[Pressure] 106 second apnea??

[chris waters]

   
   
I'm a REnewing user after quiting CPAP 12 years ago. This time the new n30i mask is so much more comfortable than the full face horror that I dillegently struggled with for 18 months before giving the Resmed S9 away to someone who appreciated it more than me.

I've been using this new machine 7 or so hours every night for a month now. The benefit is slow showing but my AHI is always below 2 and Resmed's myair app says I have "excellent results" with a score of "100" most nights  

I know its early days but I don't feel much different. Most nights I am awake a lot and don't feel I'm getting enough real sleep.
I hope things will gradually improve by using OSCAR to get my settings right. The old S9 was fixed by a sleep doc and I had no control.

I have been quite satisfied with the new machine until I got a surprise last night when I was woken up by my 02 ring buzzing. I realised I'd had a long apnea. 
This mornings data show 106 secs not breathing? why did the machine not control it?

Do I have to change pressure? Up to now the pressure has never gone above 12. Does one rough night and a long apnea mean much?

[Sleeprider]

Well that is an impressive pause in breathing and there is some pretty big recovery breathing on the back-end. A closer zoom might suggest something of a cause, but at the onset of the event you were already at or near maximum pressure. Based on what I'm seeing on this chart, I would increase pressure and EPR. Increase monimum pressure to 9.0, EPR 3.0 full-time and maximum pressure 15. You have effective treatment and low AHI at current settings, but we could reduce flow limitation with more EPR. There are only 3 OA events for the entire night and they are not pressure related, so we're looking for comfort and to reduce the respiratory effort.

[chris waters]

Thanks for that, I'll give the settings a try

Does Zoomed in give any clues?      

If I try to hold my breath that long its very difficult!

[cmpman1974]

Wow that is a scary apnea event. I'd definitely be in contact with my physician to discuss. 106 seconds is a really long time.

[gohoos1998]

That's a long time. I can't help much as I have just started CPAP myself. I do want to ask how you have the "SpO2" and "Pulse Change" categories at the top, as well as the movement statistic. I had low oxygen levels and PLMD during my sleep study and those would be fantastic metrics to track. Thanks in advance and I hope you can figure some of the stuff that is bothering you out!

[Sleeprider]

The long apnea is clearly obstructive and the breaths leading into it are flow-limited, flat-peaked breaths of increasing intensity. This is a positional apnea caused by your head settling into a complete "choke". There is no evidence of any air movement during the apnea. Most people arouse or are able to open the airway enough to cause some air movement, but not this one. It is a full lock. I can't explain the lack of arousal, but eventually you did and recovery breathing ensued. I don't recommend a soft cervical collar or any intrusive aid for a one-time apnea, but if you see this occur more often you could do that. To be honest this single event or apnea is pretty amazing and suggests you might make a good pearl diver, but it's not life-threatening by itself. Here is a thread where members are discussing their long apnea events and seem to have put it all into perspective. https://www.apneaboard.com/forums/Thread...pnea-event

[chris waters]

I bought a Wellue 02 ring which I wear at night on my little finger. Oscar can import the recorded data in the morning. I then reorganised the graphs to show the sp02 and pulse rate with the other important graphs
There info about this in the Oscar help files

[chris waters]

I tried the settings suggested by Sleeprider last night. Definately more comfortable with good stats but still pretty wakeful.

   

Thanks Sleeprider, I feel a bit less concerned knowing that it was  likely positional. My only memory of it was waking on my back by the 02 ring buzzing furiously on my finger. I think I was jammed up against my pillow with my head twisted. Hopefully this won't happen too much


meanwhile I just would like more 'good' sleep   

[chris waters]

   

Well, tonight I had another long apnea (100 secs) followed by a few others although the AHI was still only 1.48.
Doctors would have no problem because AHI is less than 5, ..right?

Some how come I feel crap this morning?

The machine only seems to increase the pressure after the apneas so the pressure does not increase in time to stop a 100 sec apnea and several others later in the night.

I don't know whether this is a problem but I do know I feel pretty groggy this morning

I know its likely I was on my back but its going to be difficult to stop this.

Is a change I can make to the settings? Maybe fixed pressure?

[SarcasticDave94]

If it's truly positional Apnea then there's not a setting that will address this. The comparison to a kinked garden hose has been used. And it's a situation where the head and neck alignment that keeps the airway kinked closed. The CPAP doesn't have the airflow or pressure to blow past this blockage. It probably now suggests you'll need to physically prevent the airway kinks.