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After thinking something was wrong with my memory for so many years, I decided to do a sleep analysis. I did two tests, and the second being the Polysomnography with the study showed 142 respiratory events and an apnoea-hypopnea index of 22.1/h. Most of the events were hypopneas (125), with som obstructive apnoeas (13), 1 mixed and 3 centrals. There was also 6 RERAs which led to an RDI of 23.2/h. The events occurred rather equally in REM and NREM sleep. The AHI was slightly exacerbated in supine position being recorded at 34.6/h.
The SpO2 baseline was 95% with a lowest of 89% The ODI 3% was recorded at 9.8/h with a total of 62 oxygen dips. No oxygen data was recorded below 90%.
Given these results I was told to get a CPAP and did so.
A brief summary:
- I've been trying for about 2-3 weeks on and off to tweak my CPAP.
- Most of the first 2 weeks was using the Resmed P10 Nasal Pillow Masks and found it very uncomfy - Last few days I tried using the Dreamwear Nasal Mask and found enjoyed it but have found myself struggling to wakeup, getting tired by 4pm - which I didn't really get with the p10 mask. Albeit only been using this new mask for 2 days but it's happened on both days.
Hoping for some advice on whether I should stick with the Resmed mask given it didn't make me so tired and struggle in the morning (i've attached that result for Resmed mask.
And if someone could give some tweaking advice for the new mask.
Welcome! It looks like you changed your pressure settings a little bit in addition to the mask. I'd recommend you stick with the more comfortable mask for now. It's hard to judge what caused your sleepiness these past few days -- could be the mask, could be the pressure settings, and could be some random thing.
Your leaks with both masks were acceptable as far as the machine's ability to compensate and deliver the pressures it was set for. But do you think leaks may be waking you up? They bother some people but not others.
You are having some periods of flow limitation. These may or may not be interfering with your ability to sleep soundly. They bother some people but not others. If the FLs are due to nasal stuffiness, you'll need to get your nose unstuffed, but if they are due to lax tissue further down in your airway, you might benefit from using EPR more consistently throughout the night. That means setting your minimum pressure to 7 with your EPR of 3 so that you can get the full 3 cmH2O difference at all times. (The machine can't go lower than 4.)
I'd say a fair number of people here regard an AHI of 1-2 as good and 0-1 as excellent. I'm going to guess many or all of your CAs are pauses between breaths of 10 seconds or more that follow arousal breathing, which is deeper and messier than asleep breathing. You can zoom in on your flow rate to check. The arousals may be a problem, but a handful of CAs per night isn't.
You're sleeping with the machine, which is good, and you're working on optimizing your treatment, which is great. It does take time, though, for your body to get fully accustomed to the new night-time experience. Some people take to it very quickly, for others it can take a few months. So patience will be another virtue.
Try your best to go to bed and get up at the same times every day, and try to arrange your schedule so you have enough time in bed for a solid 7.5 to 8 hours of sleep. This may mean you need to schedule around 8 to 8.5 hours in bed.
I can’t comment on settings because those adjustments are not in my skill set.
Regarding the mask….. By all means get a mask that’s comfortable! XPAP is har enough without making yourself miserable with choice of mask. Since you’re happy with the Dreamwear, stick with that for the time being. Your settings are the most crucial here as far as managing AHI, since you mostly have your mask leaks in hand
Limoz;
Dormeo gave good advice ..
If it were Me I would increase Your top pressure from 10 to 12 h2ocm ..
You seem to be bumping the limit at 10 and the machine wants to
increase a little more at times ..
Thanks for your comprehensive response Dormeo. I'll try raise it to 7 tonight and see if that improves anything. Do you think I should increase my max pressure? Someone was saying my CA's could be a result of the max pressure so suggested lowering it.
Also you mentioned: "You are having some periods of flow limitation" - when you refer to this, where are you seeing this? (for note I don't have any current nasal stuffiness issues). I'll try raise it to 7 tonight as it seems my body is a bit more comfortable with the CPAP.
I've attached 3 of my last apnea results.
One positive is I don't feel as tired waking up as I did when using CPAP last week. But this could be a mental thing.
Yes, I see you lowered your max to 7. I'd raise it to, say, 9; you can then do as sauerkraut suggests and inch up further. Use your new settings (min 7 max 9 or 10) for at least 3 or 4 days before trying to evaluate them (unless they're a disaster). Be sure to raise your ramp minimum to 7 too.
Your FL graph is visible in each chart you posted, and there are FL summary data in the left panel. Ideally your 95% number would be 0. (A 95% number of, say, .03, means that 95% of the time your FL level was .03 or less.) Exactly what do those numbers from 0 to 1 measure? No one really knows, but they are measures of greater or lesser resistance in the airway.
As I mentioned, some people aren't bothered by FLs at all, so don't obsess about them. The one thing you might do, if it's easy, is to sleep on your sides and use a low, fairly firm pillow. You may be slightly tucking your chin down toward your chest from time to time, which could slightly limit the flow through your airway.
Not as tired -- that's good to hear! It's often impossible to separate the mental from the physical when it comes to feeling rested. Whichever it is, take it!
