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Clear airway events after waking and going back to sleep
#11
RE: Clear airway events after waking and going back to sleep
(11-01-2019, 01:45 PM)bonjour Wrote: Flex should work nut never does.  I can manipulate a ResMed into providing 2 cmw worth of pressure support but cannot.  BiLevel in the next level of machine above the APAP and allows a significant difference between inhale and exhale pressures called Pressure Support.  This is effective for treating Hypopneas, Flow, Limitations, RERAs, and snores, and is also useful for treating UARS.  

The first step is to increase pressure to see if you need to, or not get a more capable machine.

RERAs are always bad because by definition they all end in arousal, one of the big things we try to avoid or eliminate.
thanks.  I understand.  Does OSCAR show a graph on the daily view?  I see it on the overview view, but not on the event daily charts.

Meant the say, does OSCAR show RERA's on the daily charts.
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#12
RE: Clear airway events after waking and going back to sleep
(11-01-2019, 01:20 PM)bonjour Wrote: The irregularity of the flow rate tends to say that you were likely awake for the bulk of your central apneas.
That's not what caught my eye.
RERAs, which mean Flow Limitations far in excess of the FL events reported, RERAs being significant because they are a series of Flow Limitations ending with arousal.

Please raise your min pressure to 8.  Then another look at your chart,  then maybe another boost.  There is a decent chance that you will need a biLevel with its pressure support to treat this.

Thanks for all your input.  Could sleep position cause any increase in RERA's.  Too high pillow causing neck being bent too much?
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#13
RE: Clear airway events after waking and going back to sleep
It's possible wrong sleep positioning could increase events of any type.
Dave

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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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#14
RE: Clear airway events after waking and going back to sleep
(11-01-2019, 01:45 PM)bonjour Wrote: Flex should work nut never does.  I can manipulate a ResMed into providing 2 cmw worth of pressure support but cannot.  BiLevel in the next level of machine above the APAP and allows a significant difference between inhale and exhale pressures called Pressure Support.  This is effective for treating Hypopneas, Flow, Limitations, RERAs, and snores, and is also useful for treating UARS.  

The first step is to increase pressure to see if you need to, or not get a more capable machine.

RERAs are always bad because by definition they all end in arousal, one of the big things we try to avoid or eliminate.

Okay, trying to learn.  Woke up at 2:30 for bathroom, fell back asleep with no CA's.  But woke again around 6ish, as sun started brightening and wife got up.  Tried to go back to sleep but kept rousing.  Confirmed with data.  See chart.  Is this just normal SWJ?

Also, got no idea about RERA fluctuations from night to night.  Last night was over 2, night before <0.5


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#15
RE: Clear airway events after waking and going back to sleep
What's your diagnostic history? Sleep study?

Sure seems like something consistent with UARS, and per bonjour, a bilevel may better treat that.
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#16
RE: Clear airway events after waking and going back to sleep
Sleep study showed apnea with OA, a non-CPAP AHI of 67.  As best I can discern, there were no CA’s observed, but it was a rough night.
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#17
RE: Clear airway events after waking and going back to sleep
(11-04-2019, 08:59 AM)Mpadgett714 Wrote: Sleep study showed apnea with OA, a non-CPAP AHI of 67.  As best I can discern, there were no CA’s observed, but it was a rough night.

Wow.

I'm wondering about RERAs and your RDI.
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#18
RE: Clear airway events after waking and going back to sleep
(11-04-2019, 09:18 AM)slowriter Wrote:
(11-04-2019, 08:59 AM)Mpadgett714 Wrote: Sleep study showed apnea with OA, a non-CPAP AHI of 67.  As best I can discern, there were no CA’s observed, but it was a rough night.

Wow.

I'm wondering about RERAs and your RDI.

I had 0 RERA’s.  RDI during NREM was 34, during REM was 0 and TST was 28
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#19
RE: Clear airway events after waking and going back to sleep
I agree with bonjour's previous recommendation for a higher minimum pressure of 8.0, and would not be reluctant to set it as high as 9.0 contingent on comfort. There is sufficient evidence of obstruction and flow limitation in these charts, that higher pressure seems to be indicated, and the Philips is not particularly good at getting there without setting the minimum high enough. This is particularly true when an individual does not snore as we see here. Resmed's Autoset will quickly raise pressure on flow limitation, but Philips will just sit there at minimum pressure.

What Flex setting are you using? Please consider posting a close-up of the chart (2-minute segments) in areas where you are concerned about events. We can actually interpret whether the events are arising from flow restriction or other causes. Also, you mentioned that you may be using a pillow that is too tall causing your neck to flex forward and closing off the airway. This is very common, and you should read the wikis under my signature for Soft Cervical Collar and Optimizing Therapy, with a focus on the section for Positional Apnea.
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#20
RE: Clear airway events after waking and going back to sleep
(11-04-2019, 09:41 AM)Sleeprider Wrote: I agree with bonjour's previous recommendation for a higher minimum pressure of 8.0, and would not be reluctant to set it as high as 9.0 contingent on comfort. There is sufficient evidence of obstruction and flow limitation in these charts, that higher pressure seems to be indicated, and the Philips is not particularly good at getting there without setting the minimum high enough.  This is particularly true when an individual does not snore as we see here.  Resmed's Autoset will quickly raise pressure on flow limitation, but Philips will just sit there at minimum pressure.  

What Flex setting are you using?  Please consider posting a close-up of the chart (2-minute segments) in areas where you are concerned about events. We can actually interpret whether the events are arising from flow restriction or other causes.  Also, you mentioned that you may be using a pillow that is too tall causing your neck to flex forward and closing off the airway. This is very common, and you should read the wikis under my signature for Soft Cervical Collar and Optimizing Therapy, with a focus on the section for Positional Apnea.

When I look at my pressures when I awake, it is always running at 8.5 or higher.  I will post a chart.
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