APAP Trial - First Night's Results - Interpretation?

[Juicy]

Hello,

Since last posting about my sleep maintenance insomnia I have managed to get a hoffrichter trend 2 APAP to trial for one month. I slept one night with it and have ran the data through hoffrichter's software TRENDset with some interesting results.

My actual sleep was fragmented as usual, the pressure barely changed on the APAP from the minimum of 4. Tonight I will try increasing the minimum pressure to capture these events better.

• 9 Central Apneas
  
• 5 Obstructive
  
• 27 Hypopneas
  

From the data/graphs there seems to be a few trends. Significant drops in relative respiratory volume at times along with times where there are large fluctuations in the breaths per minute figure - sometimes it flatlines briefly at 0, other times it reaches 30. I have screenshots of all these graphs but unfortunately I'm unable to link them here. There also seems to be a potential correlation where the amplitude of respiratory flow oscillations greatly increases prior to awakenings.

Any thoughts or advice is very much appreciated. At the moment I'm thinking this may be something like UARS but I can't really interpret the data any more than that.

Thanks and kind regards!

[retired_guy]

A pressure of 4 is often too low to sleep with, and could be the reason for the higher than need-be numbers. But raise it modestly a you indicated you are going to do. 5 for now, run a few days to let things settle out, then look at it again.

[Juicy]

Last night I tried a pressure of 8 (using nasal mask).

Over 6.5 hours sleep I woke just as frequently as usual and the data read

• 4 Central Apneas
  
• 1 Obstructive
  
• 1 Hypopnea
  

I then switched the full face mask, thinking that maybe mouth leakage could be causing problems.

In one hour of the full face mask I logged 9 Central Apneas.

I'm at a loss here, do I try increasing the minimum pressure again?

[Juicy]

Alternatively could the centrals be 'pressure induced' when I'm using the full face mask?

[DeepBreathing]

Hi Juicy

It's very tempting, but resist the temptation to make changes every night. Especially when you're new to PAP therapy it will take a while for your body and brain to adapt to this new way of breathing. Every night will be different and if you make too many changes too quickly, you'll never home in on an optimal setting. Don't worry if you don't get instant results, and don't worry if you keep waking up. It's all part of the adjustment process.

A question for you - when you tell us about the number of events you're getting, are they total events or averages per hour? It's more useful to use averages per hour, expressed as indices (eg apnea index AI = number of apneas per hour; apnea-hypopnea index AHI is the average of all the apneas plus hypopneas per hour).

[AlanE]

Chasing the numbers is going to lead to frustration and possibly doing more harm than good. Did you have a sleep study? Going from 4 to 8 is a huge change. Yes, increased pressure can produce more CAs. With any change large or small you can throw out the first nights data as irrelevant. You will need time to adjust to any change you make. At least 2 weeks. Some people need a lot longer. Retired_Guy and DeepBreathing gave good advice. Take smaller steps. Change to a min pressure of 5. Since you have APAP, I assume in APAP mode, what is your max pressure set at?

[tedburnsIII]

I don't believe that OP has a physician and is winging everything on his own. It appears he is all over the place.

[AlanE]

Hmm it's been awhile. any update Juicy?

[Adoniscmj]

I have found that increasing the pressure to much will cause central Apneas to increase. In my case I never had any CA's until I was on cpap. I have found a good pressure now that gives me great results. You also need to look at averages over time and not panic over one night as every night can be different in terms of severity.

[colethegamer]

Im also using Hoffrichter, just Trend III, is it working good for you? Thank you.