[Treatment] Still fatigued, history, are these CAs real?

[GuyScharf]

The two-hour reported gap last night is somewhat false. I woke up to go to the bathroom, disconnected the hose, and fell back asleep. Two hours later I woke again, noticed the hose was disconnected, and figured it out. I am dragging today, as usual, but not exhausted.

The 2:15 hour gap the previous night -- with the excellent AHI -- is real. Over the last six days, that day was the only one with a real 2 hour gap in the middle of the night. More typically, I get to bed between 9 and 10:30, sleep to about 6, up for an hour and a half, then nap for an hour or so (nap usually without CPAP, though I am changing to using it). Then I feel pretty good until sometime in the afternoon. I am trying to be very regular about bedtime (9 is the target) and avoiding caffeine. If feeling wired, I'll take a benadryl at bedtime to help getting to sleep.

OAs are relatively rare, so I am not too concerned about them. As I look through the flows, I see some evidence of sleep disturbance being triggered by flow limits, which is why I thought of addressing that. I also see what look like sleep disturbances associated with mask leaks. I figure the mask leak develops when I change position and nudge the mask out of its optimal position.

[Sleeprider]

That is a better assessment than I can make, and I think it provides some ideas on where you might want to focus your optimization.

[GuyScharf]

I have been using the VAuto for a week now, and for the last several days with EERS 12".  Oscillatory breathing continues but is somewhat muted.  Average AHI seems reduced.  I have not had one of those catastrophic nights I used to have where I was so tired in the morning that it took two days to recover.

In two years of CPAP use, I have never before seen an AHI of 0.0 for a full night.  I also slept through the entire night without waking, which is also not usual.

[Gideon]

My question is.
Is that the result of the VAuto?
Or the VAuto + EERS?
either answer is ok, it the the result you had that is important.

[GuyScharf]

VAuto + EERS I think. VAuto alone, which I reported earlier, was somewhat of an improvement over the AutoSet but not as good as last two nights.

[Gideon]

[Sleeprider]

The combination of therapy is potentially powerful, but unproven in trials. It's great to hear of your your success. We are working on the bleeding edge and have seen more success than failure. Thanks for playing Guinea pig.

[GuyScharf]

I thought I'd give you an update on my use of VAuto + EERS.

Overall, my energy is more stable. I still need a lot of sleep but have more energy when I am awake.

AHI is averaging around 0.5 instead of the 1.6 I saw with the AutoSet. Average would be even lower without the occasional outlier. For example, I had an AHI above 2 a few nights ago. I had 22 OAs in about a 30 minute period, probably while sleeping on my back. 22 events in a 30 minute period, while obviously disturbing that period, still gave me an overall good sleep for the night. If they had been evenly spread through the night, it would have been a bad night.

Looking at my history, the largest AHI I saw with the AutoSet was about 6. In the two months I have been using it, the highest AHI was less than 3.

Oscillatory breathing continues but is more muted and not enough to cause the machine to record an event. I've even seen occasional periods of "normal" breathing pattern!

I am dreaming a lot, which wasn't happening before. I think I have some catching up to do! Sleep stages, as reported by FitBit, are looking more like a normal cyclic pattern with a decent amount of time in deep and REM stages.

I'll have my own VAuto in another week or so. The process of upgrading to VAuto has gone very smoothly, with the only delay being that I had not had the Medicare-required face-to-face meeting with my doctor recently enough. I'll see him next week and the DME is hot to provide the VAuto.

[carnuntum]

Hey GuyScharf,

could you please take a picture of what the Brevida looks like modified for EERS that you wrote about in another thread? It would be good to see it. I have this mask and haven't done EERS yet and would like to modify it that way. How satisfied are you with EERS? Is it helping you? Is sleep less interrupted? Are you sleeping better than without EERS? So far, not much personal experience has been described about it. Thanks