Brazen Therapy Thread

[Brazen]

More zooms attached

[clownbell]

@Brazen - you know from your nursing experience that definitions are critical. The spikes that are not flagged is because they don't make the definition as to %blockage and #seconds needed to be flagged as an event.

[Brazen]

Okay, so I get that but do even those little spikes interfere with good, restful sleep or are they normal?

So what can I do to improve my treatment?
Or is it down to just staying the course and hoping I start feeling better?

[Brazen]

Perhaps I worded my question incorrectly. 
I wasn't asking what the smaller spikes are clinically classified, I understand they do not last long enough to be classified as anything.
Are those spikes minor awakenings or maybe position changes? Are they normal for non-disordered sleep? Are they anything I could or need to reduce?

I'm sorry if it seems like a dumb question.  I don't yet know how to look at the data. Should one have mostly even breathing through the night and anything Not That is disordered sleep?
What else should I be looking at?
I know AHI matters. 95% Flow Limit matters.  What other indicators can measure the quality of my sleep?

I am trying to learn. 
Trying to figure out why I don't feel rested and if there is anything I can do to improve my treatment. 
It'd be silly to keep doing it wrong while just waiting to feel better.

[EddyDee]

@Brazen I can't offer any insights as I'm just learning this myself, but I just want to thank you for your persistence and determination to understand. It's a really helpful learning experience for the rest of us.

And @Gideon, @clownbell, @DaveCar, @SleepHenry2 and others who have contributed their experience and wisdom on this thread, thanks so much!

[Brazen]

@EddyDee
Thanks for saying that.

I feel incredibly erksome and dumb but I really just want to understand. Is there anything in the data to explain why sleep doesn't feel restful?

[EddyDee]

I can't answer your question, but I strongly believe that asking questions and trying to understand does not mean you're dumb - quite the contrary!

[Gideon]

All 3 of those zoomed views represent arousals. That means they interrupted your sleep. Restorative sleep is peaceful. Three of those events do not constitute a need to correct. Someone here did a correlation between spikes thru the night with limb movement from a video and thus determined PLM so that is a possibility. Another is extended breathing at a below normal volume which can be improved by increasing PS. What I see is a bit of disrupted breathing immediately before those events which may be resolved by additional PS.

[Brazen]

@Gideon 
Thank you!

Okay, so trying to understand...
Even the smaller spikes are interrupting sleep, correct?
So if they are occurring closer than 60-90mins apart they would be preventing REM sleep, right? So something that needs fixed?
PLM is a possibility, I didn't have any during my sleep study but, that doesn't mean I never do.
I've had PLM keep me awake occasionally in the past but haven't consciously felt it since I started taking Mag supplements at bedtime about a year ago. (Mag. Ox. 500mg)

Additional PS? 
Sorry, what's PS?

I increased my max pressure last night (so 7-9.4cmw, 3EPR) but I took the mask off at some point in my sleep so didn't get much data.

I really do appreciate the help, thank you!

[Gideon]

It's not the spikes, it's the breathing disturbance or the arousals that are bad.
Pressure Support, it is what EPR mimics, quite well I'll add, but is limited to 3cmw. PS/Pressure Support is what EPR is called on a BiLevel.
On a CPAP EPR is subtracted from the pressure which is inhale pressure. On a BiLevel PS is added to Exhale Pressure to get your inhale pressure. The math is confusing so I view all PAP machines as BiLevels and just identify the inhale and exhale pressures and go from there.
PS is also my subtle way of prodding you more in the direction of a BiLevel for your therapy.