Another new member-Glad to be here

[SnoringMark]

[attachment=2897]Hi, I've been on CPAP therapy for just over two weeks. I am a little late to this as I am older and retired. My wife has been complaining about my snoring and gasping at night for years, and does a pretty amusing simulation complete with sounds and facial expressions. It was one of her comedy acts at my cardiologist appointment that led to my referral to a sleep doctor. It turned out that my AHI was in the low 50s.

So far my lowest AHI has been 2.2 and the highest 21 while on the machine. I have learned a lot on this site, but have a long way to go before I have an understanding of how everything works. I am going to attempt to put up a screen shot of my latest chart to see what some of the experts think is going on. Not sure I know how to do it.

Thanks, and I'm glad I found this forum!

[MitchS]

Hello SnoringMark. Welcome to Apnea Board.

[trish6hundred]

Hi SnoringMark,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy, hang in there for answers to your questions about your graphs.

[SnoringMark]

The event breakdown on my graphs seems to indicate that about half of my events are hypopnea and the next largest number of events are RERA. At this point, I don't really know what the difference is. I have read the definitions, but everything seems very similar and over lapping, including the definition of periodic breathing. After looking at the graphs, it seems the events occur with more frequency when I'm falling asleep and after a bathroom break early in the morning trying to get back to sleep. Not sure what to do next. I'm hoping to get some recommendations on settings etc. to improve my CPAP therapy.

Thanks, Mark

[Sleeprider]

Mark, what strikes me about the chart you posted is a lack of flow limitation. I'd like you to try a couple things first without changing pressures. First, if you are in CPAP mode, change to Auto, and set the minimum and maximum pressures both at 13.0 this should duplicate CPAP mode, but will allow recording of flow limitation. Second, if you are using a Flex setting of 3, change it to 1. Let's see where that goes. I would not rule out variable pressure, but we might be able to see improvement with your current prescription.

[SnoringMark]

Thanks very much for the replies. Sleeprider I appreciate the recommendations! I have made the adjustments and thought I was previously on Flex 3 but was in fact on Flex 2. I'll try the new settings for a few days and get back with my results.

Thanks again
SnoringMark

[rkl122]

Welcome and congratulations on posting a well edited SH report.

.....The event breakdown on my graphs seems to indicate that about half of my events are hypopnea and the next largest number of events are RERA. At this point, I don't really know what the difference is.....

Actually, more CA's than RERA. RERA may minimize out after you've been on therapy a while. If not, it can be addressed later. I think the first target should be hitting at the H without worsening the CA's.

.............it seems the events occur with more frequency when I'm falling asleep and after a bathroom break early in the morning trying to get back to sleep. .........

An astute observation! Those are called clusters, and if they indeed occurred while you were awake, they are not bonafide sleep apneas. (You'll see them referred to as SWJ - sleep/wake junk - on the forums.) That doesn't mean they are not problematic - they can still affect overall sleep quality. We can categorize them with greater surety by analyzing zooms of the flow graph, but for now, I would wait to see if they resolve on their own.

I would follow SleepRider's advice. And when you next post the SH images, I would suggest one change. For Resperonics machines, SH uses the VS2 channel for snores. (You can hide the VS.) We can see those in the events graphic, so the the graph for that channel is redundant. I would replace the snore graph with the respiration rate graph. (This is contrary to the commonly linked advice, which was crafted using Resmed data.) That may provide additional clues as to sleep/wake periods. And, if you happen to be like me, it may show a change in RR when you dream, thus providing markers for probable REM periods.

I think you are off to a good start.

-Ron

[cate1898]

Welcome to the forum SnoringMark! Glad you found us!

Sounds like you're well on your way to optimizing your treatment.

[SnoringMark]

rkl122, Thanks for the response and comments concerning my post and my chart. I replaced the snore graph with the respiration rate graph per your suggestion.

My uninformed observation after almost three weeks on the machine is that I am getting higher quality sleep but less of it. It takes longer to fall asleep and more importantly, after I get up to go to the bath room (usually around 5-6 am) I can't get back to sleep. This would not have been a problem when I was gainfully employed and getting up anyway, but now that I am retired I usually like to sleep another couple of hours.
Early on, I decided I should never sleep without the machine, but now I am beginning to question this. Would I be better off not being able to get back to sleep (less overall sleep) or shutting off the machine after the bathroom break and getting a few more hours of "lower quality sleep"? I'm not sure which way is best, to meet long term goals from a therapeutic perspective.

[Rcgop]

Don't be surprised about the change in sleep quality and amount. I have been on therapy for 7 months and my quality, time, and awaking have changed multiple times over this time. In fact I had my best night ever just last night. It seems to go in stages.