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Increasing Stage 3 and REM sleep

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DonMidwest +0 points · 2 months ago Original Poster

I looked at the graphs (actually histograms) provided by Resmed

In Feb, one night had 24 Apnea events! Not sure what criteria is for an apnea event. But most nights greater than 7. And several more at 7.

In Feb, one night had mask seal over 80, and 5 times that month over 70.

I am very upset. The "doctors" could have looked just at this data and known that something was seriously wrong. In the last couple of years I have taken the absence of comments, that I was doing just fine. Actually, according to their standards, I was an ongoing revenue stream so all was well.

I flipped out after the Feb 18 sleep study that showed Stage 3 and REM at 0%. That was the reason I started this connection with you which has led to OSCAR. They responded 0 = 0 They said over and over again the score was 0. That was clear. I was asking what does a score of 0 mean? I sent nasty messages to the My Chart and they even said I could come and in and speak with the head doctor. Since they have always said nothing useful, I did not go in to hear again that 0 = 0.

I am pissed off at the incredibly bad care from the "professionals."

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Sierra +0 points · 2 months ago Sleep Patron

I should not paint all sleep clinics with the same brush, but many are really only in it to the point of selling a CPAP machine at a big markup. They pretend to offer follow up care, but really do not do much. Where I am if you get a "free" sleep study done and if you test positive for the need to use a CPAP they offer it at a cost of about $2500. Things have changes due to COVID and a microchip shortage but at the time the whole machine and mask kit could be bought on line for about $800. The difference is their markup.

The other little dirty secret of the industry is that the MyAir app sends very limited summary data over the air. If the clinic even looks at it, there is not much to see. However, AHI's over 5 should be raising red flags, and it sounds like it has not. MyAir is mainly intended for those who get their machine paid for by insurance or medicare on the condition that it is used a certain minimum amount. MyAir designed to measure that compliance, and not really to provide information on how the machine should be adjusted.

Approved clinics that sell ResMed machines should have a program called ResScan that produces similar report to OSCAR. The only way they can see the detailed data that you see with OSCAR is if you bring your SD card into the clinic and they download the data like you do with OSCAR and view it in ResScan. Only then can they see the details needed to evaluate what is going on and make good recommendations for adjustment. This takes time that they don't want to spend. Instead they want you to come in and do a sleep study which they can bill for.

Dirty secrets of the industry! But, I am sure some are much more responsible....

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Sierra +0 points · 2 months ago Sleep Patron

No need to go to all that trouble. Just use the orange Write a Reply button to start a new full width window. You can find it on the top right of the page or at least sometimes on the bottom left.

On doing the graphic I think it helps to go to a full page view with Oscar to do the F12 screen capture. After that no need to leave it at full page. Just close it and drag it from the folder where you saved it to.

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DonMidwest +0 points · 2 months ago Original Poster

OK. Found button at top of page.

I messed up last night. The high levels of leakage messed up any of the numbers. I realized after the fact that I had not replaced my cushion! I have 2 new ones and will replace it now.

Even with the high levels of apneas, the 7 and one half hours sleep last night was one of the best in the last few months. With the new mask tonight we should get valid data tomorrow.

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Sierra +0 points · 2 months ago Sleep Patron

Ok, it is probably best to see another night or two, hopefully with less leakage, before making any more adjustments. The one section in the middle of the night looks pretty good, but I wonder if you were actually asleep then?

Could you go back to Saturday March 23, and specifically to the start of the sleep about 23:00. There is a section highlighted in green indicating CSR. If you left click on that area repeatedly the scale will zoom in. You can fine tune the zoomed section with the up down and sideways arrow keys. The idea would be to get a highly zoomed in section that includes the three CA events that occurred during the CSR. If you could do a screenshot and post it, I would be interested to see what it looks like. That may be a clue as to what the nature of the CA events are actually about. Here is an example of a night when I was flagged for CSR. I have some theories in what is causing it, but need to see the nature of what you are having to be sure.

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DonMidwest +0 points · 2 months ago Original Poster

I did send you the zoom that you asked for. It doesn't seem to be here so I will send it again.

I either did something wrong, or the system ate the comment.

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Sierra +0 points · 2 months ago Sleep Patron

That is close. Can you shift the zoom window to the left to capture the beginning of the green CSR area so the three CA (magenta color) events are included.

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DonMidwest +0 points · 2 months ago Original Poster

I may have done what you asked. I used the Event Flags area to select a range on the Flow rate.

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Sierra +0 points · 2 months ago Sleep Patron

That is still to the right of the area of interest with the three CA events. Just need to use the left arrow on the keyboard to move the window to the left so it covers them. See the area circled in red.

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DonMidwest +0 points · 2 months ago Original Poster

The only change was a new cushion.

I am baffled by last night. I did tape my mouth mostly closed but by morning most of the air was through my mouth Many, many apneas. Blank part with no flow. Don't know what that was.

I sleep most of the night on my back. I think. Only after get up to pee and try to go back to sleep will I move to side.

Hopes dashed that there would be linear progress

I learned how to use the editor for the text.

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Sierra +0 points · 2 months ago Sleep Patron

I suspect the blank period was when the mask came off and the machine stopped automatically, and then started again when the mask was moved back in place.

On pressure you could try moving the minimum up to 12 and the maximum up to 14. That would narrow the band between min and max to move it closer to a fixed pressure setting.

Most people have more obstructive apnea when sleeping on their back, and it is good to avoid it if you can. Some go to the extreme of sewing a tennis ball into the back of their PJ's to make them avoid sleeping on their back.

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DonMidwest +0 points · 2 months ago Original Poster

I showed the graph to my wife and she said that I was snoring so she had to pound on me in my sleep. Probably my mask was off when I was snoring.

I think I should try no tape tomorrow.

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PutSleepApneatoBed +0 points · 2 months ago Sleep Commentator

Have you tried a chin strap? They worked for me. And they avoid the hazard of suffocating due to taping, because you can still quickly open your mouth to breathe, if need be.

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Sierra +0 points · 2 months ago Sleep Patron

A chin strap should not be required with a full face mask that covers the mouth and nose. Mouth taping also should not be required with a full face mask, although there are some that claim there are other benefits to breathing through your nose only.

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Sierra +0 points · 2 months ago Sleep Patron

I noticed that ResMed has released a new full face minimalist mask in the US. It is claimed to be more flexible in changing sleep positions while still maintaining a seal to the face. It might be worth a try. Manufacturers are always releasing new masks with claims that they are the best things since sliced bread. But, one never knows until they try it. I believe CPAP.com has a money back refund on masks if they do not work for you. Or, better still your insurance may pay for it...

https://sleepreviewmag.com/sleep-treatments/therapy-devices/cpap-pap-devices/resmed-launches-compact-full-face-cpap-mask/

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Sierra +0 points · 2 months ago Sleep Patron

I found this video review that seems quite complete. It compares the F40 to the F30i and a couple of other masks. As a caution the mask uses magnetic clasps which should not be used if you have a pacemaker.

ResMed F40 Full Face Mask Review

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DonMidwest +0 points · 2 months ago Original Poster

Thanks. I looked at two more reviews of F40.

There was a time when I had a full face mask, one that went up to the bridge of the nose. It has a foam cushion. For a while it worked great. Then it started leaking and I tightened it so much that it hurt the bridge of my nose.

I am not sure about a nasal only mask because it seems my nasal area gets clogged overnight.

I have my titration study on May 19 so will continue to think about various options.

At this moment it looks like F40 would do the trick. My F30i has a hard plastic piece around the cushion so if I did roll over, the seal could be cut.

This evening: no tape on mouth. Sleep on back most of the night.

I did exercise today: 2 hours at pilates. Usually 1 hr per week but I have 4 per month on my Medicare advantage and had 2 left.

One thing I did learn from the long span with air shut off: over the years I have suspected that the CPAP was not keeping track of time correctly. A couple of times I timed it to see if it came out OK. Well, now I know that the difference is during the time when it is shut down.

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Sierra +0 points · about 2 months ago Sleep Patron

From what I can see this F40 mask is similar to the F30i, except it seems to be designed to be much more flexible. It may help to prevent the mask from being dislodged from your face.

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DonMidwest +0 points · about 2 months ago Original Poster

I slept through last night without waking up. Feel good this morning. Maybe with a night with such high large leak I shouldn't feel good. Thus if I can get things in order, maybe I will feel really good. No Tape. Used soft pillow.

When I am at pilates, they put an extra pillow under my head because my head leans forward. I have been to over thirty sessions of myotherapy - a physical therapy focusing on the fascia. The treatment is for scoliosis but along the way, there has been work to loosen up the neck so it rotates and I can see cars because I turn far enough. The two accidents in my live were within the last couple of years and both because I couldn't rotate my head and see out the left side far enough.

Here is my change for this evening. I will go back to the special pillow which I bought as a CPAP pillow. It is fairly hard foam. On my back it supports my head and that might be the problem. On a soft pillow my head is thrown backwards when I need to have it up so I look straight up.

Because of the leak over 70% probably none of the data is valid. GOAL: get valid data every night.

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Sierra +0 points · about 2 months ago Sleep Patron

Yes, it is hard to tell much from this one as I can't see the pressure graph to tell what it is when events occur. I would still suggest moving pressure up to 12 minimum and 14 maximum to see if that helps. The issue may be that leaks will increase if you are not getting a good seal.

Your head position issues reminds me that some have success with using a soft cervical neck collar. It prevents kinking of the neck and possibly obstructive events. They are inexpensive and you can probably get one at a Walmart. See this link.

https://www.walmart.com/search?q=soft+cervical+collar

If you can get the frequency of the obstructive events down, it may allow lowering the pressure instead of increasing it. It could be worth a try.

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DonMidwest +0 points · about 2 months ago Original Poster

Three changes. I will change settings to 12 min 14 max. Shave tonight - didn't do it last night. Use the special pillow. It is full size with some weird indents possibly for sleeping on your side. I only use it for a foam pillow to hold head up.

On going change from when we started: no tape on mouth.

We went to the Toledo OH Art Museum with the other granddaughter to see the Caravaggio exhibit. Another 4 hours in the car.

I will ask my physical therapist about the neck brace. Thanks for the information. They are inexpensive. I could wear one outside if I was looking for sympathy. (dumb joke)

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DonMidwest +0 points · about 2 months ago Original Poster

Great night! But first a word from Truth Central.

It is a racket! It is a racket I tell you! The mail came yesterday, my wife opened it, I didn't see it until this morning. And WTF. The bill for the Feb 18 sleep study was $6,500! I have Medicare Advantage through United Health Care and my former employer Bell Labs then Western Electric, Lucent then Alcatel and now Nokia. They changed names a few times as the country ditched manufacturing and became a full bodied country where the banks control the country. My charge after Medicare is $91. And I mentioned many times that from a data integrity point of view the Feb 18 study was a failure, but for the sleep mafia it was a smashing success because they got an AHI of 64!!! Incredible. Must keep this person in CPAP. Am I a masked rider, no a masked sleeper?

I think you said, but please repeat if correct, that the "sleepy doctors" only get the high level info over the data link. The same info I get on my Resmed Air Sense 10 screen. They provide a few tools so they can determine the average pressure needed, but not much more than I can get from Resmed web site.

The day before yesterday the AHI was over 15 and the Leak % was 70%. I drove for 5 hours and spent maybe 8 hours on my feet in a museum and was not tired. No nap. In other words, before I met you, I would have considered a good night's sleep. I had no idea what I was missing from excellent sleep!

Making the changes noted yesterday, my AHI of 5.12 is great! Big question can I do at least this well day after day? The biggest success last night is that for the first time I may have attained valid data because my air leakage level was low. I don't know enough yet to make sense of the various apneas so you have an easier time saying something useful than before when I was data deficient, or had a data disability. Ha! Maybe my stupid joke contains a way to characterize the "sleepy doctors" as having a data disability. They are childish. I know it is not politically correct to look down on a human being with a disability, but there are times one has to leap out of the box and be politically incorrect.

Before I sent this out I looked at the ResMed web site. The scores for the 4 variables was: time 63/70, mask seal 0/20, events per hour 5/5, four mask off/on 3/5 for a total of 71/100. I assume that this is the data sent over the data link which the doctors can see. From this there is no way they can properly advise about sleep. Furthermore, reading this shows the goal is compliance: use your mask 7 hours per day, stop leakage, don't take mask off and on -- comply and you will be doing fine. Only 5 points for apnea. I thought that was the reason for the device?

My wife made an interesting point. Maybe there are security reasons for not transferring all that data over the internet. In any case they have never shared any data except when my PA said that my pressure settings were good.

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Sierra +0 points · about 2 months ago Sleep Patron

That looks much better, but one night is just one night. Some suggested changes for the settings:

  • I would increase the minimum pressure to 13 cm. Leave max at 14 cm. Some of your obstructive apnea events are occurring when the machine is ramping the pressure down. This will limit the pressure that it can go down to.
  • If you find it comfortable I would increase the ramp start pressure to 9 cm. This gets the pressure up a little higher before the ramps ends.

You may want to consider rearranging the order of your graphs. You just left click on the title of the graph and drag it up or down. You can also scrunch the height of each graph down until it starts to mess up the title, but left clicking on the border between the graphs and dragging down. This lets you see more on one page. Your apnea issues are not much different than mine. Here is the order I have mine set up in. I don't find the Tidal Volume graph useful and push it down near the bottom. But I do find the Minute Ventilation graph quite useful. Ideally you want to see that quite constant and not cycling up and down. That can be the source of CSR and CA events. Sometimes what happens is a OA obstructive event messes up the breathing and after that Minute Ventilation start to cycle, and if it gets to the point that breathing stops, then you get a CA event. If the cycle continues then you can get one CA even after another.

I still think you should try the soft cervical collar if you think you can sleep with it. Some of your obstructive events, hypopnea, and flow limitation events (around 4:15 AM) look like they may be caused by your sleep position or a kinked neck which is obstructing the flow. If your neck is kinked then it makes it hard for pressure to keep the airway open. Reducing the kinking may allow you to lower the pressure used.

At some point, but not now, it may make some sense to try a fixed pressure. Currently it looks like a fixed pressure of 14 cm might work ok. But, leave that until it is more certain what pressure you need.

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DonMidwest +0 points · about 2 months ago Original Poster

It is interesting that your apnea profile is similar to mine.

This message is now number 51. It is clear why the sleepy doctors don't want to touch the detailed level.

I will go out and get a cervical collar.

I brought up the Minute Ventilation graph. And I made them smaller. Are there any other graphs you would like on the page and others to move down.

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Sierra +0 points · about 2 months ago Sleep Patron

Yes, that is more helpful. Minute Ventilation is a measure of how much air is being inhaled and exhaled over a small period of time. A high amount means that the automatic control system in your body thinks you need more oxygen. It bases this on how much CO2 is in the blood. The problem comes in when the blood flow is too slow, and by the time CO2 has reduced in response to deeper breathing, there can be too much oxygen and too little CO2. Then the body starts to reduce breathing volume. When it gets out of sync it is like a dog chasing its tail. Breathing effort goes up and down in a cycle. That is essentially CSR.

Your CA events right at 00:15 are interesting. There seems to be two CA events but the Minute Ventilation is very steady. This indicates these are not CSR type of events. But later starting about 03:15 there is another series of CA events while Minute Ventilation appears to be cycling up and down. These events may be occurring when the breathing effort cycles down to zero.

This relationship is best seen when you zoom in on the scale around those times.

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Sierra +0 points · about 2 months ago Sleep Patron

It is becoming more and more apparent that like me, you are suffering from what is called Complex Apnea. That is when a significant part of your apnea is central (CA) in nature. It is difficult to treat as in general more pressure reduces obstructive (OA) events, but increases central (CA) events. With a CPAP about all you can do is find a happy medium pressure where CA and OA are in reasonable balance and the total is not too high. The standard treatment guideline for apnea is for AHI to be under 5. However, I believe in the UK they do not treat apnea, or at least will not pay for a machine, until it exceeds 15. So the AHI<5 limit may be somewhat negotiable as to what is acceptable.

If you want to do some reading on Complex apnea I suggest two credible articles that are in the Education Blog section of this website. Read the first one first, and if you want to dig deeper then go on to the second one.

What is Complex Sleep Apnea?

Complex Sleep Apnea

If you have any questions, I will try to answer.

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DonMidwest +0 points · about 2 months ago Original Poster

find an apnea, zoom in, zoom out, find the relation to other variables to better understand what is going on

do sleepy doctors even know how to read these graphs?

here is the one around 03:15. Did I do it correctly?

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Sierra +0 points · about 2 months ago Sleep Patron

That is not quite classic CSR, and the machine has not flagged it as such, but it is a strong indication of instability in the control system regulating breathing rate. There are a couple of upsets right at the beginning of this zoomed in area around 3:09 and 3:10. Then it settles out until 3:14:30 or so. There is a bit of a blip in flow limitation and then that starts off the cycles of periodic heavy breathing with the flow waxing and waning. This is most likely when the feedback on CO2 levels in the blood are too slow. This causes an over correction, and that start of the cycle over and over again. Is suspect this is the basic cause of your CA events. If I could tell you a simple solution, I would. But, I have pretty much the same thing, and have found ways to minimize it, but not stop it. One of the things I have blamed it on is one of my blood pressure medications; a beta blocker called bisoprolol. This med slows the heart rate down and I think it may have been over doing it, causing my blood flow and CO2 feedback to be low and slow. I convinced my doctor to let me try half the starting dose of this medication (0.5 mg) and it seems to have helped some. But the issues for every person are likely to be different. If you cannot get the frequency of CA events down to an acceptable level (<5 per hour), it would be worth talking to a cardio pulmonary specialist about it.

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DonMidwest +0 points · about 2 months ago Original Poster

Incredible! AHI= 1.72!

Your suggestion about the neck collar, and my wife said that when I sleep I throw my chin back --- both of these led me on a trek to find a collar. I went to three drug stores, one Kroger and one WalMart until I found it at a Walgreens drug store. Their brand is just right. First night success! The F40 rides higher on the sides of the face which might be better than the F30i which has a lower strap on the cheeks.

I saw that large leak started 22:40 and lasted 2 hours until 1:40.

The later leaks at 05:00 and 06:00 may have been when I slept on my side.

I read the post on Complex Apnea a couple of times. I went to his Harvard web page and brought up abstracts of some of his papers. They all, so far, seem to be behind pay walls. Hopefully we can continue and get a few days of this.

The Harvard guy has a sleep lab with a continual source of data so he can continue fiddling with the complex set of graphs for some more years. Invent some new conditions. But he is not into nutrition I suspect. He is doing physiology, but at first glance, not doing nutrition and spiritual approaches like meditation and breathing exercises.

Are you familiar with the term Functional Doctors? They treat a patient rather than relying on averages and handing out pills or surgery. In my new found health focus I follow several functional doctors on line. And I have on line, but not listened all the way through, a so called Dr, Talks series on sleep,. And following various series on the web on cognitive issues and longevity who bring up sleep. And a daily dose of Dr. Mercola.

In addition I have read, but forgotten so need to reread, recommendations of Gaba and Ashwagandha Root which arrived yesterday from the on line supplement store I started using about 6 weeks ago named PipingRock.com. I have not started taking these because we are in the middle, or maybe at the start, of an experiment and it will take some more time for things to settle down and get fairly reliable data over a decent time period.

I am now shaving each evening and for some time I have gone to bed about he same time each night: 10:30 PM. And I try to cut down my screen time near bedtime. We seldom watch TV. Bedroom is dark and cool and the only electronics are wife's cell phone and hearing aid chargers.

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Sierra +0 points · about 2 months ago Sleep Patron

Yes, that is a major improvement. It seems that the cervical collar may have addressed the OA events. This would suggest that neck kinking while sleeping may be a significant issue for you. I guess more successful nights will tell the tale if it continues to work. What is encouraging is that your pressure stayed at the minimum of 13 and not once did it try to increase to the maximum of 14. I would not try it just yet, but this looks promising that pressure could be lowered. Your hypopnea and flow limitations seem to have gone to zero.

I have not tried the supplements thing, but my wife does. Gaba is one of the ones she takes. I have gotten significant help on sleep from the site at this link. It was started by a Canadian pharmacist and university professor that was concerned about the incidence of seniors taking falls and breaking bones. He blames the use of sleeping pills and instead advocates the use of CBTi, or cognitive behavioural therapy for insomnia. I found the website very helpful.

Sleepwell - It is no Dream!

I found the Hygiene of Sleep Checklist helpful, and generally follow it.

Hopefully the good results continue. If they do, then it probably makes sense to now step the min and max pressures down until OA events start to occur again. Need to see a few more good nights before jumping into that.

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DonMidwest +0 points · about 2 months ago Original Poster

Could it be? Large Leak 0.00% ? Well, I adjusted my straps: 2 at top and 2 at bottom. 1/4" for each one.

With the automatic start and putting on the collar for the first night with the collar, things got jumbled.

This time I first put on my mask. And realized that it could be tighter. Tightened the straps and ....

at 04:30 approximately I got up to pee. This is the break in the graph. I didn't think I went back to sleep, but maybe I did. I seem to be awake from 5:30 on, looked at screen a few times, and finally got up when time was over 6 hrs elapsed. On my screen AHI=.9

I have noticed for over a year that I can lie awake and AHI can often go up. I knew this was fishy. Something strange going on. Now I know that it was mask leakage that messed up AHI.

In any case, can you believe it, AHI = .98, and only CA at .98. Incredible.

Any suggestions on what to try next?

Fairly early on someone else posted here and mention that they had used a chin strap. The collar works like a chin strap I would like to give that person an update. I have tried a chin strap and for the most part it was a failure.

Update: I ran a red light this morning after dropping my daughter in law off at work. No one injured. 2 cars totaled.

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Sierra +0 points · about 2 months ago Sleep Patron

Ouch on the car accident. Good that nobody was injured.

The cervical collar seems to have been the silver bullet for your OA, Hypopnea, and flow limitations. Because they are lower the upsets to flow rates is likely less and they may have been the trigger for the instability that is causing the CA events, as they are down too. Pressure is simply holding at 13 cm, the minimum, all night. That is good.

I think it would be safe to lower both the minimum and maximum to 12 cm and 13 cm respectively. Try that for a night to see what happens. You seem to be making great progress on the leaks too. That helps. On my reports I watch the "Time over the Leak Redline" and like to see it at zero or close. You got 0% which is great.

With the ramp in Auto, the time it holds pressure constant is a good indicator of how quickly you are going to sleep. It will hold it for a maximum of 30 minutes if it does not detect you are asleep. It looks like you went to sleep in about 15 minutes when you first went to bed, and about 5 minutes after the pee break. After 4:40 or so it looks like you did not sleep and there were two very brief breaks in flow when the Auto timer reset. From that time on the Ramp stayed in Auto and did not increase to the minimum pressure, which is fine.

You may want to zoom in on the CA events that occurred at about 2:35 AM and a bit of time before that to see what let to them occurring. In any case things are improving significantly. Hopefully you can find a pressure that controls the OA that is lower than it is now. That may also reduce the CA's. Once that pressure is found, it may make sense to switch to a single fixed CPAP mode pressure.

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DonMidwest +0 points · about 2 months ago Original Poster

I was able to use the zoom feature from the top panel for the first time.

Around 02:35, the mask pressure went to 11 and stayed there for a while. The mask pressure dropped to 11 about every 2 seconds in many places.

Lets see how the max = 13 and min = 12 settings change things.

I mentioned a Dr. Talks series with Dr. Audrey Wells. There are almost 50 interviews. I just started to look at one on the nose and there was some new information. I will watch them sometime.

The reason is that D .r Wells sent out an invitation for her own organization with headline something like "20 ways to treat apnea without CPAP". My first impression is that they don't want to work through personal therapy like you have provided. Namely, creatively using the technology to get nightly updates is a way to run a series of experiments to figure out what is going on. Taking supplements, breathing exercises and so forth don't provide the kind of available data from the actual sleep. The title of her program is 20 ways to avoid CPAP - an inverse marking based on CAPAP rejection.

I have watched some other videos and there is much more to learn and for me, working with the machine and running experiments this has been the best approach. Thanks again.

PS If one of the doctors has insights that you might be interested in, I will go to their web site and find something and send it to you.

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DonMidwest +0 points · about 2 months ago Original Poster

another AHI well below 5!!! Only change was H20 to 5. Setting of 4 almost no water used.

As you can see, I woke up and went to the bathroom. 'Why We Sleep" book says to try getting up and reading. I did that. Went back to bed and fell asleep woke up cold.

With the mask and the chin strap and the instant starting of the CPAP, I have had to figure out new approaches. I now put my mask on first. Then lie down and attach the tube and off and running.

We keep the bedroom about 64 degrees. Someone recommended sleeping without socks and not being too warm. When I wake up I am usually cold. On my second wake up I put on sweat pants to keep warm. From this experience, when I wake up, I will have change of warn sleeping gear already laid out, change into them and get back into bed.

Interesting that only CA apnea. And CSR appeared. A short discussion about their interaction and their meaning would be helpful.

This morning have been dealing with insurance and rental car pickup from my accident yesterday. Still have full day ahead.

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Sierra +0 points · about 2 months ago Sleep Patron

Made a post and it seems to have disappeared. The short story is to reduce the min pressure to 11 cm, and max to 12 cm. Trying to find the point where OA events start to appear....

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DonMidwest +0 points · about 2 months ago Original Poster

I understand. Will change the pressure settings.

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Sierra +0 points · about 2 months ago Sleep Patron

Another thing you can do with the humidifier if you are not already doing it, is to select the pre warm feature 15 minutes or so before you plan to go to bed. It is on the options menu, I recall next after the mask test option. All it does is warm the water up before you go to bed. It may make the humidifier work a little sooner each night.

I like to keep our bedroom cool too and around 65 deg F. We are just coming out of the winter season here where it goes below freezing each night outside. Our setback thermostat takes a while to adjust to the warmer weather, and sometimes starts warming the house up too early. You are right though. One has do dress right for the temperature.

If you can zoom the scale in on that green CSR section just before 7:00 AM, and post it, I can have a look to see what is happening. The flow graph and Minute Ventilation should show what is happening. I am not exactly sure how ResMed decides it is CSR. The normal CSR pattern has periods of waxing and waning breathing effort with CA events when flow stops between the cycles. This is what ResMed says it looks like but I have never seen anything in my charts quite that uniform.

This is an example of what I see:

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