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2 years on - How am I doing?
#11
RE: 2 years on - How am I doing?
We will do our best to help you get it sorted out.  

I will take a look through those attachments.  

Would you mind also posting a single picture of the whole night, including the left column with the AHI Summary table, the "Statistics" and "Machine Settings."    The context provided by this top level screen is the most important screenshot to start with.

We close the Calendar and in Preferences turn off the pie chart.  

If you can squeeze these charts in this order into that top level screenshot:
  • Event Flags
  • Flow Rate
  • Pressure
  • Leak Rate
  • Flow Limit
  • Snore
This link describes how to create that top level screenshot.
 http://www.apneaboard.com/wiki/index.php...ganization 

WillSleep

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#12
RE: 2 years on - How am I doing?
Hey Will,

Thanks a lot for offering your help. I tried to take the screenshots based on the article you mentioned. They are for last night. Let me know how if it works for you! 

Btw, I increased the pressure to 12 for last night. I read that it's best to keep the min/max pressure as close as possible. Let me know what you think. Again, appreciate the help! 

   
   
   
   
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#13
RE: 2 years on - How am I doing?
(11-14-2019, 04:16 PM)Mozammil Wrote: Hey Will,

I tried to take the screenshots based on the article you mentioned. They are for last night. 

Btw, I increased the pressure to 12 for last night.


Mozammil, 

Thanks for posting the screenshots.  

An important question.  After raising pressure last night, today do you feel better, the same or worse?

You still have lots of Flow Limitations and Snores. I hate to just keep raising pressure to try to close them out. 

Lets try to improve your sleep position to help the Flow Limits and Snores go away. 

From the pattern of when your Pressure, Flow Limits and Snores it looks to me like many of them are 'positional' and they might go away giving you better sleep if you change the positions you sleep in.  

In short, when you sleep rather than tuck your chin into your chest stick your chin out, and sleep on your side rather than your back.

I recommend you try a Neck Collar or Neck Rest to help you train yourself to hold your chin out while you sleep.  
Read this article Soft Cervical Collar  


Bonjour, what do you think should be his next step.

WillSleep

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#14
RE: 2 years on - How am I doing?
(11-14-2019, 05:19 PM)WillSleep Wrote:
(11-14-2019, 04:16 PM)Mozammil Wrote: Hey Will,

I tried to take the screenshots based on the article you mentioned. They are for last night. 

Btw, I increased the pressure to 12 for last night.


Mozammil, 

Thanks for posting the screenshots.  

An important question.  After raising pressure last night, today do you feel better, the same or worse?

You still have lots of Flow Limitations and Snores. I hate to just keep raising pressure to try to close them out. 

Lets try to improve your sleep position to help the Flow Limits and Snores go away. 

From the pattern of when your Pressure, Flow Limits and Snores it looks to me like many of them are 'positional' and they might go away giving you better sleep if you change the positions you sleep in.  

In short, when you sleep rather than tuck your chin into your chest stick your chin out, and sleep on your side rather than your back.

I recommend you try a Neck Collar or Neck Rest to help you train yourself to hold your chin out while you sleep.  
Read this article Soft Cervical Collar  


Bonjour, what do you think should be his next step.

WillSleep

Hey WillSleep,

Thanks for the reply. I sleep on my back most of the time and will try to switch on to the side for now. 

I feel the same even though I increased the pressure. I also just ordered a Soft Cervical Collar which will be delivered tomorrow. Let's see if that helps!
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#15
RE: 2 years on - How am I doing?
Mozammil on Charts, we don't need a lot of charts, just one that is well organized. The link in my signature on Organizing your OSCAR chart shows how.

Your pressure is changing frequently in response to flow limitations that occur throughout the night. Flow limitations are the most likely reason you're not achieving deeper sleep and they are a leading cause of respiratory event related arousals (RERA). You clearly have considerable upper airway resistance or restriction, and the best solution for that is actually a bilevel like the Resmed Aircurve 10 Vauto. I'm pretty sure that in the long run, you will be much more comfortable if you can obtain a bilevel machine that will increase your pressure support (P.S. difference between IPAP and EPAP) to help you overcome the inspiratory flow limitations that is pervasive in your results. Your Airsense 10 Autoset has exhale pressure relief (EPR) which acts like limited bilevel with a setting up to 3. With EPR at 3 you have the equivalent to 3-cm PS.

I recommend that you increase your EPR to 3. Read this wiki article that discusses UARS and the use of bilevel therapy http://www.apneaboard.com/wiki/index.php..._and_BiPAP Keep an eye out on Craigslist, Offer-up and similar market places for a good used Resmed Aircurve 10 Vauto. You can ask your doctor to help you with a prescription for bilevel which will improve your comfort, but most doctors are only concerned with AHI, and yours is excellent.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#16
RE: 2 years on - How am I doing?
(11-14-2019, 05:48 PM)Sleeprider Wrote: Mozammil on Charts, we don't need a lot of charts, just one that is well organized.   The link in my signature on Organizing your OSCAR chart shows how.

Your pressure is changing frequently in response to flow limitations that occur throughout the night.  Flow limitations are the most likely reason you're not achieving deeper sleep and they are a leading cause of respiratory event related arousals (RERA).  You clearly have considerable upper airway resistance or restriction, and the best solution for that is actually a bilevel like the Resmed Aircurve 10 Vauto.  I'm pretty sure that in the long run,  you will be much more comfortable if you can obtain a bilevel machine that will increase your pressure support (P.S. difference between IPAP and EPAP) to help you overcome the inspiratory flow limitations that is pervasive in your results. Your Airsense 10 Autoset has exhale pressure relief (EPR) which acts like limited bilevel with a setting up to 3.  With EPR at 3 you have the equivalent to 3-cm PS.

I recommend that you increase your EPR to 3.  Read this wiki article that discusses UARS and the use of bilevel therapy http://www.apneaboard.com/wiki/index.php..._and_BiPAP   Keep an eye out on Craigslist, Offer-up and similar market places for a good used Resmed Aircurve 10 Vauto. You can ask your doctor to help you with a prescription for bilevel which will improve your comfort, but most doctors are only concerned with AHI, and yours is excellent.

Hello Sleeprider, thanks a lot for your reply and apologies for the screenshots! I will try to do better.

Unfortunately, I just relocated to a new country and it'd be hard to find a doctor that would prescribe a bi-level machine in the short run. 

I will change the EPR to 3 for now. Do you have any other recommendations on what I could do to sleep better? Is the pressure range correct according to you?

Thanks for all the help!
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#17
RE: 2 years on - How am I doing?
I don't have a problem with your current pressure range, but want to see EPR increased. We can look at the results of that change and decide if minimum pressure should be adjusted or not. I like to see automatic pressure changing in a range of 3-cm or less during a night (median to 95%) to avoid disrupting sleep. I realize that bilevel is a challenge for getting a prescription which is why many of us just bought a used on out of pocket to start. Once you have tried bilevel, you have enough proof that you can usually convince a doctor that it works better for you. In your case, we are not concerned about AHI, but with comfort, so that is what we want to work towards.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#18
RE: 2 years on - How am I doing?
(11-14-2019, 09:39 PM)Sleeprider Wrote: I don't have a problem with your current pressure range, but want to see EPR increased.  We can look at the results of that change and decide if minimum pressure should be adjusted or not.  I like to see automatic pressure changing in a range of 3-cm or less during a night (median to 95%) to avoid disrupting sleep.  I realize that bilevel is a challenge for getting a prescription which is why many of us just bought a used on out of pocket to start.  Once you have tried bilevel, you have enough proof that you can usually convince a doctor that it works better for you.  In your case, we are not concerned about AHI, but with comfort, so that is what we want to work towards.

Thanks Sleeprider! 

I will try it tonight (with the Cervical Collar) as well. I will upload the charts tomorrow.
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#19
RE: 2 years on - How am I doing?
Hey SleepRider, WillSleep

I have used a Cervical Collar yesterday and also increased the EPR to 3. Please find my graphs below.

   
   

Unfortunately, I still woke up a few times during the night Sad
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#20
RE: 2 years on - How am I doing?
I guess the question is whether you feel better or not with these changes. EPR should help with comfort and the flow limitation, but the flow limit and snores are still impressive. I think you should be using a bilevel machine like the Resmed Aircurve 10 Vauto, which has higher capability for pressure and pressure support. Your AHI is certainly acceptable, but the snores are an indication of continuing obstruction or airway resistance. If you continue to have arousals and don't feel like your sleep quality is adequate, then a bilevel is the next level of therapy to consider.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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