Still Snoring

I found some old printouts of MyEncore Daily Reports that I used to print when I first got my auto machine.

Lori, when you start comparing old reports with more recent ones, remember the "variables". Mouth air leaks really can make a difference. You were fighting mouth air leaking in the beginning, weren't you? And now you have that under control. Dunno if you'll really get much out of comparing the early apples with the later oranges.

Oh, RG, I am so lost right now. Yes, you're right about comparing the old data to the new, especially with the new Dr. Sue NB device. However, I left the setting on auto again last night and I had ZERO apnea events, but my AHI went up to 1.8 due to hypops, a lot of them. My snore index was a 2.5, too, with a low 0.6 flow limitation.
I have this forceful urge just to go back to my 10-10 or straight 10 CPAP and get the great AHI's, etc. again.
I wish I knew the significance of what snoring indicates, if anything, and why auto cannot stop my hypops. At my initial PSG, I had no apnea, only hypops, and only a 4 AHI. This is far worse after being on CPAP since the beginning of June. Something tells me this isn't the right setting for me, even though it's only been four nights.

Lori,
Try to go by what you feel, not by what the numbers say.
And when a week is over raise your lower limit just one point.
And wait.

O.

O,

I don't feel as good. When I first adjusted the machine, I thought maybe it was coincidental. But now after four nights of numerous events, I am really feeling it. No, not as bad as pre-xpap, but not as "spunky" as I had become. I truly had endless energy again and it's just not there now.

So many things have changed in my therapy that it's hard to know which one is causing it. My guess, though, is that the auto is not helping as it lets too many episodes per night happen.

WillSucceed wrote a great reply to my Why Not Auto thread before that really made me understand auto a lot better. I doubt it's anything you don't already know yourself as you seem to know a tremendous amount about all this stuff. But he helped me realize how the auto works and to get those numbers down, I would probably have to go back to the straight 10 CPAP again or try another manufacturer's auto machine in the future. Interesting reading, in any event.

But thanks for your input, as always appreciated.

Lori,

IMHO.....Go back to the "10" setting and don't worry about the Snore Index.
Unless you are snoring while mouth-breathing.....and I don't think you are, your snoring is probably a nasal snore (like mine) and is probably insignificant. I've had some of my best AHI numbers on nights with a high Snore Index. Consequently, I don't connect those two dots.

I have been tempted to tweak with my setting at times, too....maybe go up to 11 or 12, but I resisted and my numbers have continually been dropping. I get an occasional spike in something, but overall they're all dropping.....and, I'm feeling better. Sometimes I think I must still have a huge sleep deficit to make up, but I'm definitely feeling better.

Have a good one,

Den

Thanks, Den. It's always great to hear from people whose opinions you can trust, and you fall into that category.

Coincidentally, my snore index is only high on auto. When my machine is set to straight 10 or 10-10 auto (effectively the same thing except for the readout on the software), I get the same results; which is, zero snore index and very, very low AHI's. My flow limitations, though, are higher as is the leak rate. But I guess if the AHI is better and I'm feeling more energetic that way, that's what really counts. So if I go back to 10, then I will eliminate my snores, once again, and lower my AHI, making myself feel better.

I guess, as Rested Gal calls us, I am a true lab rat at heart. Didn't know it until I was afflicted with this condition, which is evidence by my constant need to tweak something! However, the mouth breathing is totally resolved with the Dr. Sue device or the Tegaderm and the only problem I have is my Swift leaks a bit more with 10, causing a higher leak rate.

Well, out with my daughter for a little last minute back-to-school shopping while we have the last day of tax-free week on clothes and shoes. It is costing me more than without tax-free week as my mindsight is to buy everything now while I don't have to pay the ridiculous 8.75% sales tax on it here on Long Island. Once of the "advantages" of living where I do ...

I've had some of my best AHI numbers on nights with a high Snore Index. Consequently, I don't connect those two dots.

I agree, Den. Same here...some of my lowest AHI's have been from nights when quite a few snores were ticked on the chart. Am definitely not "snoring" unless it's such a subtle flutter that the machine picks it up in the air flow characteristics, but listening ears don't.

Also, I noticed that more "snores" (or flutters that the Remstar took to be snores) get registered when I use the separate F&P heated humidifier instead of the Remstar's integrated humidifier. Less Sleepy thought that might be due to more rippling of the water surface with the F&P humidifier. I agreed, as there's a completely different angle of attack with air coming into the F&P humidifier from above and straight down toward the water, as opposed to coming in from the side with the integrated humidifier.

Another poster once wrote of the Remstar Auto picking up vibrations from her oxygen generator (in another room!) and counting them as snores. When she got a modern oxygen machine to replace the clunky loud older one, those false "snores" stopped being marked on the data.

Derek did several experiments in the past that were interesting....

Feb 19, 2005 subject: Experiments on RemStar Snore Detection...

I pay almost no attention to my "snore" index nowadays.

Thanks RG.

Like others, I always try to read your posts and appreciate your input. I had read either that thread (or another like it) by Derek concerning his experiments.....pretty interesting. Coincidentally, there's a portion of his testing that involves coughing.....which I found interesting. These last couple of weeks I've been battling another sinus cold with a cough. The last one I had at the end of May/first of June, I went off the CPAP for about 10 days but this time I was bound and determined I was going to try to stick with the CPAP. It worked out fairly well, but the coughing during the night due to "stuff" draining into my lungs was a little rough.....ended up with the mask off for awhile on a few nights, but managed to get my "compliance" 4 hours (or more) each night. During this time, I was wondering whether I had blown out some of the sensors in the machine as my AHI and Snore Index had dropped dramatically. There's also another "factor" I'm wondering about and am in the process of doing my own "experiment". I'm reluctant to talk about it too much as I'm only two weeks into it and I don't want to draw any conclusions yet. It involves going off of my BP medicine at about the same time (2 weeks ago). Since I've quit taking them (Diovan), my AHI has dropped even more than it had been. I'm closely monitoring my BP to see if what it's doing and so far, it hasn't gone up much more than what it was while I was on Diovan. I definitely don't advocate anyone else doing this, but so far....so good. Within a couple of numbers, my BP is running around 129/80.....sometimes a little less, sometimes a little more....but that's about a norm and I'm not unhappy with it. Maybe the CPAP therapy DOES work on BP.

I believe you said that you lived in Kentucky? Do you live in the Lexington area (you mentioned a Dr. at the University there)? I was in that area in 1983 and thought it was beautiful....did a conversion at the bank in Paris. Also got to visit Claiborne Farms and got to see Secretariat and Spectacular Bid (have photos of both). Long time ago.......

Best wishes,

Den

Den,
I was a Diovan HCT user. Diovan by itself didn't help, but with the HCT (diuretic) added, it was my answer. When I found out I was going on CPAP for OSA, I did a stupid thing, but I stopped taking my pill every day so that I could see if the therapy would work on it. Two weeks later, I was on the machine.

So far, yes, my BP has come down to a point where I don't need meds. anymore for it, technically. I use a home Omron device to monitor my BP that my physician recommended, but lately I am doubting its accuracy. Some days, my BP is as wonderful as 115/75 and then other days, it's up to 136/92. Most of the time, it's in the 124/80 range, or there abouts. Not enough to be on medication. I just worry when I see those 90's that I should be on it.

My doctor scared me before my diagnosis of OSA when she saw my BP at about 140/92-94. She said that was the start of hypertension and I needed to control it now. When I would stop taking it, she would scare me with comments like, "Do you want to see your son graduate from college?" So of course that would work and I'd be back on the Divoan HCT again. But I hate to take anything chemical every day, and hated knowing this stuff passes through your liver, but hated worse the alternative.

No one was ever able to figure out why someone who had low BP her whole life, 118/68 or so, all of a sudden had borderline high blood pressure. When I look back now, that together with constant non-stop headaches and migraines and constant fatigue and exhaustion, should have sent up a red flag to a doctor who is familiar with OSA. Unfortunately, although she is usually an incredible diagnostician, she missed this one totally. It was me who had to ask for a sleep study at the prodding of my son, who just graduated and became a licensed RT, working at a hospital since last month. Thank goodness he knew enough to put the symptoms to the condition and kept telling me to go for a study. He was on the money.

So, yes, I do believe BP is helped by CPAP therapy. If you're oxygen levels go down when you have your events at night, night after night, month after month, year after year, eventually your BP and a lot of other things start to react to it. So it's only natural to expect, once you become oxygenated again, the normalcy to return, or at least some improvement

Lori,

I too have the Omron machine (model HEM-711). I've been taking my BP frequently during the last two weeks and have found that there IS quite a variance in pressures.....even within an hour or two. I also take into consideration that my BP will also be higher in the doctor's office, too (the white-coat syndrome). I also have a similar machine available to me at work, too....so I take it there during the day when I have a chance.
If things start changing for the worse, I'll start taking the meds again. I just wanted to see what benefits CPAP might be providing.
I had also been taking Glucosamine-Chondroitin for joint pain in my knees for the last several years. I quit taking that stuff about 2 months ago.
I've also been able to take my belt in a notch or two in the last couple of months. I'm NOT complaining!!!

Later,

Den

I've been taking my BP frequently during the last two weeks and have found that there IS quite a variance in pressures.....even within an hour or two. I also take into consideration that my BP will also be higher in the doctor's office, too (the white-coat syndrome)

Den,
If you don't sound like me, I don't know who does. My doctor told me I have white coat syndrome because if the nurse takes it, it's always lower than her. She said I get nervous when she comes in and that's what happens to my BP. And my BP also fluctuates greatly from one hour to the next. AND if I press the reading button three times in a row on the Omron, it varies, usually reducing each time.

How similar can you get???

Lori,



I think mine is more from anger.....knowing they're going to charge me a bunch of money for something I already know. It's just that I can't write a prescription for myself.

I was told not to take my BP that fast (I tried that, too)......you need to wait awhile before you take it again. I usually try to wait at least 45 min. to an hour between times. Even so, there can be quite a bit of difference. I have a note pad that I've been recording my BP and glucose levels for the last 6 months or more. If I take multiple recordings like I just mentioned, I usually write down all of them so I can see how much change there really is. (You notice I said USUALLY....).

Later,

Den

Den,

My doctor told me, when I told her what I just wrote to you, to only take it once every day, and at the same time of day, preferably in the morning, to get a true reading. If I did that, I might be upset because following ones during the day can turn out better.

LOL regarding your BP going up when you see the white coat due to knowing the bill, etc., when you can write yourself your own prescription if you were allowed to. Don't let that get to you. I could write you a list of other things you could use to raise your BP (but I won't).

Also, I've been taking two tablespoons of apple cider vinegar a day. Supposed to be beneficial to your BP AND many other things. May be worth a read if you have the time. It's all over the Internet if you just google it.

Have a nice AND RELAXING evening.

I believe you said that you lived in Kentucky? Do you live in the Lexington area (you mentioned a Dr. at the University there)? I was in that area in 1983 and thought it was beautiful....did a conversion at the bank in Paris. Also got to visit Claiborne Farms and got to see Secretariat and Spectacular Bid (have photos of both). Long time ago.......

Den, I used to go up to Lexington so much for so many years that I felt very at home there. I live in E. Tennessee. My first husband and I trained American Saddlebreds and spent a lot of time at the Saddlebred barns in Kentucky, the Jr. League Horse Show in Lexington, and the Tattersalls sales. There are many Saddlebred farms around Lexington and Louisville. Actually more Saddlebred show barns are around Lexington than the Thoroughbred farms that KY is famous for. Llittle known factoid. We had trainer friends in Paris, Ky, too.

What an experience, that you got to see those two great race horses and have pictures. Yes, it's absolutely beautiful country all around Lexington. Fabulous horse farms. You got to see one of the loveliest - Claiborne.

The reason I went "wow" in a post to Swordz about his mentioning the Univ. of KY Hospital was because of my admiration for the writings of the head sleep doctor up there, Dr. Barbara Phillips. I thought he might have met her.