Advice on adjusting my settings needed

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Conrad
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Re: Advice on adjusting my settings needed

Post by Conrad » Wed Nov 24, 2021 9:07 am

Gotta go for now but I'll check back later.

Again and again, thank you!
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Pugsy
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Re: Advice on adjusting my settings needed

Post by Pugsy » Wed Nov 24, 2021 9:32 am

Conrad wrote:
Wed Nov 24, 2021 9:05 am
How's this?
Zoomed out a little too much...5 minute might have been better but I think that all 5 of those flagged centrals are also false positives.
The one at 02:01 might be a sleep onset or transitional central but it's hard to say for sure but since the ones after it look more arousal related....going to call it a false positive.
It's normal to have what we call a sleep onset central apnea...sometimes called transitional because they happen when transitioning from awake to asleep. They aren't a big deal unless we have a truck load of them.

It's hard to see but I don't think you ever went to sleep until around maybe 02:07.
The duration of the zoom in or out makes a difference on what we can see clearly enough to see the transition from flow rate that is awake breathing to asleep breathing.

Your homework is to go to each flagged event and try to figure out if you were asleep or not when it was flagged.
While doing that task just scroll and look for arousal breathing without flags. I suspect you will see more than you think...and don't assume that we remember all arousals or awakenings because we don't. We don't remember arousals unless we are awake long enough to form a memory. Most of the time we have arousals and aren't awake long enough to remember them...but we are awake.

Now what changed to cause the more awakenings or poor sleep? Million dollar question. Can't blame meds since you don't take any. Medication side effects are a common cause of poor sleep which is why I asked the meds question all the time.
Rule in or out medication side effects.

Below is a common example I use. The asleep breathing is circled in red.

Image

and a more zoomed out section with a couple of false positives in the not asleep breathing.

Image
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Pugsy
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Re: Advice on adjusting my settings needed

Post by Pugsy » Wed Nov 24, 2021 10:26 am

How long have you been using the AirCurve?
How long did you have nice normal and good reports?
When did it change?
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Conrad
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Re: Advice on adjusting my settings needed

Post by Conrad » Thu Nov 25, 2021 8:24 am

Yep, I do have some homework to do!

Somewhere in here you asked how long have I been using the AirCurve. First day was 9/22/21. I've been using a BiPAP machine for almost 10 years now. 7 years with a PR System One and 2+ years with a DS1 (till the recall) and now the AirCurve.

I liked the DS1, too bad Philips went the way they did...


I haven't looked at the data from last night using Oscar yet but the My Air app tells me that I had a good night with 3.4 events and a score of 100.

Question, do you unplug your AirCurve before removing the SD card?

Thanks P!
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Conrad
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Re: Advice on adjusting my settings needed

Post by Conrad » Thu Nov 25, 2021 8:27 am

Pugsy wrote:
Wed Nov 24, 2021 10:26 am
How long have you been using the AirCurve?
How long did you have nice normal and good reports?
When did it change?
I guess this is the best way to show you.

screenshot-20211125-082556.png
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Pugsy
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Re: Advice on adjusting my settings needed

Post by Pugsy » Thu Nov 25, 2021 9:04 am

No...I never unplug the machine.

Do your homework...I got some cooking to do.

I still wonder what changed....several really good nights so it's not like it was a one off good thing.
I guess about 3 weeks.
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Conrad
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Re: Advice on adjusting my settings needed

Post by Conrad » Fri Nov 26, 2021 8:46 am

Pugsy,

I hope that you had a good Thanksgiving? We did and I had a very good night (sleep wise) last night.

I changed the PS value from 3 to 2 and here's the results, my second best night ever, the best being back on 10/1 with a 0.38 AHI count.

I woke up around 4:50a or so and that's reflected in the graph. If I discount that I would have the best numbers ever on this machine.


screenshot-20211126-083309.png
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Pugsy
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Re: Advice on adjusting my settings needed

Post by Pugsy » Fri Nov 26, 2021 10:01 am

I always worry more about actual sleep quality than I do numbers because at the end of the day it's how we feel that is what we actually live with. I have had too many nights of near perfect numbers but sleep and feel like crap and other nights with really crappy numbers yet feel amazing to put much stock in numbers by themselves.

I have discovered that the cpap machine numbers are way down on my list of things to worry much about.
I have discovered that sleep itself and the quality of that sleep is actually the primary dictator or how well (or not well) I feel.
I have discovered that sometimes good sleep quality is very fragile and it takes very little to upset things.
Yesterday I woke way too early due to issues with one of my dogs....so I got maybe 3 1/2 hours of sleep Wed night.
I knew it was going to be a bad day. The AHI was extremely low yesterday morning but that didn't mean much with it coming from 3 1/2 hours of sleep. Yesterday I had it rough....death warmed over would have been an improvement.
So tired yesterday that I really couldn't even think clearly and didn't even want to try.

I think that your poor "numbers" are most probably a symptom of poor sleep quality...for the most part as being false positive flags. Now why the sleep is fragmented some times and not other times is always a mystery because we simply don't always know exactly what it is or was that messed with our sleep.

Yesterday I had the dog that I knew woke me up and I simply couldn't go back to sleep. Part of the reason I couldn't go back to sleep was the stress from what I knew caused the dog to be screaming in the middle of the night...she's in pain. My dogs are my kids. Their pain is my pain. Their stress is my stress.
Stress from anything will mess with us. I have had a lot of extra stress in my life this past couple of years and my sleep quality has definitely suffered. Sometimes reflected in the cpap machine "numbers" and sometimes not so much. Sometimes I have a lot of false positives on those crappy nights and sometimes I don't ....and I have yet to figure out the why the numbers don't always reflect the crappy nights. To be honest I try hard not to worry about the stuff I really have not control over. I don't need another stress in my life from something that I can't really control due to multiple factors.

If you never had good nights with the machine I might worry about the settings being a factor but when we have good nights and not so good nights at the same settings.....kinda hard to blame the machine.

Lets see if the 2 PS setting change can continue to obtain good results for more nights...one night doesn't a trend make.
Can a minor setting change affect sleep quality itself??? Sure it can and that's why we try different things as it hurts nothing to try but we need to also realize that sometimes it's what life itself is giving us that is affecting our sleep as well.

I slept better last night....took 2 pain pills and a sleeping pill and got a little over 8 hours of sleep and decent sleep for the most part. I remember a couple of awakenings but went back to sleep. AHI on the LCD screen was 1.0. I might pull the SD card later to review things (I don't routine look at the details because I pretty much already know what I will see) and I might not. All I really care about is I slept and feel halfway decent today.

And before anyone admonishes me for mixing pain pills and sleeping pills...this is under the direction of my doctor and the sleeping pill I take is one of those new (and very expensive) kinds and it is totally safe to take it with opiates.
It isn't something I do every night though. I save it for emergencies where I know I can't risk another really bad night.
My doctor and I have discussed at length this plan of attack for my sleep issues. We know that my sleep issues are caused by multiple culprits and we are doing the best we can to mitigate things.
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Conrad
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Re: Advice on adjusting my settings needed

Post by Conrad » Sat Nov 27, 2021 8:45 am

Another good night for me, both number wise and good sleep wise.


I'm really sorry to hear about your dog. Is he/she ok? I hope so!

I'm right there with you as far as dogs are concerned. Our fur kids. We had three up until 2017. The three amigos were inseparable. The youngest was 8 and she developed an autoimmune disease and had to be euthanized. This was literally the hardest decision that I ever had to make in my life, I'm still not over it, four years later and I still miss her terribly... I loved that lil dog dearly and her life was cut short.

Last year we had to euthanize our 18-year-old mini-Dachshund, Again, very difficult but at least she had a full life and that made it a bit easier, not much but a little.

That left the last amigo alone, she's currently 13 years old. She needed a companion so in May of this year we got a puppy. Another mini-Dachshund. The two of them get along great except that the pup is ALWAYS wanting to play and rough house but the older dog just wants to be left alone at times, ain't happenin...
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Pugsy
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Re: Advice on adjusting my settings needed

Post by Pugsy » Sat Nov 27, 2021 9:34 am

Conrad wrote:
Sat Nov 27, 2021 8:45 am
I'm really sorry to hear about your dog. Is he/she ok? I hope so!
Glaucoma and not responding well to the eye drops to reduce the pressure (she fights them for one thing) and is experiencing either a lot of itching or pain....so lots of scratching and SCREAMING from pain most likely. Pug dog...don't know if you ever heard a pug dog scream but they literally sound like a squealing pig. It would wake the dead.
The eye is really damaged and for all practical purposes no vision in it anyway so this next week we are going to remove the eye and see if we can get her to be more comfortable. Her name is Lucy...about 8 years old I guess now. She is a rescue dog.
Actually all my dogs are rescues...right now 2 pugs and a wire hired terrier and a beagle/blue heeler mix.

Not my avatar though...my avatar is my Pug ...Sarge...who we lost to a sudden heart condition 3 years ago I guess it was.
Died in my arms on the way to the vet. I still think about him every day and cry for him.
I got Lucy when Sarge died. He was only 9.

I do understand that hard decision though...have had to make it myself way too many times. It totally sucks.
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Conrad
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Re: Advice on adjusting my settings needed

Post by Conrad » Sun Nov 28, 2021 8:49 am

Good luck with Lucy, I hope that all goes well for her.

I've never heard a Pug scream but they sure have some funny barks! Our kitty corner neighbor has two of them. Our dog that I mentioned above, who died back in 2017, used to always have a 'conversation' with these Pugs whenever they were all outside at the same time. She would 'talk' to them and then sit quietly waiting for them to reply, very funny!
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Do not regret growing older. It is a privilege denied to many...