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David Clark - Therapy Thread
#31
RE: David Clark - Therapy Thread
Ok yep, these CA will be your treatment emergent flavor.

There's a few things to consider editing within settings to lower the CA on the OSCAR charts:

Change Trigger to High or Very High is maybe first. This should not affect things so much as an edit to PS. But a PS of 5 may be considered a touch high for some, and may enhance the treatment emergent CA.

Do not use ramp if it is on now, or at least shorten the time and make pressure equal to your EPAP Min, if you must use it.
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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#32
RE: David Clark - Therapy Thread
(01-09-2022, 01:42 PM)SarcasticDave94 Wrote: Ok yep, these CA will be your treatment emergent flavor.

There's a few things to consider editing within settings to lower the CA on the OSCAR charts:

Change Trigger to High or Very High is maybe first. This should not affect things so much as an edit to PS. But a PS of 5 may be considered a touch high for some, and may enhance the treatment emergent CA.

Do not use ramp if it is on now, or at least shorten the time and make pressure equal to your EPAP Min, if you must use it.

I did have the ramp on the first...two nights..I think..but I turned it off. Don't really care for it. Thank you for the advice.
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#33
RE: David Clark - Therapy Thread
I took a look at the OSCAR wiki to try and get a better understanding of the software. Now from looking at the wiki and my data I'm wondering if I could be having positional apneas. My bed has a powerbase and I sleep with it in the "3g" antigravity setting. It raises your head and legs...similar to the position of an antigravity massage chair if you've ever been in one of those.
I kind of would think that raising my head would help with snoring but now I'm wondering if it causes my head to dip forward once I go to sleep and cut off the air.
It is the same position I slept in during the home sleep study.
I think tonight I'm going to sleep flat and see if there's any difference in my readings tomorrow.
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#34
RE: David Clark - Therapy Thread
It's possible with regards to the obstructive events, yes. I have a hospital bed that also lifts the head (and feet, and whole bed) and I use a soft collar to keep my head from flopping around while I sleep. I have to keep mine up, but you could test yours by sleeping flat and seeing if your obstructive events go down.
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#35
RE: David Clark - Therapy Thread
I typically have the head and foot of my bed raised a bit. Nothing drastic, but even though I side sleep to keep my back happy, the slight angles help. Just don't go too drastic on your adjustment angles. Even so, any angle might increase the likeliness of the chin tuck effect.
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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#36
RE: David Clark - Therapy Thread
Reviewing the charts, it looks like there is occasional clustering of obstructive events, suggesting some positional (chin-tucking) aspect to the obstructive apnea. This might be addressed by being sure not to use a pillow too high or firm that would encourage chin-tucking, or using a collar or wedge to prevent it. I personally often pull a corner of my down pillow between my shoulder and jaw and get some elevation of the chin that way. Your pressure settings are mostly in the 5-20 range with PS 5.0. I think you would benefit from an increase in minimum pressure and using a higher trigger sensitivity. The higher minimum pressure will help avoid apnea that seem to occur near your minimum pressure. We may want to eventually go a bit higher than 6.0, but that seems like a conservative start in the right direction. Trigger sensitivity is a tool we use when we see bileel therapy that has some intermittent central apnea. By setting the trigger sensitivity to High, less inspiratory flow is needed to trigger IPAP on the machine. This can often stimulate a better breath where a central might otherwise occur. I use this in my own therapy, and it has been effective for many other forum members.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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