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Help interpreting event in Sleepyhead?

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JMB +0 points · almost 2 years ago Original Poster

Long story short: unexplained fitful sleep. Sleep test revealed "very mild sleep apnea." But I know for a fact that two of the three "OAs" it flagged were while I was not yet asleep. Experimentation with CPAP also shows that a deep relaxing exhalation breath that lasts 10 sec will be (understandably, if mistakenly) flagged as an OA event. Bottom line: I'm just not convinced that I have bad enough apnea (if I really even have it at all) to warrant continuing to subject myself to CPAP, which is definitely hindering my sleep as much if not more than whatever I have that's causing my restless sleep/many arousals a night (it's likely not RLS, or narcolepsy...it's basically a mystery...).

Here is a screen shot of an event. It looks to me like something happened with the mask, and then my breathing/the machine goes wonky and then an OA event is flagged. It doesn't seem like a real OA event to me, but I was wondering how you more experience/knowledgeable folks interpret it?.....

(I've also included the only other OA event during that session, as well as a screen shot of a randomly chosen duration when nothing of note was going on, for comparison.)

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Sierra +0 points · almost 2 years ago Sleep Patron

Some observations:

  • Your last image does indicate what looks like fairly normal sleep.
  • Your second image looks like you were not asleep and the event may be what is sometimes called sleep wake junk. The mask pressure shows positive testing for obstruction. So it may be a legitimate sleep apnea obstruction, or you were just holding your breath for some reason. There looks like some very minor mask leakage which may have been disturbing you, but it is not excessive. Leaks over 24 L/min are excessive, but you were no where near that. You actually had two events in a row, but the first one ended before it got flagged.
  • Breathing is more regular in the first image, so you may or may not have been awake. Similar minor mask leakage. It looks more like a legitimate obstructive sleep apnea event.
  • Your pressure is not going very high, so the machine determination of need for pressure is low. You are not going anywhere near your set max of 10 cm.

As we discussed before, I would set the machine to use an Auto Ramp with a start pressure of 6 cm, and then set the EPR to ramp only. That will let you start with the full 6 cm on inhale and it will cut back to the 4 cm on exhale. After you go to sleep the machine will increase the exhale pressure to 6 cm. That should still be quite comfortable, and it could prevent the few OA events that you are having.

But will that do anything for your sleep quality? Hard to say. My one thought is that 6 cm of pressure is quite low, and some can feel somewhat starved for air at that setting. It depends on how you feel it, but one other change to consider would be to increase your minimum to 7 cm to see if that feels better and gives you a better sleep. If you do I would also increase the ramp start pressure to 7 cm.

And, as we discussed before it can take a while to get comfortable with a PAP machine. One other minor comfort trick is to turn on the prewarming 10-15 minutes before you go to bed. It is a function on the user menu that you can select. That warms the water in the humidifier and get your more humidity sooner. Do you have a heated hose? That can add some comfort too. The machine can be set to auto humidity control.

Hope that helps some,

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JMB +0 points · almost 2 years ago Original Poster

Thanks for replying. :)

I have no other charts to show (I have one other night, for a few hours, which is similar to this one), and I honestly can't deal with it anymore. I have tried higher settings, and it does not help. No matter what setting, I do not feel like I am getting enough air. It's very subtle, but my body knows. There are other issues as well, no need to go into. The point is that I maybe, possibly could get used to breathing with this thing after a matter of months, but given that I honestly don't know if I have apnea bad enough that it would help, I can't bring myself to continue putting myself through this hell (which is what it is in some ways).

Re: EPR. I experimented with it being off, as you suggested, and it just doesn't work for me at all. The only way I can tolerate the machine is if the EPR is at 3. And even then, the breathing is difficult and unnatural, and it's like putting a mountain between me and falling asleep. When I wake up, it is virtually impossible for me to go back to sleep with this thing on, which is why I only have a couple nights at a few hours, because after spending an hour in the middle of the night trying to fall asleep again with this horrible thing, I take it off and let myself fall back asleep.

Okay, well, I guess the bottom line is that I still have no real idea whether CPAP would help me with a problem that I'm not even sure is bad enough to warrant it. Thank you for your help, though. It is genuinely appreciated.

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