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[Diagnosis] Am I just an apnea wannabe?
#11
RE: Am I just an apnea wannabe?
Welcome to Apnea Board,

FWIW back onto your concern for Central events, you can monitor this if you'd like, but a 0.40 CA is nothing compared to others like me that are susceptible to these Central events. On an AutoSet like yours, my CA would be about 20. However, this small bit of CA on your OSCAR is nothing to concern yourself. If it jumps up due to higher EPR, then OK we'll address it then.
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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#12
RE: Am I just an apnea wannabe?
I am no expert -- but are you sure you need a full face mask? I ask because I have the same feeling of not getting enough air when I have a FFM on. It probably isn't factually true, but it "feels" that way to me. Perhaps someone has told you that you need FFM because of mouth breathing. I understand that is conventional wisdom, but I believe that is not the case and some sleep experts agree. How about trying a nasal mask? I like the N20 but it shoots the exhaust air out the front elbow which can annoy your bed partner. The N30 does not have the exhaust problem. Anyway, worth thinking about something other than a FFM.
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#13
RE: Am I just an apnea wannabe?
(06-03-2021, 12:49 AM)clownbell Wrote: I am no expert -- but are you sure you need a full face mask? I ask because I have the same feeling of not getting enough air when I have a FFM on. It probably isn't factually true, but it "feels" that way to me. Perhaps someone has told you that you need FFM because of mouth breathing. I understand that is conventional wisdom, but I believe that is not the case and some sleep experts agree. How about trying a nasal mask? 
So far, I really do. But if you can tell me how I don't, that would be fantastic!  Big Grin The reason I had jaw surgery in the first place was a proportionally long upper jaw (if you are old enough to remember Beverly Hills, 90210, I used to get told I looked like Kelly all the time - lol. That was the only time it was a good thing.) Even with surgery, my lips naturally have a small part. So it is a small effort for me to keep them sealed. I also drop my mouth open when I sleep. So when I tried a nasal mask, I spent all night scared to fall asleep and open my lips. And even when I taped it shut, as soon as my lips parted even a little, I would startle awake with the small amount of air going through. Soo...I am back to the full face mask. But I'd love to use something less hospital-like.

Here's my graph from last night with the changes. It looks like they did help somewhat. I am amazed at how much better it feels to fall asleep with the pressure at 6 rather than 4. Unfortunately, I don't have that "refreshed" feeling today that I've been so excited to glimpse a few times, but I hope I'm on the right track. I appreciate the help of those of you in the know. I understand that so many other people are dealing with much worse problems, and I am grateful for the support toward feeling awake during the day again. 


   
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#14
RE: Am I just an apnea wannabe?
Looking at your graphs --

So first look at the flow limits: you see how you have zero flow limits to start, and then they appear and don't let up? I'm just like this, too. What it means is that "no flow limits" equals "awake" and "having flow limits" equals "asleep". This is me, too. (They say that the machine can't tell whether you are awake or asleep because you need brainwaves for that. But I can tell you as a flow-limit queen -- the flow limit calculation algorithm is a perfect sleep/wake detector for people like us!)

Next look at your pressures -- what you see is that as long as you are awake, your machine keeps your pressures at 6/4. But the instant you fall asleep it zooms up to 10/7, 11/8, even 12/9, and it stays up there, too. The only thing that drops your pressures back to baseline is waking up! (Try lying in bed awake for a few minutes after you wake up, rather than shutting the machine right off. You will see zero flow limits as long as you are awake, and the machine will drop the pressure back down to minimums. It drops more slowly than it rises, but if you wait long enough it will go all the way.)

So, to answer the question that you started with, your machine sure believes that you have sleep apnea! This really becomes obvious if you have insomnia. You will lie there in bed, eyes closed, trying to sleep, (and pretty annoyed that it's not happening.) Then you go back and look at your data in OSCAR -- you see totally zero flow limits, and your pressure stays pegged at the minimums as long as you were awake. If you didn't have apnea, then your pressure curve while asleep would look the same as when you are awake. (The insomnia test will also show that while you remember it as being awake for hours -- or more precisely, awake for $%!@#! hours! -- it will probably show that you were sleeping -- and having flow limits, and the machine raising pressures -- far more than you thought.)

What this also means is that you should set your minimum pressure to whatever feels most comfortable when you are awake, because the only time you will be spending there is when you are awake. Setting your minimum to 6 like you have it means that your awake pressures are 6/4. If you set your minimum to 7, then your awake pressure will be 7/4 -- you will have your full EPR when awake, too. If you look at your graph, you see that the machine doesn't take you below nine when asleep, so a minimum of 8 or 9 would work, too -- whatever is most comfortable.
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#15
RE: Am I just an apnea wannabe?
IMO the only real issue is the flow limits. CA are still very low so this should not be a real major monitoring need.

I'd suggest trying to shorten or eliminate the Ramp time as this itself can add disruptions as it hands off to normal therapy control.

FFM: I used the F20 for about 2 years, both AirFit silicone and AirTouch foam. It was a struggle to maintain leak control. When I tried the Fisher and Paykel Simplus and Vitera full face, I went ahead and made the Vitera my new go-to. Do a bit of research and I think you'll like it. The only perceived negative is the forehead bar, but it doesn't touch my forehead so no biggie really. Positives? I think it's lighter than the F20. It's far easier to get control over leaks, with less strap tension. These F&P masks have RollFit a bellows so go very light on straps tension and it'll work great. Comfort and control...2 checks for the win column for me.
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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#16
RE: Am I just an apnea wannabe?
(06-03-2021, 11:03 AM)SarcasticDave94 Wrote: I'd suggest trying to shorten or eliminate the Ramp time as this itself can add disruptions as it hands off to normal therapy control.

The ramp is essentially turned off already, because as soon as the flow limits start the pressure zooms immediately.

When you have lots of flow limits the A10's algorithm gives you a perfect ramp that matches perfectly to your sleep/awake state. redvines has her ramp set to "2" which is exactly equivalent to "off" when you are a flow limit queen.

(When I first started with therapy 6.5 years ago I was mystified as to the purpose of ramp because I didn't realize that not everybody has flow limits like me.)
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#17
RE: Am I just an apnea wannabe?
OK copy. I'm still in the ASV realm myself. So thanks for clarifying. I used Ramp 1 night on my ASV and killed Ramp forever after.
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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#18
RE: Am I just an apnea wannabe?
@SarcasticDave - Is it just the Vitera that uses the Roll Fit? I have read that the Roll Fit does a great job of sealing, so am wondering if other F&P masks use it too. Thanks for the feedback.
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#19
RE: Am I just an apnea wannabe?
Simplus is similar to Vitera, both have RollFit it appears but I like Vitera better. The headgear feels more comfortable to me. Both are STRONG front vent masks, makes a bit of a breeze with some sounds but I really like the leak control which overrides any perceived negative.
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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#20
RE: Am I just an apnea wannabe?
In addition to the Vitera and Simplus, I use the F&P Brevida nasal pillow. While I wouldn't classify it as a roll-fit, it grips so well that you need to almost peel it off when removing it. F&P mask designs have their act together on sealing.
Crimson Nape
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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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