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Coblation Assisted Upper-Airway Procedures
#11
Hi Susilo,

Please check out my signature area for a link on how to organize your sleep data from Sleepyhead.

EPR is a comfort setting but for some (like me) it can increase the amount of CA events. I have it turned off personally but if it makes a big difference in your comfort level for now, perhaps leave it on. Your numbers look pretty good from what I can see but I would post the detailed data screen shot from Sleepyhead arranged as mentioned below. That will get you some more detailed answers.
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#12
(04-18-2017, 01:59 PM)Marillion Wrote: Hi Susilo,

Please check out my signature area for a link on how to organize your sleep data from Sleepyhead.  

EPR is a comfort setting but for some (like me) it can increase the amount of CA events.  I have it turned off personally but if it makes a big difference in your comfort level for now, perhaps leave it on.  Your numbers look pretty good from what I can see but I would post the detailed data screen shot from Sleepyhead arranged as mentioned below.  That will get you some more detailed answers.

Hi Marillion,

My data from Apr 18 with EPR 1 :
[Image: UyNA2xZl.png]


From Apr 17 with EPR off :
[Image: 7RLDLyNl.png]

I think I slept better at EPR 1 so I'm just gonna use that.
Susilo
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#13
A Class 1 Mallampati score suggests that any likely surgical procedures would be really invasive. It isn't likely to be resolved with a tonsillectomy/adenoidectomy.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#14
That second night where you left EPR off wasn't a good sleep night though. Up to you, but I would give at least 3 nights with the same setting before making any decisions.
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#15
(04-18-2017, 08:23 PM)Beej Wrote: A Class 1 Mallampati score suggests that any likely surgical procedures would be really invasive. It isn't likely to be resolved with a tonsillectomy/adenoidectomy.

Thanks. I decided not to do it. Doesn't seems worth the trouble and risk.
Susilo
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#16
(04-18-2017, 08:47 PM)Marillion Wrote: That second night where you left EPR off wasn't a good sleep night though.  Up to you, but I would give at least 3 nights with the same setting before making any decisions.

Thanks marillion. How can you tell it wasn't a good sleep? I tried 11 days with EPR 1 and 14 days with EPR off. Generally I feel that I sleep worst with EPR off. It doesn't seems to help with the CA anyway. So I decided to go back to EPR 1. 

Below are graphs of 2 more previous days with EPR off.

Apr 16 :
[Image: YKg3ulXl.png]

Apr 15 :
[Image: Rt52oPTl.png]


Stats :
[Image: Lvs0SVIl.png]
Susilo
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#17
I see a great deal of consistency in your event rate, almost regardless of the settings being used. There is a natural variation between 2-3 AHI on a fairly consistent basis, and images posted to date suggest about half of that is CA. All of this indicates good, effective PAP treatment. While you have not found the "magic numbers" on the dial to eliminate events, they aren't that bad. I would suggest you prioritize comfort and try it increase hours of sleep if possible. The only thing that made the April 17 session less than optimal, is the fact it lasted only 5-1/2 hours. There is certainly nothing there that "wasn't a good sleep night" other than the face you need more sleep hours.
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#18
Thanks sleeprider. Before cpap, I always woke up briefly after 5-6 hours, but could easily sleep again for a total of 7-8 hours. But I felt crappy and sleepy for the rest of the day.

After cpap, I woke up after 5-6 hours, but couldn't sleep again, even though I'm still tired and sleepy. I still can't figure out why. Generally I feel and think better after cpap though.

Is there anything I can do to improve comfort?
Susilo
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#19
For comfort, eliminate the distractions as best you can. I like to suspend the hose so I don't get wrapped up in it, and use a fleece hose cover. It makes is soft so I don't wake up from the rough plastic hose touching me.

Looking over your past pressures and results, there is one thing you have not tried that might be worthwhile. You have always used a minimum pressure of 6.0, yet your average pressure is about 8.0 long-term. It appears most of the hypopnea events occur as your pressure tries to return to the minimum, but doesn't get there. I think a minimum pressure of 8.0 would give a lot of stability to your treatment and might help you sleep more soundly, and avoid some of the events.
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#20
(04-19-2017, 09:46 AM)Sleeprider Wrote: For comfort, eliminate the distractions as best you can.  I like to suspend the hose so I don't get wrapped up in it, and use a fleece hose cover. It makes is soft so I don't wake up from the rough plastic hose touching me.

Looking over your past pressures and results, there is one thing you have not tried that might be worthwhile.  You have always used a minimum pressure of 6.0, yet your average pressure is about 8.0 long-term.  It appears most of the hypopnea events occur as your pressure tries to return to the minimum, but doesn't get there.  I think a minimum pressure of 8.0 would give a lot of stability to your treatment and might help you sleep more soundly, and avoid some of the events.

Thanks again. The fleece hose cover sounds interesting.

Is it okay if I increase the min pressure straight to 8 or should I increase it gradually?
Susilo
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