[Symptoms] Insufficient deep sleep

[eriks]

It looks like the watch not only monitors motion but also can monitor nerve system activity. As it can measure ECG, I think it can also measure (maybe not very precise) brain activity as in brain wave forms that go along with one of the awakeness states of the brain.

[eriks]

As requested, a daily sleep report. I think this is pretty representative, minus the visit to the bathroom early this morning.

[eriks]

Does this suggest that minimum pressure should be raised somewhat?

[staceyburke]

The next time if you use the F12 button it will take a screen shot and it will be formatted for OSCAR.  Also Go to View at the top left and click on VIEW.  Go down to  RESET GRAPHS and choose STANDRAD.  That will give us the best picture of all the charts we need.  Then just attach it from the bottom add attachment.

I am sure others will join in but my take on your night - Your pressures like like mountain ranges.  The Resmed increases pressure because of flow limits (that chart is on page 2) and flow limits are apnea just like H and OA events.  you can see how they are classified in my signature.  

To help with the flow limits we use EPR (exhale pressure relief).  You are using EPR at a very low level (1) and only with ramp.  If we change those I believe you will sleep deeper and better.

I would do 2 things.  First I would suggest to turn off the ramp.  While ramp is on you are not getting any therapy and 1 cm is not much anyway.

Next set EPR to 3.  What that will do is you Min is at 10 that is your inhale pressure but your exhale pressure will be 7.  (min 10 minus EPR 3 = 7)

Those two changes should make a much more enjoyable nights sleep.

[eriks]

Hi Stacey, thanks for your tips, I wil definitely try!

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    Here the screenshot.

[Dormeo]

I agree with staceyburke. Do try EPR of 3, leaving your minimum pressure unchanged. Then post another chart. It may be that you'll want to raise your minimum a little as well, but one change at a time. If you don't want to go straight to 3, you can start with 1 or 2.

EPR drops your pressure when you exhale; by the same token, it increases your pressure when you inhale. This little boost helps you complete inhalation with less effort, helping you to overcome any limitations produced by relaxation of the tissues lining the airway in the pharynx.

When you post your next chart, be sure to include your flow limitation graph. You can squeeze it in by grabbing the gray bars that separate the graphs and pushing them up a little.

[Geer1]

Lets try the min 10, EPR 3 for a night and then post your results. There are a couple things in data that I am not quite sure about and that test will help clear some of them up.

[eriks]

Thanks guys, I'll do so.

I must note that I don't feel like exhailing takes effort, so I never considered ajusting the EPR.

[Geer1]

The call EPR "expiratory pressure relief" and advertise it as a comfort setting but the reality is that EPR creates a pressure differential between inhalation and exhalation. The pressure increases as you inhale and then decreases when you exhale. Not only does this provide "relief" during exhalation but it also improves flow which has therapeutic effect that helps treat flow limitations and hypopnea, both of which are present in your data.

Higher EPR can create issues in the odd case so you need to find the right balance. In your specific case it will be interesting to see the response to higher EPR and the results will help determine what balance of pressure and EPR will give you the best therapy.

[eriks]

Thanks for the information.

I started with step #1 last night. I disabled the ramp mode and increased EPR from 1 to 2 and that was an eye opener. I now consciously experience what my body has to live with all night and it's not pretty! I experienced that the minimum pressure (which is set to 10 now) is way too high to breathe comfortably, even with EPR. It feels like my lungs are constantly inflated like a balloon until I breathe out and then the pressure suddenly drops, it's not comfortable, if feels very aggressive.

So my next step, tonight, will be to decrease the minimum pressure to 8 which I think is much more sensible and then evaluate how that goes.

From there I will try if EPR needs to be increased even more and after a week I will again share the results.