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Here are the latest charts with the increased pressure support.
I think the flow limits look minimal but I don't fully understand how they are reported or the significance as this was not something I was aware of before getting this machine
There are a number of OAs dotted through the night which were not there prior to increasing the pressure support but don't know if that is connected. I can also see a number of times when the pressure is pushing up to the max so wonder if the max needs increasing?
I have included the user flags as there are quite a few of these shorter apneas which I suspect may be affecting sleep quality.
As ever your advice and support is valuable and much appreciated
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
The last 2 charts look pretty good. 0.00 95% flow limitations.
Possibly you could try lowering your pillow height, possibly trying sleeping on your side if you sleep on your back, and only if you want to, you can try a soft cervical collar. Your few events don't cluster, but just a hunch it might help.
You can increase your max pressure from 15 to 16 also. You get really close to 15. If needed you may even go higher than that.
Just a few tweaks to try to optimize a bit better.
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If you're still not feeling rested during the day, you might try raising your minimum just a little, to see whether that will head off a few OAs. Maybe 8.4? You can also raise your maximum, but since you're not hitting it now, this may not make a difference.
If you zoom in where the user flags are, I bet you'll see arousal breathing right before the pauses between breaths. If that is in fact what you see, the problem isn't really the pauses; it's the arousals. And those may be "spontaneous," meaning they don't have anything to do with what's going on in your airway.
Anything you can do to reduce arousals will be a plus. I forget whether I already posted this, but here's a list of recommendations:
• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.
I woke this morning with clots of blood in the mask and on my teeth and there was dried blood on the side of my face and down my upper arm and shoulder which seemed to have come from my mouth. I think it was from my sinuses as more came when I 'snorked' them. No blood in my nose. No pain, no soreness in mouth or gums. Can this be BiPAP/xPAP related? My pressures did go quite high towards the end of the night. Have attached a chart.
Goodness! My suspicion is that the blood is actually coming from your nose via post-nasal drip, but of course I have no way of knowing whether that's true. I have two tentative suggestions:
1. Stop using your machine and get in to see your doctor. You may have a sinus infection. If you experience an unusual headache or eye problems, get immediate medical attention.
2. Keep using your machine with a little more humidity and see whether the problem recurs.
I'm not sure whether to advise you to try a sinus rinse, but that's an option. In the U.S., NielMed is a reliable brand.
The CA index is negligible, so I wouldn't worry about it if I were you. If you zoom in where the CA flags are, you'll probably see arousal breathing right before the pauses in your breathing. (Arousal breathing is deeper and messier-looking than asleep breathing.) I don't know why you're having CAs just now, but they are notorious for being "predictably unpredictable."
No more bleeding, I hope?
And have you tracked your O2 since that last came up in this thread?
No more bleeding and the CAs seem to have been a blip. Have tracked SpO2 last night and it seems lower than I would like with a lot of the night <90%. Not sure what to do about this. Sleep technician was very relaxed about it saying it was probably just normal for me but I'm not convinced that level of desats is not having a negative impact. Chart attached
