What do clumps of A & H events mean?

The second grouping of events at 0.00 hours might be REM related, also the 02.00 hour grouping possibly. The others don't fit the pattern.

Do you take any medication at night? I found that Valium use increased events despite sleeping on my side. Ambien does not.

It is no wonder you continue to have morning headaches with these events.

I would ask for Wulfman and Ozij's opinions and a plan of attack. I admit to being a newbie myself and smart enough to know that I don't know much.

I would also try very, very hard to stay completely on my side by whatever means possible, just to see if these events are positional. I had to build sort of a wall to keep me on my side. It was hard because I tended to move the wall.

When you get a chance find the best of your reports for viewing.

I will try putting a wall of pillows behind me tonight to keep me on my side.

I do take some trazodone for my sleep. I do not fall asleep at all without help. No OTC meds have worked for me in the past. My sleep issues are more than OSA. PTSD issues keep me from falling asleep. I'm continually working to get past that.

RMinOntario wrote:I do take some trazodone for my sleep. I do not fall asleep at all without help. No OTC meds have worked for me in the past. My sleep issues are more than OSA. PTSD issues keep me from falling asleep. I'm continually working to get past that.

Understood about other sleep issues besides OSA. If only OSA and the machine was all we had to deal with this therapy would be a walk in the park.
I am not familiar with Trazodone. Someone will be. It may impact things by making events worse similar to Valium. I have seen the Valium impact first hand. Damned if I do and damned if I don't.

Edit:
I see you mention a history of central apnea events in the initial study with none during titration trial but then pressures didn't go very high. The history of centrals is worth keeping in the forefront of any ideas concerning pressure increases.

Right now, try the wall to keep you on your side and see if we can get a report after tonight's experiment.

Some information on that one:

http://www.drugs.com/trazodone.html

In particular.......this list.

Less serious trazodone side effects may be more likely to occur, such as:

* dizziness or drowsiness;
* headache;
* sleep problems (insomnia);
* dry mouth, stuffy nose;
* nausea, vomiting, loss of appetite;
* diarrhea or constipation;
* muscle pain;
* loss of coordination; or
* blurred vision.


Den

Den,
I've been off and on Trazodone for many years. It usually works for about 6 months, then I come off it and have to use something else. Without it, I do not fall asleep at all. I can be extremely tired but can't get to sleep on my own. I haven't had those side effects in the list. I definitely get many more hours sleep since I started CPAP. I am working on getting away from sleep meds, but right now I need the extra help.

RM,

I gather from your profile that you're using the Elite II.......how is it configured?
Are you using EPR? If so, what setting?
Personally, I find the ResMed reports confusing as Hell, but I'm trying to interpret yours.
If you're using the Elite, I'm confused about why the report is showing an "Average Pressure" and "Therapy Pressure".....and the Average Pressure seems to be several centimeters less than the Therapy Pressure.

Den

I am using EPR at a setting of 3.
I was also confused about the discrepancy with the pressure, therapy vs average. My DME had no answer, so I called Resmed last week and they said it was because the average takes into account the EPR setting. The next day the DME talked to the Resmed rep up here and said that my particular machine has a glitch in the machine software where it shows too high a difference between the therapy vs average. Apparently, they've fixed the software in newer machines. Mine can't be that old, since the serial # starts with 2008.

RMinOntario wrote:I am using EPR at a setting of 3.
I was also confused about the discrepancy with the pressure, therapy vs average. My DME had no answer, so I called Resmed last week and they said it was because the average takes into account the EPR setting. The next day the DME talked to the Resmed rep up here and said that my particular machine has a glitch in the machine software where it shows too high a difference between the therapy vs average. Apparently, they've fixed the software in newer machines. Mine can't be that old, since the serial # starts with 2008.

That's what I was wondering.
I don't know whether you know it or not, but that setting is dropping your (effective) pressure by 3 cm. on exhale. I would suggest trying to change that setting to a lower number or turn EPR off.

There also seems to be a pattern to your events.....as has been noted. Could be REM or could be positional. They may also occur then you need a little higher pressure and that EPR setting may not be helping things.

I would suggest trying one thing at a time for a few nights to see if it makes a difference......and reporting back to us.

Den

One more detail ResMed machines are know to report more hypopneas than other brands. ResMed uses different criteria for classifying events. It's not better or worse than the others. just different.

So, for the purpose of comparing ResMed AHIs to the AHIs reported by other brands, or to the mythical threshold of 5, some people recommend dividing a Resmed HI in half, adding it to the AI, and using this total as a revised AHI. It makes things more apples to apples.

Okay, I think I'll try a bunch of pillows to keep me on my side tonight.

Well here are results from last night. To the best of my knowledge I stayed on my side, as I kept a body pillow behind me. I still notice the clumping of events, so would appreciate any further feedback. Thanks, Rosemary

Did you take the mask off 3 times last night? Looks like it from the report.

These numbers more like what you have been getting lately?

If this were me I would continue to try to stay on my side and I would try reducing EPR or turning it off as Den has suggested.
Maybe try EPR at 2, see if you can handle it?

Yeah, I had 3 bathroom breaks last night, instead of the normal 1 or 2. The second 'clump of events seemed to start just before a 'break' and 'finish' after I masked up again. I will adjust my EPR to 2 tonight and continue with the body pillow . I hope I'm not creating centrals with my pressure at 14.

RMinOntario wrote:Yeah, I had 3 bathroom breaks last night, instead of the normal 1 or 2. The second 'clump of events seemed to start just before a 'break' and 'finish' after I masked up again. I will adjust my EPR to 2 tonight and continue with the body pillow . I hope I'm not creating centrals with my pressure at 14.

If you were (presumably) having pressure induced centrals, you'd probably be seeing them throughout the night.....not necessarily at the intervals you're seeing them.

If you turn EPR off, you could actually start with a lower pressure......like 12 cm.......which should be a little easier to tolerate than 14. It's the pressure on exhale that may be allowing the events to take place.
Also, try to use a sleeping position that doesn't put a "kink" in your neck. If your chin gets too close to your chest, it could constrict your airway. (another possible "positional" issue)


Den

Wulfman wrote:

RMinOntario wrote:Yeah, I had 3 bathroom breaks last night, instead of the normal 1 or 2. The second 'clump of events seemed to start just before a 'break' and 'finish' after I masked up again. I will adjust my EPR to 2 tonight and continue with the body pillow . I hope I'm not creating centrals with my pressure at 14.

If you were (presumably) having pressure induced centrals, you'd probably be seeing them throughout the night.....not necessarily at the intervals you're seeing them.

If you turn EPR off, you could actually start with a lower pressure......like 12 cm.......which should be a little easier to tolerate than 14. It's the pressure on exhale that may be allowing the events to take place.
Also, try to use a sleeping position that doesn't put a "kink" in your neck. If your chin gets too close to your chest, it could constrict your airway. (another possible "positional" issue)


Den

I like the idea of moving the pressure back to 12 with no EPR. I just went to lie down to see (feel) what I do with my head / neck. I do tend to curl my head down towards my chest. I'll try to keep my neck straighter. I don't think a tennis ball will come in handy to keep my head up