First time poster - Advice

[Expat31]

I guess you mean a machine with "all the bells and whistles"?

Seriously, the EPR should reduce your flow limitations and do the job. 

Ideally your flow limitations should be at 0.5 or less. You are currently at 0.21, peaking at 0.64, which is much too high.

There is just one potential downside, increasing EPR can have the impact of provoking the appearance of central apneas. 

Lets see firstly what happens at 3.

It may be necessary to dial it  back a bit.

[Expat31]

Sorry, correction, 0.05 instead of 0.5!

[Lukeh84]

So,
Last night I had EPR on 3. I woke up around 4 hours later to find the AHI had jumped up to 22. I then turned it off and slept another 3 hours or so with much better results.
It was flow limitations that skyrocketed. I am currently at work and cannot post screenshot. The large leaks decreased significantly over the whole night so thats great.

Any ideas what this might mean?

The rest of the data looked similar to previous nights just the flow limitation that jumped up massive amounts as did the AHI figure

Thanks again!

[Expat31]

We really need to see the data.

But, glancing again at your last graph posted, I noticed that where we though you had positional apnea, it was actually peaking of high flow limitations, it happened twice with no apparent reason. The rest of the night was more even generally at a lower level, but still too high, likely causing arousals and poor quality sleep.

The EPR should have reduced the overall level, but unlikely to have  stopped the peaking.

As mentioned previously, the EPR may have provoked central apneas.

Another issue is your respiration rate. It seems a bit high, have a look at the link respiration rates by age.

You may want to include the respiration rate graph instead of the tidal volume, so as to be able to compare with the other graphs, in the hope of seeing some explanation.

Last thought, anything in your original sleep report that could help and give some clues?

[Lukeh84]

I will post the data tonight once home along with the corresponding graphs.

Thanks so much for the input!

[Lukeh84]

So, this is the data from last night bearing in mind that I woke up and changed the settings mid way through the night as I saw my AHI at that time was somewhere near 25.....

Luke

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And the graph with the respiratory rate showing

[Expat31]

Hi,

You know when I look at all your graphs again, I start to rethink the original opinion of being positional may well be right. 

It looks like the impedence created by positional apnea blocking the airways, with this resistance showing up in the peaks of flow limitations. Almost every single graph peaks in unison, I don't think I have seen this before.

If this is the case, the particular sleeping position needs to be identified.

-  This supine positional apnea (video) is worth looking at with the head fallwing forward "chin tuck".

 -  Also attached schema of tongue falling back and blocking the airways. This is different trype of  positional apnea compared to "chin tuck" above.

It would be helpful if you could post your sleep study report, with your personal identification details redacted. 
The breakdown of your AHI between supine and lateral positions could be quite informative.

Thanks.

[Lukeh84]

I actually don't have or remember my speep report as it was so long ago and the pharmacy has kept the data. I did the trial back in September and I've only just purchased the machine. 

I have posted last nights screenshots which look like they have imporved alot....

I don't know if I'm on my back or side when the leaks occur and all the data spikes.... I have no idea/cannot remember in morning. 

I don't remember any stand out points the pharmacist gave me other than you stop breathing alot.....

Below is tonight's data for comparison.

Thanks again and I really appreciate the help. Not sure how to repay you for the advice but if you have any motorcycle queries let me know ? I can help in that department ! 

Luke.

[Expat31]

Hi,

Looking at your latest graphs, the positive elements are that you have mainly hypopneas, with just one 41second obstructive. So the AHI figure looks worse than it actually is.

During periods of large leaks, it is likely the the machine's algorithm will struggle to record data correctly in this environment. If you could control these, it would be a step in the right direction.

I see you have a pillows mask, normally you can get a good seal as it has a small area. I use one but for a long time still had leaks, but couldn't understand why as I detect anything, until I did, hearing a strange thundering sound waking me up. Long story short, I now tape my mouth, initially with 5cm tape, now with just 2.5cm which is more comfortable.

To find out what is going on, you could get a camera and record yourself nighttime. Whilst they sre not always good quality, with a low frame rate, you can get some idea what is going on.

Thanks for the offer on motor bikes. My motor cycling days are long gone. I remember the last memoriable ride was on a friend's Triump Tiger, I think 500cc. I drove in on a country road doing nearly a ton (100 mph) with no helmet, wearing just a T shirt and shorts. Wild days.

As you can guess, I am from another world and another century...

[Lukeh84]

Thank for the help I really do appreciate it - 100mph with no helmet and t-shirt sounds like fun with a hint of adrenaline!!!

I will try the tape tonight and see if I can figure out the sleep position before changing anymore settings.

Ill report back in a few days and let you know progress.

Once again thanks so much you've been such a big help and full of great info thus far!

Thank you very much!!

Speak in a few days