After knee surgery, recommended to sleep on back AHI high

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
ozij
Posts: 10358
Joined: Fri Mar 18, 2005 11:52 pm

Re: After knee surgery, need to sleep on back

Post by ozij » Tue Dec 19, 2023 10:06 pm

I agree with going to APAP for a while.

However, you also write:
LindaGinCanada wrote:
Tue Dec 19, 2023 8:49 am
As well as the discomfort of knee surgery I keep waking up constantly. Need sleep desperately. My pressure is 11, machine was new September 2022, headgear replaced about a week ago.
Our AHI can shoot up because the machine can't properly analyze our wake breathing.
You are:
  1. Not sleeping in your usual sleep position
  2. Suffering from the discomfort of surgery
  3. Waking up frequently
We have no idea if your frequent waking is caused by 1 and / or 2, or if lying on your back is causing breathing disruptions that wake you up.
OSCAR charts will make that easier to tease out.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

User avatar
kteague
Posts: 7776
Joined: Tue May 16, 2006 8:30 pm
Location: West and Midwest

Re: After knee surgery, need to sleep on back

Post by kteague » Wed Dec 20, 2023 5:36 am

Waking a lot with pain can really make the data look bad. Some people are good enough with looking at the data to say if the events were around wakings, but I'm not one. The pain from the surgery should soon diminish enough that you find yourself sleeping in longer chunks of time and getting better numbers. I'm now almost 6 months out and the miserable nights are a vague memory. That's a big deal for me because sleep had been horrible for years before surgery because of knee pain. My doc was quick to tell me to sleep however I felt most comfortable. While I appreciated that, I'm thinking it contributed to my delay in getting my knee entended and flat to their expectations. Good luck with everything.

_________________
Mask: TAP PAP Nasal Pillow CPAP Mask with Improved Stability Mouthpiece
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Bleep/DreamPort for full nights, Tap Pap for shorter sessions

User avatar
LindaGinCanada
Posts: 20
Joined: Tue Dec 19, 2023 8:40 am

Re: After knee surgery, need to sleep on back

Post by LindaGinCanada » Wed Dec 20, 2023 6:20 am

lazarus wrote:
Tue Dec 19, 2023 3:34 pm
Without seeing details, and if it were my therapy, my stab in the dark would be maybe to put it in APAP mode and to set the minimum pressure to 9 or so, depending on comfort, and the maximum to 20. Then I would see how that went to tweak from there.

But if you are able to post some nights of OSCAR following the instructions on what the experienced eyes like to see, I am sure you will get better observations and suggestions than that.

You'd probably want to stick to this thread to do that, and once properly-formatted OSCAR info is linked to, then adjust the thread title to mention OSCAR to make sure it doesn't get overlooked by the talented ones.

I think you are gonna be fine, Linda. Glad you are putting the work in to get there with your sleep. I hope you feel the joy in that!

-Jeff
Thanks Jeff, I have downloaded Oscar, and in the process of checking which files need to be uploaded. I did switch back to APAP, pressure was roughly the same, was able to sleep in chunks of almost 2 hours, AHI still high but certainly not as high as a week ago. I really think that is because I'm sleeping on my back and it just leaks more that way. Next is so master sleeping on my side to bring the leaks and AHI down even more. I really appreciate the help I've been getting, glad to have found this group.
Linda in Ontario, Canada

A garden is a friend you can visit anytime.

User avatar
LindaGinCanada
Posts: 20
Joined: Tue Dec 19, 2023 8:40 am

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by LindaGinCanada » Wed Dec 20, 2023 7:46 am

Still figuring out what screenshots to post from Oscar. Will keep working at it.

I think the high AHI numbers are because I'm not sleeping in my usual position. Pain from surgery has diminished, what I get most now is discomfort from being in the same position on my back and the need to move my leg a bit.
Last edited by LindaGinCanada on Sat Dec 23, 2023 8:21 pm, edited 7 times in total.
Linda in Ontario, Canada

A garden is a friend you can visit anytime.

User avatar
lazarus
Posts: 1354
Joined: Sat Mar 12, 2022 3:21 pm
Location: Just above NJ.

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by lazarus » Wed Dec 20, 2023 8:52 am

Setting the minimum to 9 or above may (or may not, but it's worth a try to) help that AHI.

Personally, I don't use ramp, since I am more comfortable without it and since the consistency in pressure allows me to keep irritating leak lower, myself. Others need ramp for comfort reasons.

Most of us choose to use an image hosting service like imgur and then post the links to images hosted elsewhere, because of the limitations of this board and in order for the images to be if higher quality.

Hopefully more experienced ones than me, such as ozij and others, will chime in with their more educated thoughts and observations.

Glad you found cpaptalk. May you continue to make progress!
There are two types of people in the world: (1) Those who can extrapolate from incomplete data.
---
My love song to my CPAP:
https://youtu.be/_e32lugxno0?si=W4W9EnrZZTD5Ow6p

User avatar
LindaGinCanada
Posts: 20
Joined: Tue Dec 19, 2023 8:40 am

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by LindaGinCanada » Wed Dec 20, 2023 11:02 am

lazarus wrote:
Wed Dec 20, 2023 8:52 am
Setting the minimum to 9 or above may (or may not, but it's worth a try to) help that AHI.

Personally, I don't use ramp, since I am more comfortable without it and since the consistency in pressure allows me to keep irritating leak lower, myself. Others need ramp for comfort reasons.

Most of us choose to use an image hosting service like imgur and then post the links to images hosted elsewhere, because of the limitations of this board and in order for the images to be if higher quality.

Hopefully more experienced ones than me, such as ozij and others, will chime in with their more educated thoughts and observations.

Glad you found cpaptalk. May you continue to make progress!
I don't use ramp either, had it turned off for ages. I use my personal website hosting to link to my images as I saw that image hosting is full at this site. Thanks for your input.
Linda in Ontario, Canada

A garden is a friend you can visit anytime.

User avatar
lazarus
Posts: 1354
Joined: Sat Mar 12, 2022 3:21 pm
Location: Just above NJ.

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by lazarus » Wed Dec 20, 2023 11:38 am

I may be misreading your chart, but it seems to say at the lower left that you are using ramp for 10 minutes. No biggie, tho.

With an EPR of 3, which basically lowers EPAP (breathe-out pressure, which is key to apnea-prevention) by 3 cm, you may need to set overall minimum pressure higher than 9.

You may also (or as an alternative) want to consider setting AutoSet Response to "Standard" instead of "Soft," if comfort isn't a big issue for you, just to see if that keeps pressure-change response in the algorithm closer to what you need, although we generally only change one parameter at a time, so we scientifically know what made the difference, and then see if that helps over time.
AutoSet Response can be set to either Standard or Soft. If set to soft, patients will receive gentler pressure rises during therapy.--https://www.resmed.com.au/healthcare-pr ... technology
Just trying to give you thoughts as options. Hope I'm not throwing too much at you at once. Some like that. Some don't.
There are two types of people in the world: (1) Those who can extrapolate from incomplete data.
---
My love song to my CPAP:
https://youtu.be/_e32lugxno0?si=W4W9EnrZZTD5Ow6p

User avatar
LindaGinCanada
Posts: 20
Joined: Tue Dec 19, 2023 8:40 am

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by LindaGinCanada » Wed Dec 20, 2023 12:28 pm

lazarus wrote:
Wed Dec 20, 2023 11:38 am
I may be misreading your chart, but it seems to say at the lower left that you are using ramp for 10 minutes. No biggie, tho.

With an EPR of 3, which basically lowers EPAP (breathe-out pressure, which is key to apnea-prevention) by 3 cm, you may need to set overall minimum pressure higher than 9.

You may also (or as an alternative) want to consider setting AutoSet Response to "Standard" instead of "Soft," if comfort isn't a big issue for you, just to see if that keeps pressure-change response in the algorithm closer to what you need, although we generally only change one parameter at a time, so we scientifically know what made the difference, and then see if that helps over time.
AutoSet Response can be set to either Standard or Soft. If set to soft, patients will receive gentler pressure rises during therapy.--https://www.resmed.com.au/healthcare-pr ... technology
Just trying to give you thoughts as options. Hope I'm not throwing too much at you at once. Some like that. Some don't.
I did go back and check, and yes Ramp was set to 10 minutes, thought for sure I had turned it off (perhaps thinking of old machine) Turned off now.
I'll try AutoSet to Standard and see if that makes a difference.

Physiotherapist was here this morning and said I should be fine to go back to sleeping on my left side now, so will also be giving that a try tonight.

Thanks for your help.
Linda in Ontario, Canada

A garden is a friend you can visit anytime.

User avatar
lazarus
Posts: 1354
Joined: Sat Mar 12, 2022 3:21 pm
Location: Just above NJ.

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by lazarus » Wed Dec 20, 2023 12:45 pm

LindaGinCanada wrote:
Wed Dec 20, 2023 12:28 pm
Physiotherapist was here this morning and said I should be fine to go back to sleeping on my left side now, so will also be giving that a try tonight.

Thanks for your help.
Great news!

You are more than welcome. Any time.

I took a peek at your site/blog. Nice! You are truly an artist.
There are two types of people in the world: (1) Those who can extrapolate from incomplete data.
---
My love song to my CPAP:
https://youtu.be/_e32lugxno0?si=W4W9EnrZZTD5Ow6p

User avatar
ChicagoGranny
Posts: 14855
Joined: Sun Jan 29, 2012 1:43 pm
Location: USA

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by ChicagoGranny » Wed Dec 20, 2023 2:40 pm

LindaGinCanada wrote:
Wed Dec 20, 2023 12:28 pm
Instructions on formatting OSCAR charts properly are in the third link in my signature.
"It's not the number of breaths we take, it's the number of moments that take our breath away."

Cuando cuentes cuentos, cuenta cuántas cuentos cuentas.

User avatar
ozij
Posts: 10358
Joined: Fri Mar 18, 2005 11:52 pm

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by ozij » Wed Dec 20, 2023 9:03 pm

lazarus wrote:
Tue Dec 19, 2023 3:34 pm
Without seeing details, and if it were my therapy, my stab in the dark would be maybe to put it in APAP mode and to set the minimum pressure to 9 or so, depending on comfort, and the maximum to 20. Then I would see how that went to tweak from there.
Here's a suggested flashlight:
LindaGinCanada wrote:
Tue Dec 19, 2023 8:49 am
My pressure is 11
LindaGinCanada wrote:
Tue Dec 19, 2023 3:23 pm
The machine was originally set in APAP mode while pressure was determined. Once my supplier determined 11 seemed best it was set that way.
Given what you've told us, and this image, if your pressure was set to fixed 11, and your AHI has shot up, then the minimum APAP pressure should be 11.
Image the image shows that you're getting many obstructive events at pressures lower than 11.

When I agreed that changing to APAP for a while might help, I meant "give the machine space to give you more pressure, should that be necessary" it didn't mean "put it back in the "searching for the correct pressure mode".

Before your surgery, you were doing fine at a pressure of 11. So that's where I'd set the minimum. No sense in creating a situation where the machine goes through a cycle of "oh, this is an obstructive event, better raise the pressure.. good now we can drop it... oh no! another obstruction" and so on.

If you're back on your side, you may want to return to a fixed pressure of 11. But whether on your side or on your back, I see no reason at all for your minimum APAP pressure to be less than what worked for you before your surgery.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

User avatar
LindaGinCanada
Posts: 20
Joined: Tue Dec 19, 2023 8:40 am

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by LindaGinCanada » Thu Dec 21, 2023 7:20 am


Given what you've told us, and this image, if your pressure was set to fixed 11, and your AHI has shot up, then the minimum APAP pressure should be 11.
the image shows that you're getting many obstructive events at pressures lower than 11.

When I agreed that changing to APAP for a while might help, I meant "give the machine space to give you more pressure, should that be necessary" it didn't mean "put it back in the "searching for the correct pressure mode".

Before your surgery, you were doing fine at a pressure of 11. So that's where I'd set the minimum. No sense in creating a situation where the machine goes through a cycle of "oh, this is an obstructive event, better raise the pressure.. good now we can drop it... oh no! another obstruction" and so on.

If you're back on your side, you may want to return to a fixed pressure of 11. But whether on your side or on your back, I see no reason at all for your minimum APAP pressure to be less than what worked for you before your surgery.
I am back to side sleeping now, things were much better for first night, so thought I would give the APAP a try for a few days and if there wasn't any drastic difference will go back to set pressure of 11. Thanks for your help.
Last edited by LindaGinCanada on Sat Dec 23, 2023 8:22 pm, edited 1 time in total.
Linda in Ontario, Canada

A garden is a friend you can visit anytime.

User avatar
LindaGinCanada
Posts: 20
Joined: Tue Dec 19, 2023 8:40 am

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by LindaGinCanada » Sat Dec 23, 2023 1:40 pm

My AHI numbers have dropped way down since I am now able to side sleep after knee surgery. I did switch to APAP and noticed my maximum pressure has gone up a bit, will leave it as it right now, till I'm able to check in with my supplier.

I really appreciate the help I received. I'll leave the images for a little while then delete from my personal server to save my storage space.
Last edited by LindaGinCanada on Sat Dec 23, 2023 8:17 pm, edited 1 time in total.
Linda in Ontario, Canada

A garden is a friend you can visit anytime.

User avatar
zonker
Posts: 11157
Joined: Fri Jun 19, 2015 4:36 pm

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by zonker » Sat Dec 23, 2023 6:21 pm

LindaGinCanada wrote:
Sat Dec 23, 2023 1:40 pm
My AHI numbers have dropped way down since I am now able to side sleep after knee surgery.
back sleeping always increases my ahi. it makes sense in that the tongue can slide down the throat and cause blockage on some folks.
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

User avatar
Hang Fire
Posts: 466
Joined: Mon Nov 04, 2013 8:03 pm
Location: Raleigh, NC

Re: Updated to included Sleepyhead and Oscar data After knee surgery, recommended to sleep on back AHI high

Post by Hang Fire » Sun Dec 24, 2023 8:57 am

zonker wrote:
Sat Dec 23, 2023 6:21 pm
the tongue can slide down the throat
Man, that sounds sexy!