Completed First Night

[MoApnea]

The leaks are still no too bad. But check out Mask primer in the link below.  It talks about how to handle mouth leaks.

Thanks, I will add that to my reading list.

[MoApnea]

Didn't have real restful night even though I went to bed a lot earlier and the baby did not sleep in my room.  Woke up several times with the mouth problems.  While I still need to read up on the mask primer article, what point can there be too much of a  good thing?  I've been upping my pressure and with that the incidence of waking up with my mouth and tongue stuck in place has increased.  I also woke a couple times having the feeling of air expelling out of my mouth.  I didn't feel that way on the lower pressure.  While Fitbit data is whatever, it definitely showed that I did not have a restful evening.

  

[Sleeprider]

Although the pressures were not very different on this last night, the comfort results and AHI deteriorated. A single night is not a good reference to establish a trend. I think give this another night, and we can go back and figure out what works best for your comfort. I don't see any consistent trend for improvement with higher pressure since minimum pressure was 8.5.

If you get a chance, let's zoom in on some normal breathing wave-form and perhaps some events. I think we need a closer look at what is going on.

[MoApnea]

If you get a chance, let's zoom in on some normal breathing wave-form and perhaps some events.  I think we need a closer look at what is going on.

Here's 1 normal and 2 events

[url=https://imgur.com/Ebjwb17][/url]

[Sleeprider]

The normal periods look really good, and I don't see how the Insp /Exp times could be as distorted as the statistics suggest.  I do prefer an even shorter period so we can see the wave forms clearly (see below).

You can also format the Y-axis of the flow rate with a dashed line at zero. That really helps in interpreting these.  The attached image shows a good example of posting a wave form with the zero line.  I have included a mask pressure graph (only available on Resmed machines) that shows how EPR or pressure support work to vary pressure with respiration.  The point is, only enough time is included in the graph so that you an see the shape of individual breaths.

[MoApnea]

Here are smaller intervals

[Sleeprider]

I'm cherry-picking a bit, but in this figure, we see a somewhat long period of zero flow at the end of respiration followed by a flow limited inspiration (downward sloping).  If we put the zero line in just above that flat spot, that would be a normal breath pattern and Inspiration would be considerably shorter than expiration.  The machine's ability to distinguish breath phase is limited, and this is normal, but flow-limited breathing.  Take a look at Robysue's guide to Sleepyhead in my signature. 




In this graph, the CPAP loses track of where "zero flow" occurs.  We see the null flow moving around and very uneven breathing.  I have no idea what significance this has other than under these circumstances the machine may improperly shift pressures between its inhale and exhale pressures, which is why we reduced Flex.  All of this could self-resolve as you become more accustomed or adapted to CPAP, but in the meanwhile, we will keep the machine Flex algorithm at a minimum.

[ajack]

That makes sense sleeprider. The I:E could be thrown off by the machine seeing part of the exhale as an inhale.
To see what's going on for a week, I would use a ffm to eliminate the mouth breathing messing up the numbers, that also throws off the stats.
I would raise the min pressure to be closer to the 95% with respironics and see what that cleans up. After the mouthbreathing is sorted, another min 1cm may help

[Sleeprider]

We can give this some time, but ajack may be correct with the addition of 1-cm. The good news is that the OA rate is pretty good in the chart from 1/28. The risk in higher pressure is that it may increase CA, and the hope is it may decrease H. The reason for keeping the current pressure a couple nights is that we get a solid baseline to compare against.

[MoApnea]

I need to catch up on all of your posts and insight.  I decided to go back to 8.5-12 last night.  I just wasn't feeling great with the dry mouth (fyi i have a chronic dry mouth issues for the past couple of years and this is aggravating things).  I am going to stick with this setting for at least a week.  I haven't stuck with a setting more than a couple days so I think I owe it to myself to stay with one thing for a bit to see how I respond.  In the mean time, i can spend time reading up on links, etc.

I tend to wake up a lot towards the end of the night/early morning.  And I noticed I have a lot of events around 6:15 but I may have been semi awake in bed at that time.  Or perhaps the events are what's waking me up, who knows.

On another topic, I am trying to wean off very slowly from ambien.  I've been on for 6+ years and I'm working with my doctor to do a slow wean (decrease 2.5mg every 2 months).  So I started that last week.  Down to 7.5mg per night.  Not sure where ambien plays a part in sleep apnea, but just thought i'd throw that in there.