5 months later..

[SemperVaporo]

Concerning nasal congestion. Just an anecdote from my viewpoint. I started CPAP with a nasal mask (the triangular, cover-the-whole-nose-from-upper-lip-to-the-eyes… I don't know what product number this might have been; it was 20 years ago!). Then I was sent a new headgear that was Nasal Pillows (the short silicone "bendy straws" that fit into the end of each nostril). Not long after that I came down with a really bad cold/flu, complete with the totally stopped up nose. Forced to breath through my mouth the whole day. MISERABLE! Went to bed early and put on the headgear out of habit! Stopped and thought: 'What good is this going to do?' But I put it on and turned on the machine. Within a minute I was breathing normally through my nose!
It was then that I really understood what a "Stopped up nose" was... ever since I was a kid, I thought it was some hardened mucus "stuck" in my nose and if I could just blow it out, I could breath again. I now understand that it is swollen membranes/skin in the nose that has gotten so thick as to touch from side to side and block the passage of air. By applying the mere 7.5 inches of water pressure that the CPAP is set to, it was enough to squeeze the swelling back down to open the passages.
WOW! I could breath again!
I have since used the CPAP not only to get a good nights sleep, but to relieve a stopped up nose during the day when I am home due to a bad cold/flu.

[CountingSheep]

“During the night around 02:00 am I woke up cause my daughter had a nightmare or something. I looked at my AHI and it was 13.xx
Damnit I slept so well... so I increased pressure to 10.0 and went back to bed. 2 or 3 hours later I checked the numbers again and it was only slightly decreasing.. it now said 11.XX”

Remember if you had a starting AHI of around 13 there’s no way your going to end up with say an AHI of 3 at the end of the night. The reason being is that the bad AHI 13 is included into the calculations for the rest of your sleep hours... no matter how good they are afterwards you won’t drop significantly.

[huydts]

Just so you know when you use fixed cpap mode your FL event flagging gets turned off.
Flow limitations are indications the airway is trying to collapse.
So the fact you had no FL flags when in cpap mode doesn't mean they didn't happen.

If you feel you must use a fixed pressure to mimic cpap mode...switch over to APAP mode but set the minimum to equal the maximum and then the machine functions like fixed cpap mode but FL flagging is turned on.
FLs are important and part of the auto adjusting algorithm. The machine will try to kill flow limitations with more pressure because they are warning signs that the airway is collapsing.

Hi Pugsy,

Thank your for your detailed information.
Tonight i will try to sleep with my p10 with your adviced settings; Apap 9 -> 11 with ramo feature 45 mins ( it takes a while before i sleep )
Ill keep you guys posted!

[huydts]

Trim your nasal hair and that should take care of the nasal itch, they blow in the wind.

The outside of my nose itches :/

Trust us. I know it sounds odd, but it does work.

my wife is looking for my nose trimmer as we speak haha

[huydts]

Concerning nasal congestion. Just an anecdote from my viewpoint. I started CPAP with a nasal mask (the triangular, cover-the-whole-nose-from-upper-lip-to-the-eyes… I don't know what product number this might have been; it was 20 years ago!). Then I was sent a new headgear that was Nasal Pillows (the short silicone "bendy straws" that fit into the end of each nostril). Not long after that I came down with a really bad cold/flu, complete with the totally stopped up nose. Forced to breath through my mouth the whole day. MISERABLE! Went to bed early and put on the headgear out of habit! Stopped and thought: 'What good is this going to do?' But I put it on and turned on the machine. Within a minute I was breathing normally through my nose!
It was then that I really understood what a "Stopped up nose" was... ever since I was a kid, I thought it was some hardened mucus "stuck" in my nose and if I could just blow it out, I could breath again. I now understand that it is swollen membranes/skin in the nose that has gotten so thick as to touch from side to side and block the passage of air. By applying the mere 7.5 inches of water pressure that the CPAP is set to, it was enough to squeeze the swelling back down to open the passages.
WOW! I could breath again!
I have since used the CPAP not only to get a good nights sleep, but to relieve a stopped up nose during the day when I am home due to a bad cold/flu.

In my experience the nose pillows ideed work pretty well while having a flue or glogged nose.
Just to be sure i will make an apointment with the doctor to check my nose internally.

[huydts]

Hey there..

So tonight i slept with the advised settings of Pugsy..
And guess what? I slept like a rose!

the first 3/4 of the night i slept without remember waking up.
Then i had to take a piss. The last part of the night ( morning ) i woke up a litle bit a few times because of air escaping a litle bit ( the sound of it )

My AHI was still too high tough 6.0

5 centrals
36 obstructves
23 hypos

so far i feel energized this morning. hope it stays like this during the day!

Any thougts of lowering the AHI any further? that would be fantastic!

min pressure 9,0
max pressure 11.9
90% pressure 10.9

[huydts]

Hello again.

Few hours later after my last post.
Fatique is starting to kick in..
I am tired and want to go to bed but I can't cause I need to take care of my 1 yr old.

Kinda demotivating after such a good night sleep.

Probably caused by the remaining apnea's... ?

[Pugsy]

Kinda demotivating after such a good night sleep.

Probably caused by the remaining apnea's... ?

Most likely but hey....look at the positives and try not to dwell on the negatives.
Rome wasn't built in a day you know.

Can I please see the report? I figured there was a good chance the machine would max out a lot and I hoped we would get lucky and the AHI would drop enough but I was really just wanting you to be able to sleep solidly or half way solid first.
Then I was going to worry about the AHI and those OAs.

Yes....we can lower those OAs and hyponeas but it's going to take more max pressure to do it.
And the reason I want to see the detailed report is to try to figure out if you also need more minimum.

With your history of aerophagia we are going to tackle the more pressure in small steps. I don't want to kill the OAs and have you miserable during the day or awake all night from belly pain.

[huydts]

Kinda demotivating after such a good night sleep.

Probably caused by the remaining apnea's... ?

Most likely but hey....look at the positives and try not to dwell on the negatives.
Rome wasn't built in a day you know.

Can I please see the report? I figured there was a good chance the machine would max out a lot and I hoped we would get lucky and the AHI would drop enough but I was really just wanting you to be able to sleep solidly or half way solid first.
Then I was going to worry about the AHI and those OAs.

Yes....we can lower those OAs and hyponeas but it's going to take more max pressure to do it.
And the reason I want to see the detailed report is to try to figure out if you also need more minimum.

With your history of aerophagia we are going to tackle the more pressure in small steps. I don't want to kill the OAs and have you miserable during the day or awake all night from belly pain.

Hey Mr or Ms Pugsy

Thanks for your dedication, its motivating!

You are absolutely right.

Allright. here are my stats of last night.

I cant figure out what do do with them.. but you probably can

I am very curious what your findings are.

Have a great day!

[Pugsy]

No need to redo your images but can you with any future graphs just omit the AHI graph and put the leak graph in its place.
I don't need the AHI graph to tell me you are having clusters of apnea events. I can see them well enough on the events graph.

So...the machine wanted to go higher than 11 cm pretty much every time a cluster of OAs/hyponeas happened.
How about just increasing the maximum and lets see what happens both in terms of AHI numbers and the aerophagia issues.
Normally I would tell people just open the max up but more pressure causes you belly issues so lets back up and go slow with the increase and see what happens.

Change the max from 11 to 11.5 and while I fully expect you will need more max I want to sneak up on the belly issues and try to prevent them by going with small and slow changes. So 0.5 cm more max for 3 or 4 nights...then another 0.5 cm more max for 3 or 4 nights...etc.
Let me know when/if the belly issues pop up.
I want you to use the new settings for 3 or 4 nights just to try to ease into adjusting to higher pressures. I don't know where the line is for triggering the aerophagia issues might be....so go slow.

[huydts]

goodmorning,

Last night i had some friends come over and had a few beers.
That probably interferes with my sleepquality & apneas
IN the past i alway had lower AHI when i drank alcohol.

The doctor said thats due to the fact when drinking alcohol you wont get as much REM sleep as in normal sleep.
And in REM sleep most apneas apear...

Anyway, i had an AHI of 3.2, slept a whopping 10.36 hours .

I dont think last night is one to take a closer look at is it?

The next 5/6 days will be alcohol free again

Or do you still wana see the stats Pugsy?

Bye

[Pugsy]

No, I don't need to see last night's results. I tend to rely on trends and patterns more than 1 night anyway.
Alcohol will mess with the sleep cycles for sure anyway.

Did you increase the max any? Did you have any aerophagia issues?

[huydts]

No, I don't need to see last night's results. I tend to rely on trends and patterns more than 1 night anyway.
Alcohol will mess with the sleep cycles for sure anyway.

Did you increase the max any? Did you have any aerophagia issues?

I increased by 0.5 . I had no aerophagia.
Increase again with 0.5? Or stick with 9 - 11.5

[Pugsy]

Stick with 11.5 tonight and lets see if any aerophagia pops up. I don't trust last night's results totally because of the alcohol.
If your REM was reduced and your OSA is worse in REM then the pressure may not have gone up as much or for as long.
We just don't know for sure about the REM or any other potential side effects the alcohol might have had on things.

[huydts]

Stick with 11.5 tonight and lets see if any aerophagia pops up. I don't trust last night's results totally because of the alcohol.
If your REM was reduced and your OSA is worse in REM then the pressure may not have gone up as much or for as long.
We just don't know for sure about the REM or any other potential side effects the alcohol might have had on things.

Sounds logic, you seem to know what you are talking about.. that's great!

I'll come back tomorrow with tonight's results

Byebye