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Inverse I:E

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emigoonie +0 points · about 2 years ago Original Poster

Sleepyhead has shown me that on average, per breath, my inspiration is longer than my expiration, an inverse ration, when it's normal to have a longer expiration. is this why i feel so bad after using cpap? my ahi is about 2.0, but i still wake up with a headache and other bad symptoms. i can't figure it out. this inverse I:E is the only thing that stands out. from sleepyhead: Insp. TimeTime taken to breathe in (Seconds) W-Avg: 2.67 Exp. TimeTime taken to breathe out (Seconds) W-Avg: 1.68

what can i do about this?

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Sierra +0 points · about 2 years ago Sleep Patron

Are you looking at the Daily median value for time? I see my median for inspiration is about 1.48, and expiration 1.64 with a tidal volume of 400. I am not sure what the significance of the differing times are. For volume pretty much what goes in must come out. It would seem to suggest your flow rate in is low. Are there any issues with asthma or COPD? What kind of pressures are you using? Are you using EPR or Flex to reduce pressure on exhale?

I have not used them, but I understand there are fairly inexpensive oxygen monitoring devices that can be used and the results displayed in SleepyHead along with the other parameters. May provide some insight into what may be happening.

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emigoonie +0 points · about 2 years ago Original Poster

thanks for replying. yes, i'm looking at daily median value. some nights, i'm breathing in twice as long as long (or worse) than i'm breathing out. this is not healthy, but i don't have any other issues like asthma or copd, so i'm wondering, what is this problem? i've used auto (4-20) pressure on my resmed (the state of the art autopap), and i've tried steady pressure at 12, 13, and 14 with EPAP of 2. i'm going to keep trying different things, like less pressure and less EPAP, but it's been over two years now and i am having a hard time making this work. i've tried combining different oral appliances as well, which can make it worse. my tidal volume and resp. rate vary but they seem abnormal as well for my height and weight.

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Sierra +0 points · about 2 years ago Sleep Patron

With the ResMed setting the EPR at 3 cm should give you almost 3 cm more pressure on inhale and help reduce the inhale time. However, it typically raises the required maximum mask pressure. With the machine set with a max of 20, it should compensate automatically for that. And, in some it can cause an increase in the frequency of central apnea events. With a BiLevel machine such as the AirCurve 10 models from ResMed you can get more than 3 cm of pressure support on inhale. Perhaps something to discuss with your sleep doctor.

The other consideration is that there may be some issues with the nasal passages restricting flow in one direction and it may be worthwhile seeing an ENT specialist.

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