airboss27 - Therapy Thread

[airboss27]

After over a year if pretty successful therapy I have encountered what I refer to as "dawn affect." My numbers of events, clear air and apnea seem to shoot up as I get into the last hour of sleep. This has been happening recently and not every night but it is concerning.  Take a look.

[upsman]

The first thing I wonder about is your minimum pressure of 5 cm comfortable for you. That's pretty low and even though your events aren't that high, it might make you feel more comfortable starting at 6 or 7 cm. 

You have EPR set to 3 but it's not doing you any good at that low a pressure. The lowest pressure your machine can provide is 4 cm, so when you subtract the 3 EPR, you're not getting the proper treatment. 

"Dawn Affect" is as good a name as any for your clusters of events near the end of your sleep session. Most likely what's happening here is positional apnea caused by you being in a semi-awake state, maybe tossing and turning a bit before you become fully awake. Some chin tucking while trying to get comfortable or just unknowingly holding your breath while turning over. It's hard to say what drove your pressure so high near the end of your sleep session, but most likely it was due to flow limitations. 

I think you may do better with a minimum pressure of 7, maybe EPR of 1 or 2. Try that for a few nights and see how you feel.

[Sleeprider]

That is all obstructive in this case. It's kind of natural to start shifting position as your normal wake-up time approaches. Maybe you're bunching up your pillow or finding some way to tuck your chin as you hide from the morning. Hard to know, but you seem to be a very early riser.

[airboss27]

Any thoughts on why my Clear Air Apneas show up in greater numbers (clusters) in the last hour or so of sleep? I have heard it may have something to do with REM sleep.

[OpalRose]

It would be helpful if you posted a chart with clustered CA's. What I see on your chart above are Obstructives.

This could be related to Rem Sleep or just plain SWJ (sleep-wake-junk). This is where you are between awake and sleep. It looks like you were "chin tucking" or sleeping in a position that allows your head to drop forward into your chest. This small bit of clustered apnea is nothing to worry about unless you were seeing this pattern throughout the night.

I combined your last two threads as they are asking about the same issue.
Going forward, please use this thread to post your charts and questions.

Thanks!