Great AHI #s. Feeling tired.

[Geer1]

I don't know that much about PR flex but the idea behind it is that it creates a pressure differential between inhalation and exhalation which increase flow rate.

You have no obvious apnea or hypopnea so the only way you currently have sleep disordered breathing is if it is due to flow restrictions and RERA's. Increasing flow rate can help overcome flow restrictions and avoid RERA's if they are an issue (in which case should see fewer of the spikes in flow rate).

One of the reasons many users prefer Resmed machines is because they more aggressively attempt to treat flow limitations. Your PR machine is slower to react to these types of restrictions. It isn't clear what exactly is causing your pressure spikes but I am guessing mostly snore (graph cut off) and some flow limitations and RERA's. Would need some zoomed in screen shot of breathing just prior to pressure increases to understand what is triggering them.

[buddy0329]

Does Variable Breathing explain the spikes in my pressure charts?

I founds this in the Oscar Wiki: Variable Breathing

According to Oscar I had 22 variable breathing episodes last night.  Over the last month my numbers show at least 9 a night and up to 22 a night.  The wiki goes on to say: "variable breathing caused by flow limitation over-rides the auto-pressure algorithm resulting is an unresponsive Auto CPAP".

I'm still confused.

[buddy0329]

I've attached my latest Oscar numbers from last night.  I added an event flag for Variable Breathing, and expanded the resolution so you can see more data panes.  I can zoom in on any of the events if that will help with assessments.  The only thing I can discern is that when the Dreamstation is flagging Variable Breathing events, the auto pressure algorithm appears to flat line as per the Wiki: variable breathing caused by flow limitation over-rides the auto-pressure algorithm resulting is an unresponsive Auto CPAP .

It's 4pm local time and I feel exhausted and eyes heavy.

[buddy0329]

The attachment in this post is zoomed in to just before a variable breathing event is flagged.  The period shown here is about 2 minutes long:

   

[SarcasticDave94]

I guess my mention on the spikey pressure trace was it looks like it's uncomfortable. Maybe it's not. Flex can be used at 1 or 2 if you'd like to try it. It's supposed to be similar to ResMed's EPR but Respironics buried details on Flex in corporate murky secrecy. However we know ResMed's EPR is definitely dropping 1, 2, 3 cmH2O when set respective to these numbers.

[Geer1]

I don't know the particulars about variable breathing but you can see that it is being flagged around periods where you have spikes in flow rates. My guess is it is being triggered by both the flow limitations that are obviously present (in that zoomed in view) and perhaps also the arousal breathing that now seeing the flow limitations could very well be RERA's.

Your best bet right now is to try flex to see if that makes any improvement. Try combing through your data before and after doing so to try and understand if flex appears to be improving your flow limitations.

See here for a bit more info on flow limitations.

http://www.apneaboard.com/wiki/index.php...ep%20apnea.

And RERA's

http://www.apneaboard.com/wiki/index.php...erapy#RERA

[buddy0329]

First two nights with the Resmed Airsense 10 Autoset are posted below.

Excellent AHI's
Only had 6 hours sleep the first night
Had 7 hours of sleep the second night...I woke up feeling like a new man.  Full of energy and clarity that sustained itself throughout the morning and afternoon.  Not saying it's due to the machine, but it had been awhile sicne I woke up feeling that refreshed.

First time seeing Flow Limitation chart as that was no available on my Dreamstation.


Any concerns that my pressures are routinely peaking in the 12.5-13 range (from a low of 11) across two different machines?
Any reason to consider using EPR based on my #s or is that just for comfort?
Any other takeaways based on the Resmed data vs older Philips?
Anything else actionable right now?

[SarcasticDave94]

EPR is comfort mainly, but we've had users turn it on and it is a limited range PS exactly like the ResMed VAuto BPAP, with one exception. PS/pressure support adds to your pressure while EPR reduces it. But the effects of PS or EPR 3 are identical.

Should you use it? Sure it won't hurt to try it. You can go in low at EPR full-time 1, or middle at 2, or maxed at 3. It may add a bit of comfort due to your higher starting pressure of 11. If you don't like what it does for whatever reason, just click it off.

[Geer1]

EPR would probably help a bit with the flow limitations. Try turning it on while wearing the mask with machine running and find what setting feels the most comfortable to you. If you set EPR to 3 and then turn it on/off you can get a really good idea of what it does and if it feels comfortable and then fine tune setting from there.

Some people are proponents for not using EPR unless needed for comfort whereas some do better with it. Kind of a trial and error process to find what works best for you.

[Dawnstar]

I was in this  same situation several years ago, my sleep specialist referred me to a sleep psychologist who specialized in treatment of insomnia with cognitive therapy (typically referred to as CBT-I). I was quite skeptical but it really helped. After forty odd years of untreated apnea, it was as if my brain was no longer able to distinguish exhaustion from sleepiness, and needed help to get back on track. I’m told this is pretty common with sleep apnea.

It’s hard to say if you’re in the same situation, but it might be worth looking into. If you’re getting insufficient deep sleep due to reasons other than apnea, identity what they are and address them.