CPAP Mystery

[CotswoldSleeper]

Hello All,

I've been CPAPing for about 3.5 years. Having CPAP treatment made a huge difference to my life and TBH I'm not sure how I would have made it this far. 

I'm new to Apnea Board and can I say how pleased I am to have found you! I could really do some some help and would welcome your thoughts ideas on how to resolve the ongoing problem of still feeling soooo tired, poor memory and sub-optimal thinking 

Although my AHI is very low, and has been almost since I have been using CPAP, I just don't seem to be waking up 'refreshed' as they say. It's got to the point where I don't really look forward to going to bed as I will probably feel worse the next morning.

About a month ago I got a Wellue O2Ring and have used that most nights to monitor my Sp02. I had a period of about a week, where my Sp02 was falling night on night to the point I spoke to my service; but they said it was all find and the odd drop out (min 86% after the alarm woke me) was ok. Generally, it has improved since then and most nights seem to be ok, with a min Sp02 of c. low 90%.
During the poor period I had one night that was shocking  and although my AHI was 0.60, I woke up exhausted. I have attached the Oscar and O2Ring files for the same night. Any ideas?

I do have nights where the AHI 5.0 - 6.0 is high (relative to me, sorry) and I know and can feel I've had a bad night. Very occasionally I have had a AHI 0.0 and I feel amazing, but that is probably once every couple of months. There just seems to be something I'm missing something  This is my mystery.

Your thought input and help would be really welcomed.

Cheers

       

[Gideon]

Welcome to the forum

This night is good, your RERAs are a bit high, not unreasonable, but thaey indicate a higher level of Flow Limits. What is the frequency of your bad nights? could you post a typical bad night?

Literally hundreds of changes have occured with OSCAR since you downloaded, you should use the new version. With the new version take the screenshot with F12 (Windows) and it will remove the calendar and piechart from the screenshot and reveal more of your breathing stats.

[CotswoldSleeper]

Welcome to the forum

This night is good, your RERAs are a bit high, not unreasonable, but thaey indicate a higher level of Flow Limits.  What is the frequency of your bad nights?  could you post a typical bad night?

Literally hundreds of changes have occured with OSCAR since you downloaded,  you should use the new version.  With the new version take the screenshot with F12 (Windows) and it will remove the calendar and piechart from the screenshot and reveal more of your breathing stats.

Hi bonjour.

Thanks.

That's so typical. I'll download the latest version. :-)

Bad nights are most nights I'll upload a typical bad night though.

Umm.. ok, what are the Flow Limits, please? 

Thanks

[Gideon]

Simple explanation:
Think of events a a continuium ranging from
Apnea (80-100%) 10 seconds
Hypopnea (50-80%) 10 seconds
Flow Limits (0-50%) not timed
Normal Breathing

Flow Limits just mean there is a resistance to to your breathing

[CotswoldSleeper]

Simple explanation:
Think of events a a continuium ranging from
Apnea (80-100%) 10 seconds
Hypopnea (50-80%) 10 seconds
Flow Limits (0-50%) not timed
Normal Breathing

Flow Limits just mean there is a resistance to to your breathing

Oh right. And this will mean...   

Oscar Updated (Lovely).

Bad night screenshots attached. Both from the same night. 1 x Long & 1 x Wide, plus Sp02 Screenshot

Cheers

[Gideon]

This bad night is in the territory where we ignore numbers and go to How you feel. Be very critical with the answer.
IMHO, turn your O2 alarm off. You will see the results in the morning and you don't need the alarm waking you from the spikes that likley resulted from movement of the probe.

Try increasing your flex. Ask yourself, which felt better Flex =1 or Flex =2. Only 1 change at a time.

Another change at a different time, Increase your min pressure, your snore chart indicates that you might benefit from it. Agan which pressure felt better.
Turn VS2 off, it is not used by us and only obscures the issue.

You may find a 2-minute zoomed chart interesting especially when leading up to a RERA (By definition, a series of flow limitations ending in arrousal)

[jaswilliams]

I would increase the pressure slightly may be 11.6 as you have some snores but I agree with Bonjour your in fine tuning territory

[CotswoldSleeper]

I would increase the pressure slightly may be 11.6 as you have some snores but I agree with Bonjour your in fine tuning territory

Thanks jaswilliams. :-)

---

This bad night is in the territory where we ignore numbers and go to How you feel.  Be very critical with the answer.
IMHO, turn your O2 alarm off.  You will see the results in the morning and you don't need the alarm waking you from the spikes that likley resulted from movement of the probe.

Try increasing your flex.  Ask yourself, which felt better Flex =1 or Flex =2.  Only 1 change at a time.

Another change at a different time, Increase your min pressure, your snore chart indicates that you might benefit from it.  Agan which pressure felt better.
Turn VS2 off, it is not used by us and only obscures the issue.  

You may find a 2-minute zoomed chart interesting especially when leading up to a RERA (By definition, a series of flow limitations ending in arrousal)

Thanks Bonjour,

I will work my way through the options and see how I get on.

It makes a huge different having others to talk to about this. So thank you to you and everyone else.

Cheers

Hi there,  So I have tried some of the changes recommended but seem to still seem to wake up more tired than when I went to sleep.
 
I have settled on Flex 3, which just seems easier, but other than that I'm still somewhat lost. I did look at the 2 min zoom (thanks Bonjour) which was interesting, as I could the 'run up' to episodes. I forgot to try the higher pressure but will try it tonight (thanks jaswilliams).
 
I have attached a couple of screen shots (normal snips as F12 seems to have stopped working) and would welcome any comments. TBH there's so much to look at I don't really know where to start.   
The first one, is without a Dr D collar, but with the collar, it was a really rubbish night’s sleep . The frustrating thing is, I can find my way around the data, but just do quite get what it all means and how it hangs together.

For example,

• I can see the Flow Rate is quite variable, but cannot understand why (have record myself sleeping, and the only clues are that I have rolled on to my back sometimes). Is this something to do with my ‘Variable Breathing’ and ‘Periodic Breathing’? What’s the difference?
  
• There seems to be high variability in Inspiratory Time and Expiratory Time ~ I don’t know what this is telling me.
  

Some people have mentioned about getting ‘professionals’ to look at their data ~ I’m sure if this is something worth looking at; or am I just being too greedy?

All thoughts/comments welcome.
 
Many thanks
 
CS

[CotswoldSleeper]

I realised I should have Replied only. :-)

Hi there,  So I have tried some of the changes recommended but seem to still seem to wake up more tired than when I went to sleep. 
 
I have settled on Flex 3, which just seems easier, but other than that I'm still somewhat lost. I did look at the 2 min zoom (thanks Bonjour) which was interesting, as I could the 'run up' to episodes. I forgot to try the higher pressure but will try it tonight (thanks jaswilliams).
 
I have attached a couple of screen shots (normal snips as F12 seems to have stopped working) and would welcome any comments. TBH there's so much to look at I don't really know where to start.   
The first one, is without a Dr D collar, but with the collar, it was a really rubbish night’s sleep  . The frustrating thing is, I can find my way around the data, but just do quite get what it all means and how it hangs together.

For example,

• I can see the Flow Rate is quite variable, but cannot understand why (have record myself sleeping, and the only clues are that I have rolled on to my back sometimes). Is this something to do with my ‘Variable Breathing’ and ‘Periodic Breathing’? What’s the difference? 
  
  
• There seems to be high variability in Inspiratory Time and Expiratory Time ~ I don’t know what this is telling me.
  

Some people have mentioned about getting ‘professionals’ to look at their data ~ I’m sure if this is something worth looking at; or am I just being too greedy? 

All thoughts/comments welcome.
 
Many thanks
 
CS