CSR reports on Sleepyhead

[AirSign]

This was Day 13 using my APAP.

Sleepyhead reports two periods of CSR, each 19 minutes long.
Have not had any before this.

Also shows 8 RERA events, which have not had before.
The RERAs do not seem to be simultaneous with the CSR periods.

6.5 hours of sleep, AHI 7.83
No Large Leaks.

Should I be concerned about either the CSR or the RERAs?

[OpalRose]

This was Day 13 using my APAP.

Sleepyhead reports two periods of CSR, each 19 minutes long.
Have not had any before this.

Also shows 8 RERA events, which have not had before.
The RERAs do not seem to be simultaneous with the CSR periods.

6.5 hours of sleep, AHI 7.83
No Large Leaks.

Should I be concerned about either the CSR or the RERAs?

AirSign,
Apparently the CSR has been mislabeled in SleepyHead. It should be Periodic breathing. Probably nothing to worry about.

I think your AHI could be lower. Are you looking at SleepyHead Graphs to see where your pressure is? It would be a benefit to you to narrow your pressure range.
Either post a graph here or look to see what your average and 90% pressure numbers are.

[AirSign]

Either post a graph here or look to see what your average and 90% pressure numbers are.

What surprised me was the 19 minutes in a single event, twice.
Pretty sure I was not awake during either of them, because I did turn off the machine one time only but after both the CSR events had happened.

The 95% pressure is reported as 14.2
Other nights, it's been as high as 15.
I've been starting it at 4, but only for a 5 minute ramp up.

Maybe these were REM? And I was having really awesome Stephen King intensity dreams?

[OpalRose]

Either post a graph here or look to see what your average and 90% pressure numbers are.

What surprised me was the 19 minutes in a single event, twice.
Pretty sure I was not awake during either of them, because I did turn off the machine one time only but after both the CSR events had happened.

The 95% pressure is reported as 14.2
Other nights, it's been as high as 15.
I've been starting it at 4, but only for a 5 minute ramp up.

Maybe these were REM? And I was having really awesome Stephen King intensity dreams?

AirSign,
If I had a Stephen King dream, there would be no sleeping after that. I used to read his novels, then couldn't sleep without a light on.

Most folk feel smothered with a starting pressure of 4, plus it takes longer for the machine to respond to an event. From what you posted here, I would start your pressure at 7, with a maximum of 16, then watch your data for at least 10 days to see if further adjustments should be made.

[Sleeprider]

This was Day 13 using my APAP.

Sleepyhead reports two periods of CSR, each 19 minutes long.
Have not had any before this.

Also shows 8 RERA events, which have not had before.
The RERAs do not seem to be simultaneous with the CSR periods.

6.5 hours of sleep, AHI 7.83
No Large Leaks.

Should I be concerned about either the CSR or the RERAs?

Take a closer look at your data and see if there is a correlation of the periodic breathing with other events or particular pressures. My guess is that your problems arise from too low of a minimum pressure, and that if you would raise the minimum pressure to your average or median pressure, you could probably cut events in half and not see PB. Without seeing the data, I can't be more specific, but an AHI of 3.5 or less is consistently available to you if you will do this.

[AirSign]

Hmm. Here's some graphs from Sleepyhead. No large leaks.

[attachment=1427]

[attachment=1426]

Could I have been pinching the air hose somehow?

[retired_guy]

Could I have been pinching the air hose somehow?

Nope. But looking at your graph I agree with Opal and Sleep guy that increasing your range should help you. I forgot what they said but I would do the following:

1. Change the ramp setting to off. (You only use it for 5 minutes anyway, so why suffer that long?)

2. Change the pressure to minimum of 7 and maximum of 16. (That's really a larger range than I like to see, but I think some of your goofiness may be caused by sleeping position, and this range may be needed to offset that.)

3. Do you want to use EPR? That may help, but I wouldn't set it higher than 2 for now.

You're doing fine, you just need a little adjusting of the dials. You do not need to worry about the CSR's you're seeing killing you. On the other hand, if they did kill you, you wouldn't be worried about it anyhow.

Just unlax and enjoy your day, then sleep well tonight.

[AirSign]

Thanks, Opal, SleepRider, and RG -- I will change those settings for tonight. It's such a joy after 6 years to be able to actually SEE what happens with my breathing when I'm sleeping!

And R-G, more likely that the sacral neuromodulator that got put into me on Thursday is going to kill me, especially if I join some protest demonstration somewhere and get zapped by a taser !!!!

[retired_guy]

Thanks, Opal, SleepRider, and RG -- I will change those settings for tonight. It's such a joy after 6 years to be able to actually SEE what happens with my breathing when I'm sleeping!

And R-G, more likely that the sacral neuromodulator that got put into me on Thursday is going to kill me, especially if I join some protest demonstration somewhere and get zapped by a taser !!!!

Just remember "Hands up! Don't Shoot!" and you'll be fine. ..and don't be burning your bra at the demonstration..... That's so "yesterday."

[Sleeprider]

First, thanks for posting the data. Youre doing pretty good for just being two weeks into therapy and things will likely improve, even if you do nothing. Adjusting to sleeping with CPAP takes some time.

I agree with Retired_Guy but would place the minimum pressure at 8.0. If you look at the second chart you posted, you can see your therapeutic pressure is between 12 and 14 cm (EPR drops that pressure on exhale). Pretty much any pressure under 8.0 is a waste of time, and I would use that as a minimum if you can tolerate it. The biggest cluster of OA was during ramp after that break at 03:00.

You appear to be using EPR of 3.0 which can make higher pressures more comfortable, but some people experience apnea if the EPAP (expiration pressure) is insufficient to support the airway at the bottom of the respiratory cycle. I might use a bit less EPR and see if it helps, or makes any difference in your comfort level.

You can zoom in on the periodic breathing. It looks like this is a period of time where you breathing is shallowing out and is a series of hypopnea followed by recovery breaths. This can be cyclical and the machine scores it as periodic breathing. True Cheye-Stokes is a very smooth waxing and waning of breath punctuated by central apnea at the low ebb of the cycle. It's not something to be concered about unless it becomes a regular feature of your sleep, and this will likely disappear as you adapt to CPAP.