Why doesn't APAP respond to apneas?

So on CPAP at 14 cm, we see some "machine-scored" periodic breathing. None of the OSA machines have data sets that are even capable of revealing that extremely essential SDB clue. Home-machine data bashers: please don't throw that clue out as if it were an artifact. It corroborates the central emergence shown on Bev's NPSG---and a variety of other essential SDB clues presented here as well.

It's not typical of narcolepsy. That's not to say narcolepsy isn't present----especially if there was a head injury having caused a variety of breathing as well as sleep/wake dyscontrol issues.

What happened to the pressure at hours 4-5 and 7-8? With all those minimums set, how come its hovering at 10? doing at 10?

O.

ozij wrote:What happened to the pressure at hours 4-5 and 7-8? With all those minimums set, how come its hovering at 10? doing at 10?

It clearly shouldn't deliver anything but 14 cm when IPAP min, IPAP max, and EPAP are all set to 14 cm. It seems to be related to the fact that her peak flows are elevated during that same time period. Three hypotheses in no particular order: 1) the algorithm may selectively override the 14 cm setting when peak flows spike on either a clustered or sustained basis, 2) manometry-related servo-feedback is typically and dynamically signal-skewed by erratic or unusually turbulent patient peak flows (so averaged dynamic machine-end pressure readings are being very accurately reported versus more sustained mask pressure estimations, thus factoring but not reporting dynamic/additive patient pressures---summary: utilizing different and more dynamic reporting criteria than sustained-estimation reports more typical of basic OSA machines), or 3) yet another Encore software reporting error.


on edit: most pressure drops seem to correlate to either a spike or sustained increase in patient peak flow. I'm favoring hypothesis two at this point. Hypothesis one sure doesn't fit the definition of CPAP modality. Hypothesis four: broken machine---which I doubt.

Doug, what does your BiPAP autoSV machine do in CPAP mode?

Banned wrote:Could the headache be from the cocktail of anti-depressants, pain-meds, and sleeping pills?

Banned

Bev, in light of the headaches I would suggest going back to your APAP 14 - 17 treatment. I also wonder if the headaches might be attributable to the added stress or anxiety associated with these experiments. Quite frankly I don't know that I would be able to sleep well if the whole world were anxiously watching my every sleep experiment. That's potentially quite a bit of emotional pressure IMHO.

SAG, here is my analyzer report for 10/23 to 10/24




and to keep it on the same page, here is the Encore report from my APAP



Banned, my "cocktail" consists of 3mg melatonin and 5mg of Ambien. I am not taking any pain medication.

Bev

I think that machine needs to be sent back to Black & Decker for repairs.

Has the apnea duration of skinners reports been compared to long term trend report for apnea duration?

Are they the same or similar? If not you may be looking at a math error.

summary: utilizing different and more dynamic reporting criteria than sustained-estimation reports more typical of basic OSA machines

The above rock-solid 14 cm pressure graph is precisely what I mean by "sustained estimation reports". That's a typical sustained pressure report for a more basic OSA machine. Yet dynamic pressure measurements, even averaged, shouldn't reflect that solid 14 cm line. That sold 14 cm line is not a pressure measurement reality by any stretch of the imagination. But it's very typical of what our more basic OSA machines report.

snoredog wrote:I think that machine needs to be sent back to Black & Decker for repairs.

Or the shaver company that made it.

Snoredog,

Encore showes my Time in Apnea average for June to present at 3 minutes.

Analyzer shows the 6 moth average at 3.1. Pretty close. It's interesting to me that the Analyzer goes back to last November when I got this machine. The Encore reports only go back to when I got this laptop, after my hard drive failed in my desktop.



Those spikes in March were the nights after my surgery. That's Bev's brain on drugs. And that is why I'm afraid to take any pain medication.

Bev

Just realized those are accumulative times spent in apnea per night. My first thought was: "Wow, there's a 1200 second apnea". I don't use EP analyzer. So much for first thoughts. Glad it wasn't a twenty minute apnea.

Bev, was that spike while using Lexapro or some other/additional post-surgery med(s)? Wonder if the drug brought you into REM where you experienced obstructive apneas that were simply too heavy for your usual machine pressure to resolve.

OutaSync wrote:SAG, here is my analyzer report for 10/23 to 10/24

OK, an average of 20.7 seconds vs 36.6 seconds makes a heckuva lot more sense. That spot seems pretty consistent time-wise, and the events continue to appear in salvo, so I think that's probably where a REM period sets up shop evey night.

SAG

I believe some CPAP users are vulnerable or susceptible to headaches from CPAP use. I am getting headaches while using CPAP in the following areas, but sometimes it's just one, not both: above the eye on the skull bone and side of the nose.

Like with all researched based science, I suspect in 40 or so years scientists will come out and reveal the side effects of of CPAP therapy instead of the usual, it's all in your head, take an antidepressant.

SWS,
THat was Lexapro, Tylenol and Ibuprofen, alternating every 4 hours and oxycodone every 4 hrs. Did that for two days and then toughed it out after I saw my apnea spikes. I still have 16 left out of a 40 pill prescription.

Bev

Hmmm,

That chart shows 9 CMs as the starting point. Peculiar ?

I'll have a little play with my machine but am on notice from my other half. My machine only just got back to normal after the experiments from a week ago.
I don't believe that playing with settings leaves artifacts that will distort its subsequent behavior, but the doubt is there

I it possible the machine is still influenced by saved data from prior operation (like in Bev's case epap had been at 9 - Bev changes it to 14 but the machine unless reset to factory default (internela memory emptied) may have artifacts related to running at 9 CMs & they may intervene ? - anyone got any thoughts re such a scenario ?

DSM

DSM, I think that theory falls under the general category of Encore Pro data reporting errors---and we sure have seen plenty of that with the other machine models that utilize Encore Pro.

Bev, you mentioned that you initially had a difficult time getting used to CPAP. Headaches during that initial acclimation period as well?

Ok. Then the cure for the morning headache is at the Dentist's office. He or she will take impressions for a little plastic device that fits over your front teeth. It's advertised as the morning headache cure. I think it actually works. I use one every night. It's definitely too small and light to use as a door stop.

Banned

Banned wrote:Ok. Then the cure for the morning headache is at the Dentist's office. He or she will take impressions for a little plastic device that fits over your front teeth. It's advertised as the morning headache cure. I think it actually works. I use one every night. It's definitely too small and light to use as a door stop.

Is your dental device intended to guard against bruxism/grinding or does it advance the mandible to help with SDB? Either problem can cause headaches.

Interesting that you should mention that. Yesterday evening I was wondering if Bev might benefit by resolving at least part of her SDB with a dental device. If she got lucky and resolved all of her SDB with a dental device there would be no worry about the pressure side effects of using PAP therapy.