Events per hour has increased

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
vandownbytheriver
Posts: 256
Joined: Sat Feb 03, 2024 11:42 pm

Re: Events per hour has increased

Post by vandownbytheriver » Sat Mar 23, 2024 10:39 pm

chzuck wrote:
Sat Mar 23, 2024 8:01 pm
I don't know how to change the air settings and did not know I was allowed. What would my doctor say. I thought the reason I had the sleep test was to determine the settings. Just asking because I am new at this.
I will post some results when I get a chance.
Your machine is in 'S' mode... fixed iPap and ePap pressures. It is registering OA events but it is not letting us see any Flow Limitations due to the mode... so we can't be sure if more pressure would help. Pressures are already pretty high, your machine only goes to 25.

I'd ask your physician if there's a reason you were not put in vAuto mode. We could try and give you settings but that's pretty scary given the extreme situation you're in.

I would be interested in a zoom-in to one of those clusters of OA's... are the breaths flat-topping or otherwise distorted? That's the kind of thing we'd see FL's for if the machine was allowed to graph them. Can you correlate the clusters with your sleeping position? OSA is often positional.

_________________
Machine: AirCurve 10 Vauto USA C2C CO
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: I use O2Ring, Oscar, SleepHQ, and Cover Roll Stretch mouth tape.

User avatar
Miss Emerita
Posts: 3444
Joined: Sun Nov 04, 2018 8:07 pm

Re: Events per hour has increased

Post by Miss Emerita » Sun Mar 24, 2024 11:48 am

You can emulate your current settings by switching to VAuto mode and using these settings:

EPAP min 15
IPAP max 19
PS 4.

This will allow you to see your flow limitations.

As for what the doctor will think.... First, you have the right to change your settings. This will not void your insurance, for example. Second, some doctors get very huffy if you change your settings, while others support their patients who want to take a more active role in their therapy.

If your doctor even notices you've changed your settings, and if he or she gets huffy, you can point to your AHI and explain that you are using Oscar data to try to get better results from your therapy. But again, the change of mode won't change your effective settings, so you could at least start with that step.

Your clusters of OAs could conceivably be caused by chin-tucking. Some people get a lot of improvement by wearing a soft cervical collar at night. Lots of information and tips here:

https://www.apneaboard.com/wiki/index.p ... cal_Collar

I'd suggest you give that a try.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

chzuck
Posts: 57
Joined: Tue Feb 13, 2024 12:32 pm
Location: Pennsylvania
Contact:

Re: Events per hour has increased

Post by chzuck » Sun Mar 24, 2024 6:56 pm

Miss Emerita wrote:
Sun Mar 24, 2024 11:48 am
You can emulate your current settings by switching to VAuto mode and using these settings:

EPAP min 15
IPAP max 19
PS 4.

This will allow you to see your flow limitations.

Your clusters of OAs could conceivably be caused by chin-tucking. Some people get a lot of improvement by wearing a soft cervical collar at night. Lots of information and tips here:

https://www.apneaboard.com/wiki/index.p ... cal_Collar

I'd suggest you give that a try.
Current settings:
Mode
BiLevel-S
EPAP 15.00 cmH2O
IPAP 19.00 cmH2O
PS 0.00 cmH2O
I am new at this and learning the machine. What will a PS increase to 4 do? And what changes in the machine operation would I see in vAuto mode?

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Additional Comments: Pressure: EPAP 15.0 IPAP 19.0 (cmH2O)

chzuck
Posts: 57
Joined: Tue Feb 13, 2024 12:32 pm
Location: Pennsylvania
Contact:

Re: Events per hour has increased

Post by chzuck » Mon Mar 25, 2024 7:24 am

Last night's results. Best events per hour that I had in awhile. Not sure what I was doing wrong, but I could not paste the graph into the post.

https://imgur.com/a/DcCeeuv

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Additional Comments: Pressure: EPAP 15.0 IPAP 19.0 (cmH2O)

chzuck
Posts: 57
Joined: Tue Feb 13, 2024 12:32 pm
Location: Pennsylvania
Contact:

Re: Events per hour has increased

Post by chzuck » Mon Mar 25, 2024 8:29 am

vandownbytheriver wrote:
Sat Mar 23, 2024 10:39 pm


Your machine is in 'S' mode... fixed iPap and ePap pressures. It is registering OA events but it is not letting us see any Flow Limitations due to the mode... so we can't be sure if more pressure would help. Pressures are already pretty high, your machine only goes to 25.

I'd ask your physician if there's a reason you were not put in vAuto mode. We could try and give you settings but that's pretty scary given the extreme situation you're in.

I would be interested in a zoom-in to one of those clusters of OA's... are the breaths flat-topping or otherwise distorted? That's the kind of thing we'd see FL's for if the machine was allowed to graph them. Can you correlate the clusters with your sleeping position? OSA is often positional.
Does this help at all?

https://imgur.com/8Sjma4o

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Additional Comments: Pressure: EPAP 15.0 IPAP 19.0 (cmH2O)

User avatar
vandownbytheriver
Posts: 256
Joined: Sat Feb 03, 2024 11:42 pm

Re: Events per hour has increased

Post by vandownbytheriver » Mon Mar 25, 2024 9:15 am

chzuck wrote:
Mon Mar 25, 2024 8:29 am
vandownbytheriver wrote:
Sat Mar 23, 2024 10:39 pm


Your machine is in 'S' mode... fixed iPap and ePap pressures. It is registering OA events but it is not letting us see any Flow Limitations due to the mode... so we can't be sure if more pressure would help. Pressures are already pretty high, your machine only goes to 25.

I'd ask your physician if there's a reason you were not put in vAuto mode. We could try and give you settings but that's pretty scary given the extreme situation you're in.

I would be interested in a zoom-in to one of those clusters of OA's... are the breaths flat-topping or otherwise distorted? That's the kind of thing we'd see FL's for if the machine was allowed to graph them. Can you correlate the clusters with your sleeping position? OSA is often positional.
Does this help at all?

https://imgur.com/8Sjma4o
I'm seeing OA's that look more like CA's... there's one little devil-horn breath at the left end... so some flow limitation there? MissE has given you settings that would give the same pressure results yet turn on FL graphs. if you use those we could see if there's further improvement to be had in pressure changes. We can't see your Ti and trigger settings on the left panel, the machine uses these to tell when to switch from inhale to exhale.

My non-doctor non-expert opinion is that you have complex sleep apnea and may be on the wrong machine. There are several different options, ASV being one:

https://www.utoledo.edu/policies/utmc/s ... -07-01.pdf

Beyond the changes MissE suggested I have no suggestions for change, this is expert time, get with a good doctor.

_________________
Machine: AirCurve 10 Vauto USA C2C CO
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: I use O2Ring, Oscar, SleepHQ, and Cover Roll Stretch mouth tape.

chzuck
Posts: 57
Joined: Tue Feb 13, 2024 12:32 pm
Location: Pennsylvania
Contact:

Re: Events per hour has increased

Post by chzuck » Mon Mar 25, 2024 9:21 am

I will make the PS change and monitor and submit another graph in a day or so.
I am seeing a pulmonary group and here is what she said when I messaged about the rise in events: I reviewed your last month compliance and data revealed average events 7.2 / hour. Mild leak noted. Are you noticing any leak, I recommend replacing mask and monitoring for any leak. You had severe sleep apnea, AHI 56 on your sleep study. I recommend continuing same pressure.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Additional Comments: Pressure: EPAP 15.0 IPAP 19.0 (cmH2O)
Last edited by chzuck on Mon Mar 25, 2024 9:25 am, edited 1 time in total.

User avatar
Pugsy
Posts: 64020
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Events per hour has increased

Post by Pugsy » Mon Mar 25, 2024 9:23 am

I have my doubts as to whether you were really asleep or not when those events got flagged that you zoomed in on.

Did you wake up during the night?

I don't see anything that comes close to a complex sleep apnea diagnosis. What I see is awake/arousal breathing irregularities.

A scroll through a SleepHQ report is in order.

_________________
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.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

chzuck
Posts: 57
Joined: Tue Feb 13, 2024 12:32 pm
Location: Pennsylvania
Contact:

Re: Events per hour has increased

Post by chzuck » Mon Mar 25, 2024 9:28 am

Pugsy wrote:
Mon Mar 25, 2024 9:23 am
I have my doubts as to whether you were really asleep or not when those events got flagged that you zoomed in on.

Did you wake up during the night?

I don't see anything that comes close to a complex sleep apnea diagnosis. What I see is awake/arousal breathing irregularities.

A scroll through a SleepHQ report is in order.
Woke up twice for bathroom call. I am new, where do I go for a SleepHQ report?

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Additional Comments: Pressure: EPAP 15.0 IPAP 19.0 (cmH2O)

User avatar
Pugsy
Posts: 64020
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Events per hour has increased

Post by Pugsy » Mon Mar 25, 2024 9:37 am

How old are you?
Male or female?
If male what are the odds the nocturia is related to the old prostate?
Pee a lot during the day????

SleepHQ has a free and paid for version. The free version is sufficient and it allows for an interactive report so we can zoom in and scroll through the flow rate looking for asleep breathing vs awake/arousal breathing.
If not asleep those flagged events don't matter except to point to less than optimal sleep quality

Sorry....I don't have the download link handy for SleepHQ and no time to go looking. Someone here will point you to it.

_________________
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.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Pugsy
Posts: 64020
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Events per hour has increased

Post by Pugsy » Mon Mar 25, 2024 9:43 am


_________________
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.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

chzuck
Posts: 57
Joined: Tue Feb 13, 2024 12:32 pm
Location: Pennsylvania
Contact:

Re: Events per hour has increased

Post by chzuck » Mon Mar 25, 2024 10:04 am

Pugsy wrote:
Mon Mar 25, 2024 9:37 am
How old are you?
Male or female?
If male what are the odds the nocturia is related to the old prostate?
Pee a lot during the day????

SleepHQ has a free and paid for version. The free version is sufficient and it allows for an interactive report so we can zoom in and scroll through the flow rate looking for asleep breathing vs awake/arousal breathing.
If not asleep those flagged events don't matter except to point to less than optimal sleep quality

Sorry....I don't have the download link handy for SleepHQ and no time to go looking. Someone here will point you to it.
75 year old male and yes, pea a lot especially if I drink coffee in the am. One of my blood pressure meds is a diuretic. I do have some nights where I get up only once, but there are other nights I am up 2 or 3 times.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Additional Comments: Pressure: EPAP 15.0 IPAP 19.0 (cmH2O)

User avatar
Pugsy
Posts: 64020
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Events per hour has increased

Post by Pugsy » Mon Mar 25, 2024 10:11 am

My own husband will be 75 next month and he also has the "pee alot" thing because of enlarged prostate.
Comes with the territory but there are meds which might help. My own husband is too bullheaded to ask about the meds but they might be worth considering.
While nocturia is also a known symptom of sleep apnea....it's not the only known cause.

Get us that SleepHQ report please for us to scroll through. I have asked a sleep tech to review your thread and he will want to see that flow rate up close. Without seeing those breaths up close all we can do is guess about what is going on with your flagged events (and/or sleep quality) and I don't like WAGs...wild ass guesses. I refuse to do them when data is available for verification.

_________________
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.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

chzuck
Posts: 57
Joined: Tue Feb 13, 2024 12:32 pm
Location: Pennsylvania
Contact:

Re: Events per hour has increased

Post by chzuck » Mon Mar 25, 2024 10:53 am

Pugsy wrote:
Mon Mar 25, 2024 10:11 am
My own husband will be 75 next month and he also has the "pee alot" thing because of enlarged prostate.
Comes with the territory but there are meds which might help. My own husband is too bullheaded to ask about the meds but they might be worth considering.
While nocturia is also a known symptom of sleep apnea....it's not the only known cause.

Get us that SleepHQ report please for us to scroll through. I have asked a sleep tech to review your thread and he will want to see that flow rate up close. Without seeing those breaths up close all we can do is guess about what is going on with your flagged events (and/or sleep quality) and I don't like WAGs...wild ass guesses. I refuse to do them when data is available for verification.
I thank you much for your interest in my situation. I will change the PS setting before I use it tonight and my wait for a couple days of data before I post results again. I will check out that SleepHQ site and do the questionnaire. This site has been more helpful than my provider or doctor.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Additional Comments: Pressure: EPAP 15.0 IPAP 19.0 (cmH2O)

User avatar
Miss Emerita
Posts: 3444
Joined: Sun Nov 04, 2018 8:07 pm

Re: Events per hour has increased

Post by Miss Emerita » Mon Mar 25, 2024 12:05 pm

Change the mode first; then use the settings I gave you. Any chance your doctor could work with you on changing the timing of your diuretic pills?
Oscar software is available at https://www.sleepfiles.com/OSCAR/