Feedback Request

DreamDiver · Post by **DreamDiver** » Thu Apr 16, 2020 7:57 am

Amishboy51 wrote: ↑
Thu Apr 16, 2020 6:20 am
And here is last night, which is the second using EPR. I'm not sure that I'm seeing any significant change in FL or Pressure, with spikes to 20 at midnight and 2:00, and a couple other near-20 spikes. Should I increase EPR to 2 maybe? Something else?

Look at the freakin' drop in AHI! I'd say that's progress. Way to go! Flow limitations around 2am, just before you get up to pee. Other spikes seem to resolve in the pressure graph normally.

It's best to make just one tweak over, say, five days to a week. This will give you a nightly average of how well you're doing at those settings. The only time to maybe not do this is if your numbers get significantly worse, in which case you would dial back to your previous settings and try something else. This setting regime shows drastic improvement. Unless you're getting aerophagia, why not leave your settings as they are for now to dial it in?

And as Pugsy suggests, it really is more about how you feel than it is about numbers. How do you feel?

Amishboy51 · Post by **Amishboy51** » Thu Apr 16, 2020 6:47 pm

Thanks for the additional feedback.

Pugsy, I slept “okay,” but still felt tired and fell asleep while sitting this afternoon.

DreamDiver, yes, the AHI was pretty low, but as I said, still felt tired. And I’ll stick with the EPR at 1 for a week.

Pugsy · Post by **Pugsy** » Thu Apr 16, 2020 7:32 pm

Here's the deal....sometimes despite the best cpap therapy in the world and nice perfect low AHI reports and minimal leak and getting 8 hours of sleep....we don't always feel those numbers because other things affect how we feel or how we sleep that have nothing to do with sleep apnea.

Give yourself at least a couple of weeks at the new settings before even remotely expecting much change.

Consider taking a hard look at other factors that might be a factor in your unwanted daytime symptoms.

Amishboy51 · Post by **Amishboy51** » Fri Apr 17, 2020 6:46 am

Thank you again, Pugsy. I think I understand where you're coming from. I've considered other possible causes, such as depression, and been checked for physical causes, e.g., glandular, viral, etc., but haven't found anything plausible.

And this is one of the things that bothers me; I feel like I didn't do anything all that different last night, but, wham, big leaks again:

Pugsy · Post by **Pugsy** » Fri Apr 17, 2020 6:56 am

Masks move sometimes. Maybe a little extra sweat or facial oils or just sleeping in a position that causes extra stress on the mask and it moves.
As long as it doesn't happen all that often and we sleep through it...I don't worry so much about what happened last night. Not much I can do about it anyway after the fact.

Pugsy · Post by **Pugsy** » Fri Apr 17, 2020 7:06 am

You know if you really want to do more digging into sleep quality as being a possible factor you can learn how to spot arousal/awake breathing vs asleep breathing and evaluate how much you might actually be waking up during the night and compare that with how you feel.

http://freecpapadvice.com/sleepyhead-free-software

It would involve scrolling though all the flow rate zoomed in and manually counting the episodes of arousal/awake breathing.
See if you are having arousals that you don't remember that might be impacting sleep quality and messing with the restorative powers of sleep.
Bear in mind though...not all arousals are related to airway issues. You can have what are called spontaneous arousals which just means you wake up and we don't know why.
CPAP can only fix arousals related to airway issues. It's completely useless for fixing spontaneous arousals. To fix those we have to try to figure out what is causing them and that sometimes is damn hard to figure out the cause much less fix it.

DreamDiver · Post by **DreamDiver** » Fri Apr 17, 2020 8:44 am

Amishboy51 wrote: ↑
Thu Apr 16, 2020 6:47 pm
Thanks for the additional feedback.

Pugsy, I slept “okay,” but still felt tired and fell asleep while sitting this afternoon.

DreamDiver, yes, the AHI was pretty low, but as I said, still felt tired. And I’ll stick with the EPR at 1 for a week.

Amishboy51,

I hear you. If I seem happy for you, it's because it seems to me it's taking you less time to get to a point where you can actually evaluate how you slept way before I was able to at the same point in my own sleep therapy. It can take time before you're out of the waking dead stage. I hope you'll find in the coming weeks that you're well on your way to feeling rested.

You might want to try a papcap. I put it on under my mask straps. It stabilizes the mask on my head better so that the mask doesn't shift or torque while I'm sleeping if I turn my head against the pillow, plus the wide straps keep my cheeks from puffing out, so I'm less likely to feel like a chipmunk and blow large leak at the sides of my mask.

Amishboy51 · Post by **Amishboy51** » Fri Apr 17, 2020 2:05 pm

Thanks, again, Pugsy and DreamDiver, for the info, encouragement, and suggestions! I’ll try to keep working at it.

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