How to reduce my events while using my Cpap

Posted by alan bruce @alanbruce, Feb 25, 2019

I track my events, usage, seal and total score daily on Myair which is a Resmed product. I have used a Cpap machine for about 6 months and have had good success however my events seem stay below 5 for a few days and then jumps up to 8 or 9 for a day and then goes back to below 5.. It seems to be a regular pattern however I have not been able to determine why my events go up. Any suggestions are ideas on how to reduce my events would be great.

I have had my cpap for 2 months and I have great usage hours each night and I no longer feel sleepy during the day BUT I am frustrated by the erratic results wrt events. The number of events do not correlate with the mask seal. I've had leakage of 40 litres per minute coincident with 4.0 events. I've had 10 events per hour with a good mask seal. What else affects event numbers besides mask seal, sleeping on back and being overly tired? Do alergies come into play?
Am I correct in wanting each night or at least most nights to have fewer than 6 events per hour?
Any help you may provide will be most appreciated. I really want this treatment to result in more REM sleep and I don't understand how that will happen as long as the events are above 5 per hour.

REPLY

Hello @rfries, Welcome to Mayo Clinic Connect. I have been using a CPAP since July 31st, 2018 when I was diagnosed with obstructive sleep apnea. My sleep medicine doctor said the goal for me was to have fewer than 4 events per hour which is I think what you are saying….below 5 events per hour. I took a look at my first 60 days and it's probably similar to what you are going through now and I can relate to the frustration of trying to reach the goal of 4 events or fewer and maintain that level. I attached my first 60 days so you can see my struggle was similar (I think).

One thing that I have discovered that helps me is when I sleep on my side. My numbers go up dramatically when I'm sleeping on my back. I tend to do this a lot when my hip starts hurting and I turn to the other side and back and forth. Sometimes I end up sleeping on my back for awhile due to the pain in my hips. Another thing that I found that affects my numbers are the mask. If it's not comfortable, it adds one more thing in the mix. Here's some information I found that may give you some things to try.

How to Improve Your AHI Score Overnight: https://www.cpap.com/blog/good-ahi-score/

@alanbruce @thankful and other members may have some suggestions for you also.

Is your CPAP mask comfortable?

REPLY
@rfries

I have had my cpap for 2 months and I have great usage hours each night and I no longer feel sleepy during the day BUT I am frustrated by the erratic results wrt events. The number of events do not correlate with the mask seal. I've had leakage of 40 litres per minute coincident with 4.0 events. I've had 10 events per hour with a good mask seal. What else affects event numbers besides mask seal, sleeping on back and being overly tired? Do alergies come into play?
Am I correct in wanting each night or at least most nights to have fewer than 6 events per hour?
Any help you may provide will be most appreciated. I really want this treatment to result in more REM sleep and I don't understand how that will happen as long as the events are above 5 per hour.

Jump to this post

@rfries Welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion about CPAP and events. It sounds like you are understandably frustrated by your erratic results. I'd like to bring a few members into this discussion who have experience with CPAPs like @thankful @johnbishop & @alanbruce

I'm wondering if your provider or the CPAP supplier would be able to help you answers those questions?

REPLY
@johnbishop

Hello @rfries, Welcome to Mayo Clinic Connect. I have been using a CPAP since July 31st, 2018 when I was diagnosed with obstructive sleep apnea. My sleep medicine doctor said the goal for me was to have fewer than 4 events per hour which is I think what you are saying….below 5 events per hour. I took a look at my first 60 days and it's probably similar to what you are going through now and I can relate to the frustration of trying to reach the goal of 4 events or fewer and maintain that level. I attached my first 60 days so you can see my struggle was similar (I think).

One thing that I have discovered that helps me is when I sleep on my side. My numbers go up dramatically when I'm sleeping on my back. I tend to do this a lot when my hip starts hurting and I turn to the other side and back and forth. Sometimes I end up sleeping on my back for awhile due to the pain in my hips. Another thing that I found that affects my numbers are the mask. If it's not comfortable, it adds one more thing in the mix. Here's some information I found that may give you some things to try.

How to Improve Your AHI Score Overnight: https://www.cpap.com/blog/good-ahi-score/

@alanbruce @thankful and other members may have some suggestions for you also.

Is your CPAP mask comfortable?

Jump to this post

That's a terrific reply and I thank you. I did go to that site and it's good also. The part that I want to follow-up on is the sleep position. From what you've said it makes sense that I stay off my back – period. Any tips on how? When I wake I am on my side and I don't know when I am on my back. My sciatica rolls me around a lot. I am a 79 year old male. Use pillows as wedges to prevent rolling over? Sleep propped up at 30 degrees? I think my hybrid mask is probably comfy enough. Is it worthwhile to invest in a pillow having one corner cut off so that the mask rests on nothing?

REPLY
@rfries

That's a terrific reply and I thank you. I did go to that site and it's good also. The part that I want to follow-up on is the sleep position. From what you've said it makes sense that I stay off my back – period. Any tips on how? When I wake I am on my side and I don't know when I am on my back. My sciatica rolls me around a lot. I am a 79 year old male. Use pillows as wedges to prevent rolling over? Sleep propped up at 30 degrees? I think my hybrid mask is probably comfy enough. Is it worthwhile to invest in a pillow having one corner cut off so that the mask rests on nothing?

Jump to this post

@rfries, I have bought 3 different CPAP pillows and didn't have much luck with any of them but it might just be me. The first one I bought was spendy and was the worst. It was way to firm for me but had the cutouts on the sides for sleeping on either side. Then I tried the little triangle pillow and it wasn't any better than the first one. I was already using a My Pillow regular size which I really like and saw someone recommend using two pillows. A regular or large pillow and then have your head on a smaller travel pillow that rests on the top of your larger pillow. Here's the one I got (actually got the 2 for 1 deal) – https://www.mypillow.com/rollandgoanywherepillowbuyonegetonefree.html.

Another thing that helped me because I do roll from side to side at night is a CPAP hose stand. I put the base under my mattress so that it holds the hose above my head and out of the way. It make a really big difference. Here's the one I bought on Amazon – https://www.amazon.com/North-American-Healthcare-JB5651-Holder/dp/B0034CHMRU/ref=sr_1_5. The picture shows it placed on the side of the bed under the mattress but I've found it works better if I put it under the mattress at the head of the bed.

REPLY
@johnbishop

@rfries, I have bought 3 different CPAP pillows and didn't have much luck with any of them but it might just be me. The first one I bought was spendy and was the worst. It was way to firm for me but had the cutouts on the sides for sleeping on either side. Then I tried the little triangle pillow and it wasn't any better than the first one. I was already using a My Pillow regular size which I really like and saw someone recommend using two pillows. A regular or large pillow and then have your head on a smaller travel pillow that rests on the top of your larger pillow. Here's the one I got (actually got the 2 for 1 deal) – https://www.mypillow.com/rollandgoanywherepillowbuyonegetonefree.html.

Another thing that helped me because I do roll from side to side at night is a CPAP hose stand. I put the base under my mattress so that it holds the hose above my head and out of the way. It make a really big difference. Here's the one I bought on Amazon – https://www.amazon.com/North-American-Healthcare-JB5651-Holder/dp/B0034CHMRU/ref=sr_1_5. The picture shows it placed on the side of the bed under the mattress but I've found it works better if I put it under the mattress at the head of the bed.

Jump to this post

Thanks John, I will look at that. I want you to know that because of your earlier comments I had a great sleep last night with 2.4 events per hr. I decided to focus on staying off my back instead of just hoping to. My wife had a good tip and I want to pass it on. I wore a reasonably snug tee shirt to bed with a tennis ball between the shirt and my spine about half way up the back. A few times during the night I felt the ball and those were likely times when I would have unknowingly turned over or onto my back. I slept 6.4 hrs. on one side. I am just hoping this continues.

REPLY
@rfries

Thanks John, I will look at that. I want you to know that because of your earlier comments I had a great sleep last night with 2.4 events per hr. I decided to focus on staying off my back instead of just hoping to. My wife had a good tip and I want to pass it on. I wore a reasonably snug tee shirt to bed with a tennis ball between the shirt and my spine about half way up the back. A few times during the night I felt the ball and those were likely times when I would have unknowingly turned over or onto my back. I slept 6.4 hrs. on one side. I am just hoping this continues.

Jump to this post

@rfries that's great news!

REPLY
@johnbishop

Hello @rfries, Welcome to Mayo Clinic Connect. I have been using a CPAP since July 31st, 2018 when I was diagnosed with obstructive sleep apnea. My sleep medicine doctor said the goal for me was to have fewer than 4 events per hour which is I think what you are saying….below 5 events per hour. I took a look at my first 60 days and it's probably similar to what you are going through now and I can relate to the frustration of trying to reach the goal of 4 events or fewer and maintain that level. I attached my first 60 days so you can see my struggle was similar (I think).

One thing that I have discovered that helps me is when I sleep on my side. My numbers go up dramatically when I'm sleeping on my back. I tend to do this a lot when my hip starts hurting and I turn to the other side and back and forth. Sometimes I end up sleeping on my back for awhile due to the pain in my hips. Another thing that I found that affects my numbers are the mask. If it's not comfortable, it adds one more thing in the mix. Here's some information I found that may give you some things to try.

How to Improve Your AHI Score Overnight: https://www.cpap.com/blog/good-ahi-score/

@alanbruce @thankful and other members may have some suggestions for you also.

Is your CPAP mask comfortable?

Jump to this post

@rfries– I have been using a C-pap for over 20 years and many who follow this subject on Mayo here me say over & over that the mask is the most important. Because I am more of a mouth breather when I sleep idealy I've been told a full face mask would be the most beneficial, but after trying at least 6 different masks I was experiencing high leakage in all that I tried. The sleep tech seemed to think that I had what she called a "tweener" problem in that my face was in between sizes. Well anyway I have been using nasal masks for most of all these years and have found the Fisher Paykel Eson 2 nasal mask works well for me. In addition I use the Respironics deluxe chin strap which stays in place most nights and keep just enough resistance to mouth breathing.
My AHI #'s rarely exceed 3, but I still seem to have more often a mask leak (red unhappy face) noted on my machine display anywhere from 2-12. Generally my overall score is approx. 85. When I spoke to my sleep doctor about this he seems to minimize this because of the good AHI score that I continuely are getting.
Something I would like to bring up and ask all C-pap users is how they drape the hose to their mask?
It seems all the pictures, video's, etc. that I've seen always show the hose coming from below the head.
I've always pulled the hose up behind the headboard of my bed and have the hose come over my head.
For me that keeps the hose out of the way when I am sleeping?
Happy Zzzz's Jim @thankful

REPLY
@thankful

@rfries– I have been using a C-pap for over 20 years and many who follow this subject on Mayo here me say over & over that the mask is the most important. Because I am more of a mouth breather when I sleep idealy I've been told a full face mask would be the most beneficial, but after trying at least 6 different masks I was experiencing high leakage in all that I tried. The sleep tech seemed to think that I had what she called a "tweener" problem in that my face was in between sizes. Well anyway I have been using nasal masks for most of all these years and have found the Fisher Paykel Eson 2 nasal mask works well for me. In addition I use the Respironics deluxe chin strap which stays in place most nights and keep just enough resistance to mouth breathing.
My AHI #'s rarely exceed 3, but I still seem to have more often a mask leak (red unhappy face) noted on my machine display anywhere from 2-12. Generally my overall score is approx. 85. When I spoke to my sleep doctor about this he seems to minimize this because of the good AHI score that I continuely are getting.
Something I would like to bring up and ask all C-pap users is how they drape the hose to their mask?
It seems all the pictures, video's, etc. that I've seen always show the hose coming from below the head.
I've always pulled the hose up behind the headboard of my bed and have the hose come over my head.
For me that keeps the hose out of the way when I am sleeping?
Happy Zzzz's Jim @thankful

Jump to this post

Hi Jim @thankful, I had the hose problem the first few months and then someone told me about the CPAP hose stands. I got one from Amazon and it has bee great. It keeps the hose above my head and out of the way when I roll over in bed changing sides. Depending on how high your bed is you can also put the stand on the floor but may have to set some books on it to keep it from moving (it's really lightweight small aluminum tubing). If the stand part is under the mattress it kind of holds it in one place. On the floor it could move around easily. It also helps me keep the cat from chewing holes in the hose 🙂.

REPLY
@johnbishop

Hi Jim @thankful, I had the hose problem the first few months and then someone told me about the CPAP hose stands. I got one from Amazon and it has bee great. It keeps the hose above my head and out of the way when I roll over in bed changing sides. Depending on how high your bed is you can also put the stand on the floor but may have to set some books on it to keep it from moving (it's really lightweight small aluminum tubing). If the stand part is under the mattress it kind of holds it in one place. On the floor it could move around easily. It also helps me keep the cat from chewing holes in the hose 🙂.

Jump to this post

@johnbishop– Those look handy, but I don't seem to have any problems with my method. As long as you have space between the mattress and bottom of headboard (or if your headboard is low you could go over the top) to run the hose it has worked well for me.
I sleep on both sides and back and rarely have issues.
One thing I've been noticing for awhile now is when I have higher a AHI score I often have happy faces showing on my display then when the display shows mask leak my AHI scores are lower? Wondering if there is something to this?
Happy Zzzz's Jim@thankful

REPLY
@thankful

@johnbishop– Those look handy, but I don't seem to have any problems with my method. As long as you have space between the mattress and bottom of headboard (or if your headboard is low you could go over the top) to run the hose it has worked well for me.
I sleep on both sides and back and rarely have issues.
One thing I've been noticing for awhile now is when I have higher a AHI score I often have happy faces showing on my display then when the display shows mask leak my AHI scores are lower? Wondering if there is something to this?
Happy Zzzz's Jim@thankful

Jump to this post

Hi Jim @thankful, I used to run mine over the top of my headboard but we got a different bed and it doesn't have a headboard although I may have to get one. We bought a Ghostbed with 2 Twin XL frames that slide together so we can have twin adjustable mattresses. It's nice when I need to elevate my feet and head and the wife likes the raised head a little for TV.

My display on my Dreamstation has no happy faces 🙂. It only shows the AHI, Usage (hours), Mask Fit %. I don't think the mask fit numbers are too accurate on mine. Most of the time it is 100% with 99% once in awhile unless I have a really bad night. The AHI normally has been in the 2+ to 3+ range and then into the 5's to 7's if it's a bad night for some reason. I'm about to try the new ResMed Evora Nasal mask since the CPAPComfortCover.com folks sent me a cloth cover to see it it works. I tried the mask one night and put it back because the air pressure got to high (into the 14's – normally it runs 8 to 9.5 during the night but is set to run from 8 to 18 if needed). I think I didn't have the chin strap tight enough and started mouth breathing or my nose got plugged up which is common for me with my deviated septum. I use a cloth cover for my ResMed AirFit F20 full face mask and it really helps make it more comfortable although it leaks a little. My sleep doctor's PA told me a little leak doesn't hurt and not to worry about it.

Sleep well my friend!

REPLY

I am using nose pillows and chin strap with Resmed AirSense. My report shows good seal and humidity but 44 events. Pressure setting is 9. What’s going wrong?

REPLY
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