Help please.....in the UK
Re: Help please.....in the UK
Good morning and once again thank you for your detailed advice I will be sure to do my home work . Unfortunately not a great night sleep time 4.33 events 21.9 . Before cpap I always sleeped on my side it seems now I prefer to sleep on my back . I think on my side there seem to be two issues first can’t really get that comfortable with the mask on my side. Second feels like some sort of lung restriction on my side ? Will try and explain better. On my back breathing in and out under pressure seems so much easier quite therapeutic actually. Do you think if I try to raise my top half of my body and head that will help ? Hope I have explained this ok many thanks Andy 
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Re: Help please.....in the UK
A lot of people have trouble on one side vs the other - have you tried sleeping on the other side?
Re: Help please.....in the UK
Good afternoon many thanks for your reply yes tried both sides pre cpap all ok but with the mask and pressure being pumped into me laying on my side seems to restrict the breathing 
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- Miss Emerita
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Re: Help please.....in the UK
Would it help to put a pillow under your top arm so your chest stays more open?
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Re: Help please.....in the UK
Hi thank you for your reply yes it’s worth giving it a go
many thanks
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Re: Help please.....in the UK
Hi again Pugsy,Pugsy wrote: ↑Fri Mar 11, 2022 6:09 pmNeeding to pee often during the night (official medical term is nocturia) is a common symptom of sleep apnea.
I had it myself and it was the first symptom to go away with effective treatment. I always said that even if nothing else got better that the no more peeing every hour on the hour was well worth it.
Now of course there are other reasons that people might have nocturia issues...over active bladder for male or females as well as for the guys that are a bit older the old prostate causing problems is another.
Then there's the "habit" thing....people get used to waking up needing to pee and once the sleep apnea takes care of the nocturia the people may have developed the "habit"....you know wake up for some reason and decide "I am awake so I might as well go pee" but maybe the bladder isn't full. I know when I had it prior to starting cpap....my bladder was painfully full causing the wake up. Big difference between having to pee and just "I might as well go pee".
Your OSA is much worse on your back and if you need to sleep on your back we may need to re-evaluate the pressure settings but for now just sleep in any position that you can sleep in and don't worry about it.
Your main priority right now is to decrease the wake ups. If at all possible try to figure out what might be causing them.
Now it is normal to wake up after the end of a REM sleep stage cycle but most of the time we aren't awake very long and don't have a memory of the awakening....but if you do wake up 2 or 3 times a night....it could be REM related and we just accept it. What we don't want to go doing is starting more sleep problems by worrying about waking up.
The lack of dreaming...doesn't mean much really.
We can dream in any sleep stage and not just in REM and not remembering them doesn't mean they didn't happen.
All it means is you didn't wake up during the dream which is actually a good thing. We want to keep the wake ups at a minimum.
Also...sometimes we just wake up and don't really know why and can't find anything comfortwise that we can maybe blame the wake up on. Sometimes it's just the newness of it all and the brain wanting to alert its human that there is an alien plastered on the face and blowing air up the nose. I had this happen to me for at least 3 months when I started therapy.
I was happy with the mask and the therapy and doing very well but I still would have these wake ups 8 to 10 times that I couldn't figure out why except my mind seemed to be on the therapy. Once I got used to the pressures a lot of times I would wake up wondering if the machine was on because I didn't notice the pressure anymore.
Eventually the brain does adjust and comes to see that alien as its human's new best friend.
There is a lot of truth to the old adage of "give it time" as well. Time for the body and brain to adjust to the new way of doing things. This is why once we get settings that give us decent results that we say to just keep those settings for a while and lets see how things go. Don't go changing things without a really good reason. Give the body and brain a chance to adjust. I like to have at least a weeks worth of data without any changes before I consider changing anything unless there is a huge problem with a new setting.
I am reasonably certain some of your central apneas are related to arousal/awake breathing false positives but I can't say for sure that the majority are. There are people who have centrals pop up just from starting cpap therapy. I don't know yet if you fall into that category or not. It's about 10% of the people who start cpap that end up having this happen.
Sometimes if it does happen the centrals will fade away on their own....sometimes people need a different machine.
So for you...we don't know for sure how many of the centrals are the real deal and even if the bulk were real....the most common thing done about them is to sit back and just watch them because sometimes they will go away on their own.
In the meantime you learn how to identify real vs awake centrals.
So...work on sleep quality itself. Continue the on/off button thing so we know for sure when awake times are happening...and do whatever it takes for you to get to sleep and stay asleep.
Google "good sleep hygiene habits" and see if there is something you are doing that can be improved upon to facilitate sleep.
If you can safely take some sort of OTC sleep aid...try it and see if it helps or not.
We need a night with maybe only 2 or 3 wake ups to best evaluate your pressure needs as well as those centrals.
3 or 4 hours of solid sleep would be a big help.
Don't obsess over it though. There are 2 kinds of insomnia...sleep onset insomnia which is trouble falling asleep and sleep maintenance insomnia which is where we wake up too many times during the night or wake up and can't go back to sleep which sort of turns into sleep onset insomnia. The insomnia monster feeds on worry though. So try not to worry about it because most of the time it just makes things worse.
You are reporting feeling better though...which is another reason I tend to think those centrals are arousal related.
If they were the real deal asleep centrals I think with that many we are seeing that you would feel like total crap...and not feeling better.
Your assigned homework....read up on good sleep hygiene....work on identifying real vs awake/arousal centrals...and just get some sleep any way you can.
Here are some more…
This is last nights (11/03):
https://gyazo.com/2f1a21e1387a23414cbb5438f284fc28
The following are random nights some good, some bad, for comparison.
27/10/21
https://gyazo.com/ed2481e64e60b99f489918e360994e45
06/11/21
https://gyazo.com/dd4ef8f9356250bb814ccfbd475ba120
26/11/21
https://gyazo.com/ae4c4e336dfb3cd6680240b5bdcee954
13/12/21
https://gyazo.com/2f23c45d46af5841100adf45598cb163
17/01
https://gyazo.com/d7c7d889461ccbf3ea68914588db266a
20/01
https://gyazo.com/62aa0a1aba7c3ff9d848bade6c949168
I hope these help shed some light,
Thanks again
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Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Re: Help please.....in the UK
Not much light spreading....but a lot of question making.
Like how come some nights just one little cluster of centrals and other night end up being like last nights?
Like what change to cause such a big difference?
On the good nights did you even sleep?
How did you sleep last night?
Spend much time awake with mask and machine on?
Or soundly for the most part with minimal time with mask and machine on?
When did you actually start cpap?
Has it always been "some sort of good nights with not all that many central clusters" and "some where all hell breaks loose"?
Within the last month have you had any "good" nights at all? If so, how many?
Like how come some nights just one little cluster of centrals and other night end up being like last nights?
Like what change to cause such a big difference?
On the good nights did you even sleep?
How did you sleep last night?
Spend much time awake with mask and machine on?
Or soundly for the most part with minimal time with mask and machine on?
When did you actually start cpap?
Has it always been "some sort of good nights with not all that many central clusters" and "some where all hell breaks loose"?
Within the last month have you had any "good" nights at all? If so, how many?
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Re: Help please.....in the UK
Hi good evening I am really not sure much changes to be honest on good nights I seem to sleep well for say 3 to 4 hours have had my machine since last October not many good nights in the last month really really confused about these centrals
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Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Re: Help please.....in the UK
No last night wasn’t a good night
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Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Re: Help please.....in the UK
You could have what is called treatment emergent central apnea which when combined with your obstructive sleep apnea diagnosis ends up giving you what is called complex sleep apnea.
That's why I have tried so hard to figure out if you were awake or asleep when these centrals are being flagged.
Now sometimes when people do develop central sleep apnea because of the use of cpap itself they will find that with some time the centrals fade away. Sometimes they never fade away and when the centrals are numerous enough the person needs a different machine.
And last night you had some periods of time where you didn't have any centrals.
You have centrals cluster with and without pressure changes so I don't see it being a situation where pressures above so and so are the trigger.
You really need that in a hospital sleep study to be done. I realize that isn't an easy or quick option for you right now and about all I can offer is to try to get you to sleep soundly so we can confirm whether or not these centrals are related to your poor sleep....or is your poor sleep caused by the centrals???? Which came first kind of thing.
There's nothing we can really offer with this machine except not using EPR that might stand a chance of helping and then only if EPR is the trigger and you have already used the machine without EPR and the centrals didn't reduce....so that leads us to believe that EPR is NOT the trigger. That's too bad because it really is the only thing we can do with this machine that would maybe have helped.
How are you doing with your homework trying to figure out if you were asleep or not when those centrals got flagged???
That's why I have tried so hard to figure out if you were awake or asleep when these centrals are being flagged.
Now sometimes when people do develop central sleep apnea because of the use of cpap itself they will find that with some time the centrals fade away. Sometimes they never fade away and when the centrals are numerous enough the person needs a different machine.
And last night you had some periods of time where you didn't have any centrals.
You have centrals cluster with and without pressure changes so I don't see it being a situation where pressures above so and so are the trigger.
You really need that in a hospital sleep study to be done. I realize that isn't an easy or quick option for you right now and about all I can offer is to try to get you to sleep soundly so we can confirm whether or not these centrals are related to your poor sleep....or is your poor sleep caused by the centrals???? Which came first kind of thing.
There's nothing we can really offer with this machine except not using EPR that might stand a chance of helping and then only if EPR is the trigger and you have already used the machine without EPR and the centrals didn't reduce....so that leads us to believe that EPR is NOT the trigger. That's too bad because it really is the only thing we can do with this machine that would maybe have helped.
How are you doing with your homework trying to figure out if you were asleep or not when those centrals got flagged???
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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
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Re: Help please.....in the UK
I understand I have been watching the videos and I am getting a good understanding of these centrals I will look at more tmrw . My average pressure to stop my apnoeas over the month is 12.5 just a thought if I put my machine on cpap only setting at say 12.5 could that help ? . Or I elevate my upper body up the pressure and sleep on my back turn epr down to say 1 ? I will be guided by your knowledge 
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Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Re: Help please.....in the UK
Where are you getting the 12.5 number that you think is the average? That 95% number on the statistics???
That's not an average like you are thinking normal average. 95% numbers just mean you were AT OR BELOW that number for 95% of the night. The "or below" part of the definition is real important.
If you are looking for average...look at the median average number. It will be much closer to the overall average than the 95% number.
Sleeping on your back is going to make your obstructive apneas come fast and furious per your sleep study report.
Hugely worse and along with that you may also need more pressure to prevent the airway from collapsing.
Not a 100% certainty but often when OSA is worse with position then the pressure needs also greatly increase.
But...your idea of trying cpap mode is a good idea. I don't think you need 12.5 though. Maybe try cpap mode at around 7 cm. See what happens.
In a very few people who develop centrals with cpap....auto adjusting pressure mode can make it worse.
That's why I had you try minimum of 8 and max of 9...that's almost fixed mode. Very tight range.
That's not an average like you are thinking normal average. 95% numbers just mean you were AT OR BELOW that number for 95% of the night. The "or below" part of the definition is real important.
If you are looking for average...look at the median average number. It will be much closer to the overall average than the 95% number.
Sleeping on your back is going to make your obstructive apneas come fast and furious per your sleep study report.
Hugely worse and along with that you may also need more pressure to prevent the airway from collapsing.
Not a 100% certainty but often when OSA is worse with position then the pressure needs also greatly increase.
But...your idea of trying cpap mode is a good idea. I don't think you need 12.5 though. Maybe try cpap mode at around 7 cm. See what happens.
In a very few people who develop centrals with cpap....auto adjusting pressure mode can make it worse.
That's why I had you try minimum of 8 and max of 9...that's almost fixed mode. Very tight range.
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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
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Re: Help please.....in the UK
Ok great I will give it a go many thanks 
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Re: Help please.....in the UK
I seem to remember that you'll lose access to some data in CPAP mode. If that's true, you can get the same effect by setting the minimum and the maximum to the same number in APAP mode.
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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Mask: Bleep DreamPort CPAP Mask Solution |
Oscar software is available at https://www.sleepfiles.com/OSCAR/
Re: Help please.....in the UK
Might lose the FL graph but that's it I think. In this situation his FLs aren't all that exciting anyway.Miss Emerita wrote: ↑Sat Mar 12, 2022 4:38 pmI seem to remember that you'll lose access to some data in CPAP mode. If that's true, you can get the same effect by setting the minimum and the maximum to the same number in APAP mode.
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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.