[CPAP] New User - What is the data telling me?

[Sleeprider]

Your comfort is very important, and the ability to maintain sleep is also a factor. I am optimizing AHI, and have to rely on you to give me comfort feedback. I'm getting a mixed message, that it is easier to breathe, but you're sleeping less. Normally the least disruptive sleep is with relatively small pressure variations, so I still think it is worth trying the higher minimum pressure at 8.0. In the end, we may also add EPR at 3 back into the mix to see where that takes us. In the end, you get to choose what works best. I'm just the tour guide.

[kcw196]

Fully agree.  I am not yet convinced that "sleeping less" is related to the CPAP, and even if it is it could resolve itself after a few more days. It could be environmental, stress, etc.?  Planning to try 8.0 and will report back what happens in a few days.


Thanks so much for your help.....

[kcw196]

So I increased the min pressure to 8.0 and tried it for 4 nights.  When compared to min pressure of  7.0 my OA went down a little, and my CA went up somewhat, so my overall AHI is somewhat worse.  Attached is a table showing the last 12 nights so you can see the results with 6.0, 7.0, and 8.0. Note that the EPR level changed when going from 6.0 to 7.0 as recommended.  I also attached the OSCAR data from the last 2 nights. 

Is 4 nights a sufficient amount of time to try out a new setting before drawing a conclusion?  Is there something else going on not directly tied to the min pressure? Any suggestions on what to try next? 

Thanks.

Ken

[kcw196]

I have attached another nights worth of data.  

For yucks I lowered the EPR to 1 to see what impact it would have on the CA's.  Also turned on ramp.  The results seems pretty consistent with an EPR of 2.  Any comments or recommendations based on the above or last nights data would be much appreciated.  Should I turn off EPR? Should I go back to 7?   Even though they are below the threshold, on the surface it seems that with the higher pressure the leaks have increased somewhat.  Is that relevant?  

Not sure what to try next, or maybe I just need to be patient.

Thanks.

Ken

[Gideon]

Pressure at 8 is fine, do try EPR off.
Also post a 5 min zoomed view of some CA events so we can see the character in them. Looking to see if CO2 influenced or ideopathic. CO2 influenced is seemimg not likly as EPR hasn't made a difference. That makes EERS not viable if it holds up.

Options

1. VAuto with Trigger Sensitivity on High/Very High, which has helped several here, not guaranteed.
2. ASV which will manage it.

[kcw196]

Thanks so much for your help. Will turn off EPR tonight and see what happens. Attached are 2 5 min views from last night.  Looking forward to your feedback.

Ken

[kcw196]

So my AHIs seem to be somewhat better with min Pressure 8.0 and EPR=0. My OAs are certainly lower.  Not sure what my CAs are doing.  I guess lowering the EPR improved them.  

Attached are the results from last night, a 5 minutes view of of some of the CAs, and a summary of results by date for different settings dating back to 7/18. 

Any thoughts on this?  Should I stick with 8.0 and 0?  Short of switching to a VAuto or an AVS is this as good as it gets?

Thanks.

Ken

[kcw196]

Attached is last night's data.  Any thoughts on the above or the data attached here? What's interesting (at least to me) about last night's data is that the cluster of CA's after 6:15AM all happened after I woke up for a few minutes and then went back to sleep sort of.  Before that point the results seemed like one of my better nights.

Thanks

Ken

[BB63]

the cluster of CA's after 6:15AM all happened after I woke up for a few minutes and then went back to sleep sort of

Hi Ken,

I can only provide input as to the cluster of events near your wakening end of the plot.

But, I have trouble falling asleep, so I lay in bed sometimes for 1.5 hours before I fall asleep. And, when I wake up, I sense that I haven't sleep well and I try to fall back asleep again. So, I tend to have clusters of events at the beginning and the end of my plots.

I asked about this in one of my earlier posts and was told it's a normal thing, the inference being that these events don't count for much and should be largely disregarded.

If I note my exact moment I become conscious, I notice that the clustered events start slightly before I become conscious enough to note the time I actually wake up though. My guess is that the brain knows I am in the process of waking up, but is still suppressing memory somewhat. Memory is one of the 3 subfunctions of sleep that the brain controls. Each subfunction is very separate from the other subfunctions, so it's possible for one to be totally coherent and communicative while the brain is still suppressing memory-hence, you're actually very much wide awake but without memory of being awake. The interaction of these separate subfunctions can be quantified in real time (with difficulty) by testing the blood for specific chemical messengers that the brain acts upon to induce sleep or to wake someone up, or to keep the patient asleep. These chemical messengers might determine what stage of sleep the patient is in-however I am not aware that this has been verified.

The brains atypical response to these chemical messengers is another form of a sleep disorder, and it's beyond the scope of this forum. So, I hesitate to say much more.

Short version is however....events that cluster near the wakening time are likely NOT as significant as they appear to be.

AB

PS:Just between you and me, periodic sampling of these chemical messengers as we sleep is probably the best way to determine if there are sleep disorders. Chemical messengers are often hormones, though sometimes not.....Cortisol is probably the most POWERFUL IMPEDIMENT to sleep, yet few doctors test for it. WE tend to use our 'impression' of our rest level/sleep quality as a gauge to tell us if we are sleeping well. However, our 'impression' is horribly subjective and possibly IS NOT the best way to quantify the quality of our sleep. An internet search for 'human stress hormones' yields many useful articles on the topic, if you're interested in further info.

[kcw196]

Thanks for the info. Good stuff.  

Any other input on my results to date, my current settings of min pressure = 8.0 and EPR = 0, and as well as input on the 5 min views of the CA's would be very much appreciated.