxIPAP, 4 PS, Very High trigger / cycle, max humidity (8), TiMin 0.4s / TiMax 3.0s, no heat.

Went to bed around 10:30pm, my alarm went off at 7:30am. Took 3mg of melatonin about 20 minutes before bed. Slept for about 6 hours (according to the machine) with the mask before I took it off around 4 am. Had some low-grade but constant aerophagia and felt like I was just barely suffocating for most of the night, I don't think I dreamt at all while on the mask. I started getting some restless leg during my more conscious periods, mostly due to discomfort. The N20 fit like a charm: before bed I quickly made a homemade pad-a-cheek-like barrier for the cushion (used a sheet of soft cotton jersey fabric with a hole cut for my nose), since it had started to irritate my skin during yesterday's 2-hour test while awake, and with the homemade barrier the mask was very comfortable, at least for as long as the air was turned off. I didn't notice any leaks at all up until right before I decided to take the mask off, and even then the leaks were very fixable -- I definitely think the barrier helped with this, although I wonder if it might've contributed at all to the suffocation feeling, even though I made sure to cut away any fabric that might get in my nostrils. I can take pics of the barrier if needed, it's a pretty humble construction.

Subjectively: I definitely feel sleep deprived since I only got about three hours of sleep where I was relaxed enough to dream, but it's more of the not-enough-hours kind of deprived; in terms of sleep quality, I feel more or less as I usually do (which is to say, dubiously functional). My biggest discomforts last night were the mild aerophagia and the suffocation-like feeling. Does that mean my pressure is too high / low? Or do you think it's more due to me and my body being new to this? If anything I'd like to get the aerophagia dealt with ASAP because it created a lot of uncomfortable bloat-like feelings and for the couple of times I was fully conscious it was really unpleasant to sit upright and try to burp out the excess air, made me feel like I could've thrown up.

Open OSCAR

Select the last day in your data on the Daily screen

From the menu at the top select Advanced => Purge Current Selected Day.


Then you can import the data from last night.

Why did you elect to use a very high trigger?

Pugsy wrote: ↑

Wed Dec 11, 2019 8:27 am

Why did you elect to use a very high trigger?

I heard from someone else that it helps with their UARS, figured I'd give it a try. Wasn't sure if I noticed any difference.

Jas_williams wrote: ↑

Wed Dec 11, 2019 8:21 am

Open OSCAR

Select the last day in your data on the Daily screen

From the menu at the top select Advanced => Purge Current Selected Day.


Then you can import the data from last night.

Thank you! Graph is attached. I guess I was wrong about sleeping for a solid 6 hours last night -- that must have been the total hours I spent with the machine yesterday. Weird, because I'm 80% sure I checked the time when I finally took it off and it was close to 4am....
The first graph is a zoom on the latter half of yesterday's data, when I was actually in bed. Second graph all data collected yesterday.

Edit: BTW, the large leak was from when I took the mask off briefly to recoup.

Raising trigger to high or very high can help with CAs.

I don't have any experience with aerophagia, but given what I see, I wonder if you should drop max IPAP to 15, to avoid it going higher than it needs to go.

Maybe drop min EPAP to to 7 to see if that also helps?

Mainly, we need you to sleep through the night.

There's a clock you can set on the machine so that your times are correct.
You can go forward easily but backwards can be a bit difficult if there is data within a certain time frame.
If you need to go backwards wait until after 12 PM per the machine clock.

Does lowering the IPAP + EPAP reduce the suffocating feeling? The pressure didn't look like it exceeded 15cm in the graphs, so I'm not sure that lowering the IPAP max would help.