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Could you please review ?
#21
RE: Could you please review ?
Without question, you do not qualify for an ASV based on your numbers.  A favorable Doctor may be able to manipulate the system to get one.  But before that is considered let's complete this.  If the PS of 4 is tolerated I'd be tempted to extend the experiment to a PS of 5.  Note that PS of 4 is considered normal for BiLevel.
Pressure Support is intended to treat Flow Limits and Hypopneas, It is real hard to have RERAS without flow limitation.

Again with good numbers how one feels is by far more important.

Fred
Fred Bonjour - 0 - LAUNCH Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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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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#22
RE: Could you please review ?
(02-03-2019, 04:59 PM)bonjour Wrote: Without question, you do not qualify for an ASV based on your numbers.  A favorable Doctor may be able to manipulate the system to get one.  But before that is considered let's complete this.  If the PS of 4 is tolerated I'd be tempted to extend the experiment to a PS of 5.  Note that PS of 4 is considered normal for BiLevel.
Pressure Support is intended to treat Flow Limits and Hypopneas, It is real hard to have RERAS without flow limitation.

Again with good numbers how one feels is by far more important.

Fred
oh i know, the DME gave me such a hard time to get me the aircurve 10 vauto looking at my low AHIs. i had to fight for it. i'm asking your opinion if ASV is really better than bilvevel vauto in elminating RERAs even i have to buy a used one out of pocket. that is why i was asking your opinion.

I will definitely follow the plan you wrote me first before anything, and thanks for the PS information, what is weird is last night my PS was only 1, and i see little higher flow limitations spikes in REM but i almost feel i slept better then these 2 other night where my PS was 4, and 6 ( below screenshots) but i was waking up a lot more often and was very sleepy through the day. That is why i don't understand how this works.. shouldn't the pressure increase eliminate flow limits and then less RERAs happen ?  that is not how my body is responding..
it is struggling to breath, almost like it doesn't matter if pressure is 5, 7 or 11. 

PS 4, EPAP:4, IPAPmax: 12

[Image: k3mNsmO.png]

PS 6, EPAP:5, IPAP max:13

[Image: sC6Uv2n.png]
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#23
RE: Could you please review ?
Look at this.  Are you comfortable with this. Recognize the charts?  BTW based on the PS4 chart you posted PS at these levels I doubt will resolve your RERA. The PS6 does have diminished Flow Limits  but is more difficult to resolve the RERAs at this level.

I'm looking at a couple of your RERAs and it reminds me a lot of Chin Tucking.  I have nothing to back this up but do you have a soft cervical collar or an anti-snoring collar?  Would you be willing to try one to see if it resolves your RERAs?

Fred
Fred Bonjour - 0 - LAUNCH Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
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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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#24
RE: Could you please review ?
(02-03-2019, 07:23 PM)bonjour Wrote: Look at this.  Are you comfortable with this. Recognize the charts?  BTW based on the PS4 chart you posted PS at these levels I doubt will resolve your RERA. The PS6 does have diminished Flow Limits  but is more difficult to resolve the RERAs at this level.

I'm looking at a couple of your RERAs and it reminds me a lot of Chin Tucking.  I have nothing to back this up but do you have a soft cervical collar or an anti-snoring collar?  Would you be willing to try one to see if it resolves your RERAs?

Fred

i do have actually a cervical collar, and i do chin tuck when i sleep on my side.
should i wear the collar while i am trying the experiment you gave me? like from first day or maybe 3rd day ?

i was not sleeping ok with any of those charts, even though flow limitation looked less and AHI was way low. 
i kinda slept better ( but i'll confirm tonight) with the PS 1 and IPAP 5, ePAP4. (last night chart) which had low AHI as well but higher flow limitation. IS the fact that they are happening at REM mean anything? does that affect anything in the therapy pressure settings or type of machine ?
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#25
RE: Could you please review ?
REM doesn't impact machine or settings.  When we see events we may adjust settings whether or not REM sleep.  We do usually wake from REM but normally fall back asleep without realizing it.

Try the collar tonight then scan for that RERA pattern.  You will need to scan the entire sleeping period and take a baseline scan, then repeat with the collar.

I'm hoping that the collar may solve your problems.
Fred Bonjour - 0 - LAUNCH Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download OSCAR
Organize Charts
Attaching Charts

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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#26
RE: Could you please review ?
(02-03-2019, 09:54 PM)bonjour Wrote: REM doesn't impact machine or settings.  When we see events we may adjust settings whether or not REM sleep.  We do usually wake from REM but normally fall back asleep without realizing it.

Try the collar tonight then scan for that RERA pattern.  You will need to scan the entire sleeping period and take a baseline scan, then repeat with the collar.

I'm hoping that the collar may solve your problems.

Thanks Fred, how do I scan for RERA ? From the graph it shows? 
I know I got a RERA from waking up bc I was trying to inhale air but I don't know how to find them from the graphs
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#27
RE: Could you please review ?
You zoom to a 2 minute view then use your arrow key to scan thru your graph.
Fred Bonjour - 0 - LAUNCH Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download OSCAR
Organize Charts
Attaching Charts

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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#28
RE: Could you please review ?
(02-03-2019, 07:23 PM)bonjour Wrote: Look at this.  Are you comfortable with this. Recognize the charts?  BTW based on the PS4 chart you posted PS at these levels I doubt will resolve your RERA. The PS6 does have diminished Flow Limits  but is more difficult to resolve the RERAs at this level.

I'm looking at a couple of your RERAs and it reminds me a lot of Chin Tucking.  I have nothing to back this up but do you have a soft cervical collar or an anti-snoring collar?  Would you be willing to try one to see if it resolves your RERAs?

Fred

oops sorry,  look here for the pattern
Optimizing_therapy RERA
Fred Bonjour - 0 - LAUNCH Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download OSCAR
Organize Charts
Attaching Charts

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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#29
RE: Could you please review ?
(02-03-2019, 10:06 PM)bonjour Wrote: You zoom to a 2 minute view then use your arrow key to scan thru your graph.

Ok thanks a lot, when there is a spike up  followedf by irregular few curves  after a normal curve that means it's a RERA correct ?
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#30
RE: Could you please review ?
No read the article
Fred Bonjour - 0 - LAUNCH Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download OSCAR
Organize Charts
Attaching Charts

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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