Best Night Yet (And a Few Questions)

[Spy Car]

So at exactly the 3-month mark, I had by best night ever in terms of AHIs (only 4, all OAs) and feel pretty good (relatively speaking). I'd still like to feel less fatigue, but this is hopeful. A very rare night under 1.

Questions. I see that I hit Max pressure a few times last night (one leak related?). I recently raised my Max Pressure to 13.6 (from 12.2) to stay about 2 points over 95% pressure. Last nights 95% was unusually high (for me) at 13.

Do I fiddle upwards, or leave it alone for a bit?

Also, I have tried cutting down the EPR, which I understand works for many, but every time I remove or reduce EPR my numbers go up and I feel worse. So I think I'm sticking with Level 3.

The other thing I've noticed is my numbers go up quite a bit with the P10s (pillows) vs the Wisp (nasal). I do reset the machine to the proper type, but each time I switch to the pillows the numbers almost double. I love the minimalism of the P10s.

Should I just accept that I do better with a nasal mask?

I read the forum every day to add to my education. Far from feeling expert in pressure management, and very grateful for those who support us all with your knowledge.

Cheers,

Bill

[robysue]

So at exactly the 3-month mark, I had by best night ever in terms of AHIs (only 4, all OAs) and feel pretty good (relatively speaking). I'd still like to feel less fatigue, but this is hopeful. A very rare night under 1.

A small clarification in what you are saying here.

You had a total of 4 OAs scored during the night and your AHI = 0.51, which is a very, very good AHI. Many people do not get AHI < 1 on a regular basis. And truth be told, once the AHI < 3.0 or so, it really doesn't matter too much how lower the AHI is: At that point, the most important data point is how you are feeling and not whether the AHI = 0.5 or the AHI = 1.5 or the AHI = 2.5.

Questions. I see that I hit Max pressure a few times last night (one leak related?).

No. The times you hit the max pressure are not related to your leaks. And your leaks are not really significant except at the very end of the night.

I recently raised my Max Pressure to 13.6 (from 12.2) to stay about 2 points over 95% pressure. Last nights 95% was unusually high (for me) at 13.

Do I fiddle upwards, or leave it alone for a bit?

I would leave it alone. There is nothing in this data that indicates you need more pressure.

Also, I have tried cutting down the EPR, which I understand works for many, but every time I remove or reduce EPR my numbers go up and I feel worse. So I think I'm sticking with Level 3.

There is NOTHING wrong with using EPR, but there are a few people on this board who seem to think they need to tell all newbies that "EPR should be turned off". Fact is EPR is an important comfort feature that is critically important to SOME people. If you find it more comfortable to use EPR = 3 and your AHI < 3 or 4 most nights, then EPR is working just fine for you and there is NO reason to not use it.

The other thing I've noticed is my numbers up quite a bit with the P10s (pillows) vs the Wisp (nasal). I do reset the machine to the proper type, but each time I switch to the pillows the numbers almost double. I love the minimalism of the P10s.

Which numbers? The leak numbers or the AHI?

Should I just accept that I do better with a nasal mask?

Not necessarily.

If we're talking about the difference between having an AHI < 1 with the nasal mask and some discomfort from the mask versus having an AHI between 1.5 and 2.5 (or even 3) with the pillows and less discomfort from the mask, then I'd say go with comfort and the slightly higher AHI.

Here's the thing: Once your AHI is below 5.0, the most important data point is how do you feel? If your sleep is better subjectively when you use the P10 nasal pillows and the AHI is still less than 5.0, then you're better off using the nasal pillows and getting the better subjective sleep.

[Spy Car]

Robysue,

Yes, I should have put AHI 0.5. I understood that (you just know how sleep deprived brains work) and forgot to include that. I was astonished there were only 4 events all night.

Many nights I seem to have about half CAs, and sometimes it's like a Christmas tree with yellow, green, purple, and dark-blue mixed in. And those nights generally mean fatigued days.

I'm not always under 3. I will keep in mind that how I feel is more important than the numbers.

When I said my numbers go up with the P10s, I was referring to the AHI numbers. That disappoints me as I like the minimalist design. Many nights on the P10s were over 5. Here are recent AHIs (rounded to nearest tenth)

P10s: 6.7, 5.4, 4.7, 6.7, 2.9, 3.2, 3.5, 4.9, 3.5, 4.6, 3.2, 11.0, 7.9, 3.3, 4.4, 3.5, 5.0, 5.5, 3.2

Nasal (Wisp): 2.5, 4.2, 2.2, 2.0, 1.7, 4.0, 1.8, 1.6, 1.5, 0.8, 1.4, 2.7, 2.6, 1.7. 1.6, 1.8, 2.3, 2.9, 1.7, 1.8, 2.3, 2.9, 1.7, 1.8, 0.67, 2.9, 2.9, 2.1, 2.3, 4.2, 3.6, 2.3, 2.4, 2.9, 2.3, 4.2, 3.6, 2.3, 2.4, 2.9, 2.3, 3.5, 4.8, 2.3, 2.4 1.5, 1.3, 0.5

Glad to know you don't think I need more pressure.

With the EPR, I was happy to try cutting it down (and off) to see if it worked for me (as it does for some). For now, I feel I do better with it on in terms of both my numbers and quality of sleep. I respect that all tweaks don't work for everyone and appreciate the time invested by people on this forum in helping people like me. No harm done in trying.

I'm still pretty brain fogged and am experiencing fatigue. So trying to maximize my sleep apnea therapy as best possible.

Thank you for the help. I appreciate it!

Bill

[robysue]

When I said my numbers go up with the P10s, I was referring to the AHI numbers. That disappoints me as I like the minimalist design. Many nights on the P10s were over 5. Here are recent AHIs (rounded to nearest tenth)

P10s: 6.7, 5.4, 4.7, 6.7, 2.9, 3.2, 3.5, 4.9, 3.5, 4.6, 3.2, 11.0, 7.9, 3.3, 4.4, 3.5, 5.0, 5.5, 3.2

Nasal (Wisp): 2.5, 4.2, 2.2, 2.0, 1.7, 4.0, 1.8, 1.6, 1.5, 0.8, 1.4, 2.7, 2.6, 1.7. 1.6, 1.8, 2.3, 2.9, 1.7, 1.8, 2.3, 2.9, 1.7, 1.8, 0.67, 2.9, 2.9, 2.1, 2.3, 4.2, 3.6, 2.3, 2.4, 2.9, 2.3, 4.2, 3.6, 2.3, 2.4, 2.9, 2.3, 3.5, 4.8, 2.3, 2.4 1.5, 1.3, 0.5

What do the leaks look like with the P10?

[Spy Car]

When I said my numbers go up with the P10s, I was referring to the AHI numbers. That disappoints me as I like the minimalist design. Many nights on the P10s were over 5. Here are recent AHIs (rounded to nearest tenth)

P10s: 6.7, 5.4, 4.7, 6.7, 2.9, 3.2, 3.5, 4.9, 3.5, 4.6, 3.2, 11.0, 7.9, 3.3, 4.4, 3.5, 5.0, 5.5, 3.2

Nasal (Wisp): 2.5, 4.2, 2.2, 2.0, 1.7, 4.0, 1.8, 1.6, 1.5, 0.8, 1.4, 2.7, 2.6, 1.7. 1.6, 1.8, 2.3, 2.9, 1.7, 1.8, 2.3, 2.9, 1.7, 1.8, 0.67, 2.9, 2.9, 2.1, 2.3, 4.2, 3.6, 2.3, 2.4, 2.9, 2.3, 4.2, 3.6, 2.3, 2.4, 2.9, 2.3, 3.5, 4.8, 2.3, 2.4 1.5, 1.3, 0.5

What do the leaks look like with the P10?

Not too bad, really. When they happen they tend to be strong leaks (I presume from moving?) but short (I guess I'm fixing them?).

The worst night AHI-wise (11.0) there were almost no leaks from the P10s. The most recent night with P10s (AHI 3.2) was one of the best leak-wise, with a scattering of short leaks (Max 19.2) but a 95% Leak Rate of 0.00. Other nights more mixed. The pillows actually seem better than the nasal (Wisp), which I had not noticed before.

Please let me know if you need more detailed info. Despite the good numbers last night, I'm having a bad "brain-fog" day/evening.

Bill

[holden4th]

First, you're doing really well and ahead of where many people are at this stage.

I'm now down into the minus 1s most nights but that doesn't mean I always feel good the next day. I've had higher AHI days that were better than the minus ones.

I'm not suggesting that you do this but on the few days I've fallen asleep before turning on the machine how I've felt the next days has been soooo bad. I've also woken up on a few occasions and felt a bit brain fogged but have improved rapidly once I've got to work. Before PAP the brain fog would have lasted all day.

I'm now a year into PAP therapy and I can finally feel the benefits. My body has adjusted and while I don't feel like a 21 year old (I wish) I know I am so much better now.

[Spy Car]

First, you're doing really well and ahead of where many people are at this stage.

I'm now down into the minus 1s most nights but that doesn't mean I always feel good the next day. I've had higher AHI days that were better than the minus ones.

I'm not suggesting that you do this but on the few days I've fallen asleep before turning on the machine how I've felt the next days has been soooo bad. I've also woken up on a few occasions and felt a bit brain fogged but have improved rapidly once I've got to work. Before PAP the brain fog would have lasted all day.

I'm now a year into PAP therapy and I can finally feel the benefits. My body has adjusted and while I don't feel like a 21 year old (I wish) I know I am so much better now.

Thanks for the encouragement. If I have one thing going for myself it's that I'm 100% committed to the treatment. I have a very incomplete understanding of how to master understanding the Sleepyhead data. It strikes me that I have no "typical" nights, with all sorts of patterns to AHI "types" etc.

I so desire to feel better. Having this forum, and people who share knowledge and experiences, is very helpful. Thank you!

Bill