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Brand new cpap user! Some questions regarding my first night
#41
RE: Brand new cpap user! Some questions regarding my first night
xdestry, you are beginning to convince me that a move towards ASV is in your future. The CA events are very inconsistent, so it's not going to be easy to convince someone that ASV is the way to go. Maybe we should start reducing pressure support from 2.0 to 1.6.
Sleeprider
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#42
RE: Brand new cpap user! Some questions regarding my first night
I see the consistently inconsistent CA, up and down roller coaster. Maybe practice how to convince doc the PAP ain't working very well. Note your symptoms and complaints and what steps you've tried on current and prior machines and the results.
Dave

OSCAR
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#43
RE: Brand new cpap user! Some questions regarding my first night
(12-07-2020, 10:17 PM)Sleeprider Wrote: xdestry, you are beginning to convince me that a move towards ASV is in your future. The CA events are very inconsistent, so it's not going to be easy to convince someone that ASV is the way to go.  Maybe we should start reducing pressure support from 2.0 to 1.6.

(12-07-2020, 10:30 PM)SarcasticDave94 Wrote: I see the consistently inconsistent CA, up and down roller coaster. Maybe practice how to convince doc the PAP ain't working very well. Note your symptoms and complaints and what steps you've tried on current and prior machines and the results.

Thanks, I will try reducing the pressure support tonight to 1.6.   Should I keep the max IPAP the same?  

 A lot of my CAs seem to follow a slight blip in the leak rate, any idea why that is?
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#44
RE: Brand new cpap user! Some questions regarding my first night
I don't see a relationship between leaks and CA events. In many cases, you have several larger breaths ahead of a CA which might be explained by the decrease in CO2 or even arousal and movement. There is only so much we can interpret from the OSCAR data, and one thing it does not clearly tell us is movement or PLM which can result in soem breath holding. Even where you capture some OA events, they look to have the same pattern of arousal or increase breath rate ahead of the event. This blip in respiratory volume ahead of events looks a lot more suspect to me than leaks.

[Image: attachment.php?aid=28569]
Sleeprider
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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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#45
RE: Brand new cpap user! Some questions regarding my first night

.pdf   
SAGirl_a00010919_LR_111420_CPAP.pdf (Size: 407.46 KB / Downloads: 7)

Screenshots

Hi guys, been a while since my last post here but I finally received my sleep study from my doctor.  The treatment lately seems to be getting a bit better.  I have switched back to the CPAP for now so the doctor could get the data (and also for insurance reasons) and my AHI has been at a consistently low number each night.  I am currently at a pressure of 6.0 to 12.0, and the machine stays usually at the lower end of that. I have EPR at 3 on only ramp, and off during the rest of the time.  

I am now exclusively using the airfit p10 mask and taping my mouth using the micropore 3m strips.  The mask however is really uncomfortable sometimes and I will be switching to the bleep dreamport to try as soon as I can get one.  

My events still seem to be mostly central, but it seems like there are a bit more obstructive events recently than the first few weeks of treatment.  I have stopped taking diphenhydramine(benadryl) to sleep, but am still taking 5mg of melatonin each night.  

The last time I posted I was suggested by some members to ask my doctor about possibly going on ASV, it seems like the centrals are lessening but not completely going away so do you guys think even with an AHI of 1-2 it would still be recommended to switch?  It seems like there were some central events indicated in the sleep study as well.

A few questions I have are :

1. Does the current pressure of 6-12 seem fine to continue on for now?  Also if I wanted to switch back to the aircurve bipap what would the best settings be to try?

2.  Would you guys be able to take a look at the sleep study for me and see why they recommended such a high minimum pressure?  It seems like the doctor just kept raising the pressure till there weren't any more events, but now it seems the machine never really goes past 8 or 9.

3.  Have you guys seen any evidence of sleep aids like benadryl or melatonin causing central events?  I stopped taking benadryl to sleep a week ago and it seems like the AHI dropped from around 3-4 a night down to 1-2 immediately.  I am still taking melatonin now but am considering slowly weaning off it.


Treatment has been going better and I am feeling a lot more energetic through the day and have been needing less sleep to feel like that.  
 Thanks again for any help anyone can provide!
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#46
RE: Brand new cpap user! Some questions regarding my first night
I'd like to help but I'm not able to access the PDF and Imgur OSCAR images get blurry. You can add those same OSCAR shots direct to the post.

PS sorry that above was with the tablet, which apparently dislikes PDF.

Pretty good results as far as I could make out on the OSCAR images. Ramp needs to go. EPR should be your friend. Both inline with Sleeprider's info after this.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#47
RE: Brand new cpap user! Some questions regarding my first night
Kill the ramp. Consider EPR at 1 full time. Results look great.
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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#48
RE: Brand new cpap user! Some questions regarding my first night
Here's a link to a google drive with the sleep study.

Sleep Study

I can only upload 3 at a time on here so I'll just pick a few recent ones to attach.

3 more


Attached Files Thumbnail(s)
                       
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#49
RE: Brand new cpap user! Some questions regarding my first night
Yep definite, the Ramp has got to go. 45 minutes of less than ideal therapy pressures. Most of your OSCAR data shots shows "high" levels of CA, high meaning that it's higher than the other flags, but it is still within treated status it appears.

So now after Ramp dies off a quick painless death, how has therapy been doing and how does things shape up in the "how do you feel" department?

BTW it's possible that BPAP may be a bit worse for the CA, but if it's a VAuto there is Trigger setting to adjust to high or possibly very high that may combat CA. So it would seem it's a try and see if that's what you want.

Note you did have CA in this study but it was at 9 CA to 30 OA not quite 1:3 CA/OA so it is there but at 1/3 the OA.

4 Hypopneas in there too, probably obstructive due to higher OA number is my guess
scored 35 RERAs
not a great deal of desats at what appears to be down to about 94.3% for most of the night- not a huge factor there IMO
sleep efficiency was 82.1%, my guess was the events themselves dropped it but arousals may have contributed
arousals were counted at 30 respiratory and 66 spontaneous giving total of 96, so that will decrease sleep efficiency/combo with the apnea events

Big thing is CA were there but not equal or more than OA so this diminishes ASV to likely not a need unless these stay around and your complaints of lacking well rested sleep are directly caused by these CA, then you're in steep uphill battle to get ASV...likely a fight that's not necessary by these numbers.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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