CPAPtalk.com

Dog Slobber wrote: ↑

Fri Aug 21, 2020 9:15 am

Except you would have to go back to your AirSense, AirCurve doesn't support Auto-Ramp. That is the one thing I missed about moving to the Curve.

Yeah, I figured that but I still have the AirSense if I want to do that experiment.
To be honest it just wasn't ever that important to me. If I wondered how long it took me to go to sleep I would just look at the flow rate.
Pretty easy to spot for me. I tend to look at all this stuff as "it is what it is" kind of thing and unless what I might see is actually going to cause me to make changes in anything I can make changes in then I just don't worry about it. Stuff I really have no control over I tend to just shrug my shoulders and move on. I figure no sense in expending time and energy worrying about it if I really can't fix it.

That experiment will have to be on hold for the time being. Just too much other stuff going on right now feeding my own insomnia monster.

I'm adding 4 days worth of charts (Aug 21-Aug 24).

Looks like on the night of the 23rd I had something called a Cheyne Stokes Respiration event.

I tried to do the stop/start whenever I noticed myself waking up, but for some reason I didn't seem to have many wake events (or I just cannot recall them)

Last chart didn't attach for some reason..

Okay....next experiment...and I know it is going to sound weird but please give it a try.

Fixed cpap mode at 9 cm...or the equivalent in apap mode with minimum of 9 and maximum of 9.
EPR still off or EPR in ramp only if you need it and it's okay to use the ramp.

Yes...we might see more OAs and hyponeas and probably the FL graph will get uglier...but that's okay.
I don't want the machine going above 9 cm....and I don't want it varying during the night either...so 9 cm constant.

camo wrote: ↑

Tue Aug 25, 2020 7:22 am

Last chart didn't attach for some reason..

there is a cap of three at one go.

though i SWEAR i've seen people post more than three at a time.

zonker wrote: ↑

Tue Aug 25, 2020 11:02 am

camo wrote: ↑

Tue Aug 25, 2020 7:22 am

Last chart didn't attach for some reason..

there is a cap of three at one go.

though i SWEAR i've seen people post more than three at a time.

You can do a dozen images if you link them to some sort of image hosting website like imgur or whatever but when doing images as attachments using the forum storage the limit is 3 attachments in one post.

Pugsy wrote: ↑

Tue Aug 25, 2020 11:09 am

zonker wrote: ↑

Tue Aug 25, 2020 11:02 am

camo wrote: ↑

Tue Aug 25, 2020 7:22 am

Last chart didn't attach for some reason..

there is a cap of three at one go.

though i SWEAR i've seen people post more than three at a time.

You can do a dozen images if you link them to some sort of image hosting website like imgur or whatever but when doing images as attachments using the forum storage the limit is 3 attachments.

oh! <slaps head>

but i'd rather wallow in me ignorance and whine about it!

Camo,


I'm in Ontario as well. According to my doctor, you can get a copy of your reports, but it costs $$, which is lame.


Just wanted to pass along some words of encouragement. I'm new to this as well and learning as I go. You got this!!

Pugsy wrote: ↑

Tue Aug 25, 2020 10:23 am

Okay....next experiment...and I know it is going to sound weird but please give it a try.

Fixed cpap mode at 9 cm...or the equivalent in apap mode with minimum of 9 and maximum of 9.
EPR still off or EPR in ramp only if you need it and it's okay to use the ramp.

Yes...we might see more OAs and hyponeas and probably the FL graph will get uglier...but that's okay.
I don't want the machine going above 9 cm....and I don't want it varying during the night either...so 9 cm constant.

As it turns out, by pure coincidence, my doctor/clinician actually adjusted my pressure settings the same day that you suggested this. Except they went with 10cm instead of 9, so I figured I would leave it at 10 and see what happens.

First night I did not get great sleep. AHI of 11.34 with a bunch of central & hypopnea events. But! Last night was much different.. AHI of 3.36, with minimal CA/OA events. RERA was actually more prevalent than anything else..

I waffled on the fence with whether to suggest 9 or 10 and went with 9 since I tend to be ultra conservative at times.
Sometimes there is a fine line between a pressure that can trigger centrals and just a little below it we don't see many centrals.
My idea was to see if we could maybe find that sort of line for you. If with 9 there were more OAs/hyponeas than we wanted to see...try 10 and see what happens.

Your first night...we can hopefully just chalk it up to a lot of poor sleep quality and false positive SWJ sleep/wake/junk stuff. It happens when we change settings. The body and brain takes a bit of time to adjust.

I would suggest more nights at fixed 10 cm and see what kind of trend or pattern develops.
The RERAs mean your breathing pattern looks like the pattern normally seen when people have arousals related to respiratory events.
It could be a flagged event or maybe a respiratory related event that doesn't make the criteria to earn a flag caused an arousal which you may or may not remember.
They more more of a symptom of something than a specific kind of event.
It is also possible that just the newness of the settings and with getting used to the new settings you sleep more soundly they will reduce in numbers. I wouldn't worry about them at this time.

Pugsy wrote: ↑

Fri Aug 28, 2020 8:06 am

Your first night...we can hopefully just chalk it up to a lot of poor sleep quality and false positive SWJ sleep/wake/junk stuff. It happens when we change settings. The body and brain takes a bit of time to adjust.

Yeah I figured it was just an adjustment period due to the new settings. Well, I was HOPING it was just an adjustment period.

Pugsy wrote: ↑

Fri Aug 28, 2020 8:06 am

I would suggest more nights at fixed 10 cm and see what kind of trend or pattern develops.

I will def keep it at this for the time being and see how the new few nights go.

Pugsy wrote: ↑

Fri Aug 28, 2020 8:06 am

The RERAs mean your breathing pattern looks like the pattern normally seen when people have arousals related to respiratory events.

Would you mind explaining a little just what RERA is? What exactly is this 'arousal'?

RERA is a Respiratory Event Related Arousal
now here's the sticky wicket part of this flagging.....you have to have been asleep and then have the arousal from some sort of airway issue for it to be a real RERA
BUT these machines don't/can't even tell if we are asleep or not.
So when they flag RERA they are saying the breathing pattern LOOKS LIKE the breathing pattern that goes along with an arousal related to airway issues. It's an educated guess of sorts and probably fairly accurate but awake breathing can cause RERA flags and the awakening may or may not be related to an airway issue.

When we see a large number of RERAs....we know there was some poor sleep quality for sure but we don't know for sure what caused the poor sleep quality. Might be airway related...might be the neighbors dog barking all night. The machine can't tell if we are asleep or not. It only measures air flow.
But since it might be airway related...we tend to at least try to reduce RERAs and the fix is more pressure...probably wouldn't take much
Yours seem to be sort of clustered around flagged hyponeas...makes me tend to think they are probably a result of the flagged events you see.
In other words...RERA a symptom caused by the hyponea. They aren't a different class of event. They aren't part of the AHI. It's just another data point that points to maybe less than optimal sleep quality. It's not a reduction in air flow like OA or hyponea....it's a subtle change in the breathing pattern and it's so subtle I can't really spot it on the flow rate graph.