HELP! Suddenly my charts have changed

[vsheline]

Hi Woozie 38,

Assuming here that there's been no change in diet, such as a glass of wine or cup of coffee after dinner. 

While sleeping we unconsciously change our sleep position several times during the night.  I suspect that starting Jan 20 a new sleep position is getting included which increases your pressure needs.

When your pressure increased rapidly Flow Limitations were occurring.  FL events are obstructive in type.  Obstructive events are properly treated by increasing the pressure, so I think the machine is properly increasing the pressure.

If the new problem is that you have started rolling onto your back while asleep, you may be able to take precautions to avoid this, such as wearing a T-shirt with a tennis ball in a pocket sewn midway between the shoulder blades or a little higher.

I would think gradually increasing the Min Pressure would tend to lower the AHI.

[woozie38]

Hi Woozie 38,

Assuming here that there's been no change in diet, such as a glass of wine or cup of coffee after dinner. 

While sleeping we unconsciously change our sleep position several times during the night.  I suspect that starting Jan 20 a new sleep position is getting included which increases your pressure needs.

When your pressure increased rapidly Flow Limitations were occurring.  FL events are obstructive in type.  Obstructive events are properly treated by increasing the pressure, so I think the machine is properly increasing the pressure.

If the new problem is that you have started rolling onto your back while asleep, you may be able to take precautions to avoid this, such as wearing a T-shirt with a tennis ball in a pocket sewn midway between the shoulder blades or a little higher.

I would think gradually increasing the Min Pressure would tend to lower the AHI.

No, no change in diet or sleeping position. (I learned long ago not to sleep supine). Your advice is sound, so I did two things. First I raised my minimum pressure from 8 to 9 and; disabled "sense awake" (similar to EPR). This morning my chart shows very little difference. Almost the same as the night before only with 0.14 OA. Perhaps I should try dropping min. pressure, rather than raising it? Will send link to chart ASAP (FTP server down)

[woozie38]

Woozie, it's pretty obvious your hypopnea events corrolate with increases in pressure.  I'm going to suggest you set your pressure at 8.0 fixed, or variable pressure in a narrow range of 8-9.  There was some flow limitation at 00:40 that caused a pressure increase leading to a lot of H events. In every instance, hypopnea was associated with increases in pressure.  I think trying a fixed pressure will show us if this can be eliminated.

Hi Sleeprider,

Last night, acting on advice I raised my min. pressure from 8 to 9 & disabled "sense awake" but this resulted in very little change. Tonight I will lower min pressure & turn auto off, & see what happens. I can't post  last night's chart because my FTP server is down.

[Sleeprider]

Geoff, it's all about a bit of trial and error...well done.

[woozie38]

Hi All,
Trial & error is certainly the name of the game "Sleeprider". Last night auto was set to off & pressure set to 8. The result is a slight improvement, not so much on my chart for last night, but in the way I feel this morning. The acid test is to see how much memory or recall there is, & this morning I'm a little better. 
Chart 5 (press:9; auto on, Sense awake off). Chart 6 (press; 8 auto off). Charts are still weird though

Think I will raise pressure to 9 and still leave auto off, & report again tomorrow.

[Sleeprider]

Completely agree. Rest is the best, and how you feel is most important.

Tom

[woozie38]

Hi All,
Trial & error is certainly the name of the game "Sleeprider". Last night auto was set to off & pressure set to 8. The result is a slight improvement, not so much on my chart for last night, but in the way I feel this morning. The acid test is to see how much memory or recall there is, & this morning I'm a little better. 
Chart 5 (press:9; auto on, Sense awake off). Chart 6 (press; 8 auto off). Charts are still weird though

Think I will raise pressure to 9 and still leave auto off, & report again tomorrow.

Set pressure to 9 for last night and going by the chart, there seems to be some improvement. I am aware that one night on its own is not really proof of gains but will leave settings alone for the time being & see if the improvement remains. Many thanks Tom for your help.

[Sleeprider]

Hypopnea seem to be replaced with flow limits. It could be that all you needed was a higher auto minimum pressure. Looking better.

[woozie38]

Hypopnea seem to be replaced with flow limits.  It could be that all you needed was a higher auto minimum pressure.  Looking better.

I did try higher min. pressure on auto, but over a number of days there was no improvement. The main problem being,  I believe was, on increased pressure, mask leaks cause multiple arousals with consequent ill effects of lost sleep. Set pressure seems to eliminate that.

[vsheline]

Hi Woozie,

If running fixed pressure, it is conventional to run near the auto-mode 90% pressure. In your case that may be near 10.

So you may want to consider gradually increasing pressure weekly until your set pressure is near 10.