Deep Sleep

[rkashyap]

Attaching screenshot from Friday night. OA seems to have gone up with the new settings. I only had OAs on 5 days out 28 with the fixed rate setting of 13. Now have OA on all 3 days with the new setting. One without EPR turned on and 2 with EPR turned on.

Best Regards,

Kashyap

[staceyburke]

There will be small changes daily. One or 2 new events are not important. The main thing is how you are feeling. Don’t try to chase numbers try for feeling better. Your flow limits look better with EPR. Did EPR make it easier to breathe? - sleep quality?

[Geer1]

I am torn if it looks like the increasing pressure is helping your flow limitations or making them worse. Try increasing max pressure to 16 cm and collect a few more days of data then post them.

You can also post some zoomed in shots of a couple of the obstructive apnea (showing ~ 2 minutes of flow rate data mostly before and including the apnea). That will help better understand if they are real apnea or not. They aren't occurring very often so even if real it doesn't look like a big issue.

You seem to do decent at times and then breathing gets more restricted at others. Makes me think there might be something positional going on (either sleeping on back or chin tucking or something like that). For now lets just be aware and collect some more data then might try something more in the future.

[hegel]

I'm curious because I don't know the answer to this: what's the harm of having a higher maximum pressure (say, 20) if you never reach that? In other words, a lower pressure resolves a person's apnea events. But imagine a stubborn event that required more pressure: why not have it available?

[staceyburke]

Because some people get “run away” pressures. If you don’t then no problem having a higher max.

[rkashyap]

Hi All,

I have changed the max pressure to 16. From the Samsung/Fitbit I am seeing that deep sleep is back in the range of 60-90 minutes. I feel more rested, however eyes feel tired. I will get a full set of readings for the week and post screenshots for 2 or 3 days.

Best Regards,

Kashyap

[rkashyap]

Hi All,

Posting last night's screenshot. I am feeling tired and lethargic today and will probably end up taking a nap later this afternoon. While Hypopnea seems to have gone down OA has gone up with duration from 11 to 21 seconds.

Best Regards,

Kashyap

[rkashyap]

Also including previous night's screenshot. The tired feeling may be a cumulative effect of two bad nights of sleep in a row.

Best Regards,

Kashyap

[rkashyap]

I am attaching a zoomed screenshot around one of the OAs with the flow rate.

Best Regards,

Kashyap

[Geer1]

What is curious about that example you posted isn't the OA itself but that there were three other blockages/restrictions in same window. Those were obstructive in nature but because they are less than 10 seconds in length they don't get flagged as apnea or hypopnea.

You appear to be having more OA at these recent settings and that makes sense.

Your minimum pressure (EPAP) is what stints airway open to stop obstructive apnea from occurring. Initially you were using a fixed pressure of 13 cm with no EPR so your EPAP was constant at 13 cm. You followed directions and lowered min pressure to 9 cm and turned EPR on and to 3 cm which makes your minimum EPAP 6 cm. Because you also turned the machine onto auto it increases EPAP on its own but it does so reactively (after apnea or flow limitations have occurred). On the 27th your average EPAP was 9.42, still significantly lower than your original settings.

Hopefully that makes some sense. In short you should increase EPAP (by increasing min pressure) to try and treat these obstructions. Since min EPAP = min pressure - EPR my recommendation is a minimum pressure of 13 cm (10 cm EPAP). This is still lower than your original settings but hopefully will be enough to stint your airway open.

I would also increase the max pressure to 20 cm as the machine came close to/hit your max pressure setting of 15 cm both nights. If it starts going too high and is uncomfortable then you can reduce maximum but if the higher pressure doesn't bother you it might help resolve a few more events.