Is this normal or my APAP is simply stupid?

[fejsbukpejdz]

Here are three questions:

1. Those dips of O2 woke me up, machine recorded no hypopneas, no RERAs, no centrals... nada.. nothing.
Why? 

2. If the machinedid record hypopneas here, why didn't it increase the pressure acorrdingly and that way prevented those stupid O2 dips?

3. Why am I having those weird dips in the first half of the night and then in the second half of the night, everything seems good and stable? Is it that APAP needs time to adjust OR that's just normal way of sleeping?


Hope the images help?

Btw one question not in the images so let's just make it 4 here

4. My heart rate, literally dropps to 40 sometimes and one time I saw it at 38 while my oxygen levels in at those times were 97% or so. Is that normal for heartrate to go that low?

[Sleeprider]

Frist, your SpO2 averages 96% and the lowest reading is 90%. We are not dealing with an O2 problem, rather there are several short spikes downward, mostly at the 00:45-00:00 before a therapy break, and 01:30--02:00 period. Your questons are, why these SpO2 desaturations are not showing in the respiratory flow rate data in OSCAR. Part of the problem, is that we are trying to understand very short-term drops in recorded by looking at a resolution of 3.5 hours of data. To see if there are respiratory anomalies in these time frames, we need to zoom-in and compare the respiration in those segments very closely, and compare that to periods that have no apparent problems with arousal or oximetry. It's like trying to identify flowers from the highway, you just have to slow down and get closer to know more than their general color.

For question 1, there is clearly an arousal at 00:45, but we don't know the antecedent conditions, which from here appear normal. We could zoom in on those segments to see if there are visual changes in the flow rate, and OSCAR also lets us easilyt switch to an Advanced View by using the menu option View/Reset Graphs/Advanced. Your current view is Standard, and the Advanced view lets us see changes in tidal volume,, respiration rate and minute vent. The answer to question 2 is the same. We can see uneven respiration and event flage at this zoom level, but we need to be closer and use the Standard and Advaced views to better understand what leads to a drop in SpO2 or arousal. Understanding question 3 regarding why you have better SpO2 is again very similar, but I would suggest this may be a period of deeper sleep stages that OSCAR cannot really tell us. I suspect when we zoom in to about a 2-minute segments we are gong to see respiratory waves that change in flatness, flow rate and frequency that we can't see from this view.

The question your tital asks, "is my APAP just stupid", has an easy answer, yes! Your machine has a very wide range of algorithms that measure flow rate, pressure and respiratory parameters that control the machine response in CPAP pressure. You are using a Philips APAP which I think is relatively stupid compared to Resmed, which seems to use a more responsive set of algorithms, with an emphsis on flow limitation and uses much more dense data at 25 Hz vs 5 Hz frequency to calculatet the response. Simply based on available data and the speed of calculations to execute APAP functions, the Philips is pretty dumb in comparison to Resmed, and I can nearly guarentee the pressure profile would be very different in response to what we are seeng here.

[fejsbukpejdz]

So what happens if I set it to constant pressure then?

Let's say 10

It didn't bother me much to fall asleep with 8.

We set it 10 and then I go to sleep. 

What do you think?

[Sleeprider]

I have found many prople that sleep better with fixed pressure. Changes in pressure can be disruptive to sleep in sensitive individuals and there is a great deal of merit in using fixed pressure, usually about the 90% pressure from auto pressure. It's actually much easier to titrate fixed pressure and to identify problems when pressure is not variable.

[fejsbukpejdz]

So I increased the pressure to 10.. that is the minimum pressure.

The machine raised it only occasionally but my O2 leves suffered a major blow tonight (right picture). They are much worse than the previous night (left picture). My puls oxy woke me up a lot of time to prevent it from falling even more.

On the other hand machine reported nothing bad happening. In fact it reported less AHI than the last night (left picture).


All I did was increase the minimum pressure from 9 to 10. 


Now I put the min pressure back to 7 and I turned on A flex instead of C flex, whatever that means...


1. Why did my O2 drop so much yet AHI was lower than the previous night?
2. Why was my breathing less variable, yet my O2 levels dropped more?
3. Is A flex better for performance or C flex? I understand C flex is more comfortable but I am starting to think A flex is more simple so machine will work better?
4. What to do?

please help I can't breathe...

[fejsbukpejdz]

even this night... with more hypopneas and whatever and obstructives... still had waaay better O2 levels..

Why :S

[Sleeprider]

What level are you setting alarms on your oximeter?

[fejsbukpejdz]

It was at 93% and it kept going off, and then I turned it off...

Eventually my O2 dropped to 88% at one point after I turned it off and then it dipped 4 times below 90% after that.

My brother came in and woke me up and said we aren't doing something right. This min pressure increase to 10 didn't solve much it seems...

Here I zoomed in a little bit on that biggest O2 drop I had to 88%. It doesn't show anything... nor hypopnea nor centrals nothing... Yet my O2s were dropping and breathing doesn't look regular to me. 

I am puzzled...

Usually people get a bunch of hypopneas and then they do something about it or centrals or whatever...

But this? What the hell is this?

Maybe too high pressure? and then hypocapnia? so brain wants to stop breathing?! but then why doesnt it show "centrals"?

---

please help me I'll buy you a beer via Paypal or however it's possible : am desperate... I just cried

[fejsbukpejdz]

And here I have zoomed in on one of those segments where my breahting becomes weird and irregular...

Why doesn't machine show anything at all for that?

It just ignores it as if everything is normal...

[fejsbukpejdz]

I can't stop crying