Soon to start CPAP - Question on dehydration

[Fats Drywaller]

It's best to switch off the Ramp feature, if you can stand that. Ramp is sort of like training wheels on a bicycle, only not even that necessary in a lot of cases. Getting used to breathing at the Rx pressure (or thereabouts) as soon as you put the mask on shouldn't be all that difficult.

[picante]

Thanks, I'm turning it down, especially for naps (experiments).

I just downloaded Sleepyhead and imported data. Respiratory rate is:
Median is 11 on both nights
Max resp. rate is 50 on the 29th Nov.
Max resp. rate is 44.6 on the 30th

Is this normal? Were these transient events?

[Sleeprider]

The maximum and minimum statistics are mostly useless, it the median and 95th percentile give you a more useful statistic. The machine are not perfect at measuring respiration and can be fooled int reporting errors by small breathing irregularities that are pretty. common in most of us. If you and a respiration rate of 50 over sustained periods we would be concerned. We have seen that, and that member eventually received ASV therapy that solved the problem. The data is useful, but it is important to use it for trends, rather than working about exceptional or individual events. Mostly we like to view thing in the context of the whole night or longer, but sometimes it's useful to zoo. in and have a closer look.

[picante]

Any suggestions? BTW, my AHI was 4.8 Thurs. and 1.2 last night. (Down from 40 during my sleep study.)

I really need to know the breakdown of events in that AHI.  Yes I have suggestions and have helped a lot of people overcome aerophagia and apnea, but I need to know more.  Either post a chart, or tell me what kind of events you are having.

I just downloaded Sleepyhead yesterday, and today I found the events list. This is a backwards chronology.

Data for Dec. 1, excluding the afternoon experiment:
Range for the night: 9.5-13.5 on Autoset for Her, EPR of 3
17 events at night: 14 CA events, 2 RERAs, and 1 hypopnea.
5h 24 m = 3.15 AHI    Stopped therapy around 5:00 am due to stomach & gut pain
(I had to calculate AHI, because in the afternoon experiment there were 13 events, and those were lumped in with the nighttime data.)

Data for Nov. 30, on doc's script of 12 cm, EPR of 3:
1 CA event, 2 hypopnea events
4h 43m, AHI .85
Stopped CPAP at 3:40 am due to stomach pain. Ate a bit more than yesterday, less pain & bloating.

Nov. 29, doc's script of 12 cm, EPR of 3:
29 CA events, 9 hypopnea events, 1 obstructive event, 2 RERA events
7h 55m total, AHI 4.93   Stomach pain on rising, too bloated all day to eat much.

[Sleeprider]

Thanks for the insight of your settings and events. You have consistently used EPR 3, and have been reducing thempressure settings from your doctor's original prescription of 12 cm (12/9 IPAP/EPAP) to a variable pressure 9.5/6.5 to 14.5/11.5. None of your trial pressures has resulted in obstructive events. Now we're going to solve your aerophagia and your apnea. Set minimum pressure to 7.0 and maximum at 8.0 with EPR 3.

[picante]

Thanks for the insight of your settings and events.  You have consistently used EPR 3, and have been reducing thempressure settings from your doctor's original prescription of 12 cm (12/9 IPAP/EPAP) to  a variable pressure 9.5/6.5 to 14.5/11.5.  None of your trial pressures has resulted in obstructive events.  Now we're going to solve your aerophagia and your apnea.  Set minimum pressure to 7.0 and maximum at 8.0 with EPR 3.

Oh wow, you're going to help me titrate! Here is some more data from Dec. 1 - this was my afternoon experiment (the data I subtracted above):
Range for the experiment: 5-14, Autoset for Her  20 min. ramp
16 events: 6 CA events, 1 hypopnea, 7 obstructive events, 2 RERAs
1h 12 m total (mostly dozing)
Leak rate was zero, pressures were 4.0 Min / 11.26 Med. / 12.82 95% / 13.2 Max.
Given my 20 min. ramp, it seems odd that the first CA and obstructive events were after that.
That night I did a 5 min. ramp instead.

I do need to get ahold of the doctor and tell him about my weekend experiments. He's not going to like it, but I'll say I was desperate to remedy the aerophagia, and I can't afford to stop eating bc of stomach pain. I've also been constipated since Thursday, very unusual for me.

[picante]

Last night's data looks horrible because I couldn't get the mask to seal. I tried from 11:00 until 2:00, with attendant stomach pain. Gave up and took it off at 2:00, slept until 6:00 and tried again, just to reach "compliance". I had similar troubles Thursday (the first night on CPAP), but not as bad.

Do you want that data, or is it irrelevant?

[Sleeprider]

The disrupted sleep would not be a good representative for the new settings. In my suggested settings, zi am proposing narrow range of pressure because you seem to have fewer events than with wider pressure range. Based on the types of events we see, we can decide which direction pressure and EPR need to go. Your afternoon trial at 5-14 is thinking along the same lines, but I want to see what happens when the machine is unable to increase above 10 cm.

[picante]

Now we're going to solve your aerophagia and your apnea. Set minimum pressure to 7.0 and maximum at 8.0 with EPR 3.

Your afternoon trial at 5-14 is thinking along the same lines, but I want to see what happens when the machine is unable to increase above 10 cm.

So shall I set max pressure at 8 or at 10?
And run the experiment for an hour this aft. or all night?
BTW, 5 out of those 6 CA events happened after I shifted from lying on back to side. The obstructive events were 3 on my back, four on my side.

[Sleeprider]

Since there are some OA, let's go with 10. I don't pay much attention to short session results because there isn't really enough time to get representative results in a one hour session.