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[Diagnosis] Experimenting with CPAP titration for my wife
#11
RE: Experimenting with CPAP titration for my wife
Attaching the charts for 2 naps on the AutoSet 10. I'm telling you, she can sleep like there's no tomorrow!

Edit: You can't see it in the screenshots but EPR was set to 2 on Monday (on accident - note the CAs) but it was off for Tuesday's chart (no CAs).


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#12
RE: Experimenting with CPAP titration for my wife
Those have beautiful low AHI and smooth uninterupted sleep.  


I saw three CAs in the second screenshot.  

I recommend posting another three charts, each zoomed in to show a 2 mins long waveform centered on each of the three CA events.     

So we can start to better understand if those are real CAs, etc. (especially before you sell the really hard to get CA machine, the ASV).

WillSleep

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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#13
RE: Experimenting with CPAP titration for my wife
Also, at the bottom of the first screenshot between there clusters of flow limitations between 7:45 - 8:00.

Clusters like that are often "positional'" people have rolled onto his/her back or is tucking his/her chin into his/her chest.  

These events often have the easiest fixes to get more satisfying sleep.
  • Don't sleep on your back
  • Teach yourself to sleep with your chin extended rather than tucked.  Many people like to use Neck Rests/Collars to help 

A link to share with her..  5.2 Positional Apnea

WillSleep

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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#14
RE: Experimenting with CPAP titration for my wife
(10-17-2019, 06:22 PM)WillSleep Wrote: Those have beautiful low AHI and smooth uninterupted sleep.  


I saw three CAs in the second screenshot.  

I recommend posting another three charts, each zoomed in to show a 2 mins long waveform centered on each of the three CA events.     

So we can start to better understand if those are real CAs, etc. (especially before you sell the really hard to get CA machine, the ASV).

WillSleep

She's always been a deep sleeper. I wonder if that would make a self diagnosis harder? She doesn't really snore (definitely not like me!!) but I can hear her "catch up" on breathing a few times a night without a machine.

I attached the 2 minute waveforms from the CA events. This was with EPR 2 and Min 6 Max 10 (cmH2O).


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#15
RE: Experimenting with CPAP titration for my wife
(10-17-2019, 06:49 PM)walkingdead Wrote: She's always been a deep sleeper. I wonder if that would make a self diagnosis harder?

Not in my book.   Count that as an asset in the bank.   

(10-17-2019, 06:49 PM)walkingdead Wrote: I attached the 2 minute waveforms from the CA events. This was with EPR 2 and Min 6 Max 10 (cmH2O).

Well Done.  

The first 2 min Screenshot on the left is the last, to the right of the screenshot.  It occurred during recovery from a Flow Limitation so we should not worry about that as far as being a CA goes.  

In the second 2 min Screenshot at 10:50, a CA was flagged shortly after she took a really big breath.  The large breath may have washed out enough CO2 to cause the next breath to delay so also not yet a big concern as far as a "true CA" is concerned.

In the third 2 min Screenshot at 9:13, that one is a little more troubling.  There looks like what might be a little flow limitation, mouth breathing or small leak a minute prior at 9:12 but we should look at more rows OSCAR at that time to better understand what is going on.  

If you would not mind..    Update your OSCAR and repost that third 2 min image:
  • No need to show Snore
  • Show Pressure
  • Show Resp. Rate 
  • If you can show Tidal Volume      

To get more rows on the screen
  • You can reduce the height of existing rows with your mouse.
  • Click on the row title "Flow Rate" Then Right-Mouse-Click  >> Y-Axis >> OVERIDE and change both the low and high values to 100.0
  • Click on the row title "Mask Pressure" Then Right-Mouse-Click  >> Y-Axis >> OVERIDE and change the low to 3.0 and the high 16.0  

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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#16
RE: Experimenting with CPAP titration for my wife
Of the two sessions with the Airsense 10, the one using EPR 2 looked best to me. I don't think the CA events are particularly important, and what both sessions show is that auto CPAP is the right solution. I think that you know the direction to take on this. My wife and I both use the machines at night with P10 nasal pillow masks, and we both are more comfortable and sleep better. Her apnea is far less than mine, but she never sleeps without it. Good luck!

Another supplier to talk to is Supplier #33. Good prices and they also do used machines and exchanges.
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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#17
RE: Experimenting with CPAP titration for my wife
Looks good on that chart with the APAP. I can't give anything more other than what Sleeprider had given. Best wishes to you both for success.
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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#18
RE: Experimenting with CPAP titration for my wife
(10-17-2019, 07:18 PM)WillSleep Wrote:
(10-17-2019, 06:49 PM)walkingdead Wrote: She's always been a deep sleeper. I wonder if that would make a self diagnosis harder?

Not in my book.   Count that as an asset in the bank.   

(10-17-2019, 06:49 PM)walkingdead Wrote: I attached the 2 minute waveforms from the CA events. This was with EPR 2 and Min 6 Max 10 (cmH2O).

Well Done.  

The first 2 min Screenshot on the left is the last, to the right of the screenshot.  It occurred during recovery from a Flow Limitation so we should not worry about that as far as being a CA goes.  

In the second 2 min Screenshot at 10:50, a CA was flagged shortly after she took a really big breath.  The large breath may have washed out enough CO2 to cause the next breath to delay so also not yet a big concern as far as a "true CA" is concerned.

In the third 2 min Screenshot at 9:13, that one is a little more troubling.  There looks like what might be a little flow limitation, mouth breathing or small leak a minute prior at 9:12 but we should look at more rows OSCAR at that time to better understand what is going on.  

If you would not mind..    Update your OSCAR and repost that third 2 min image:
  • No need to show Snore
  • Show Pressure
  • Show Resp. Rate 
  • If you can show Tidal Volume      

To get more rows on the screen
  • You can reduce the height of existing rows with your mouse.
  • Click on the row title "Flow Rate" Then Right-Mouse-Click  >> Y-Axis >> OVERIDE and change both the low and high values to 100.0
  • Click on the row title "Mask Pressure" Then Right-Mouse-Click  >> Y-Axis >> OVERIDE and change the low to 3.0 and the high 16.0  

You got it, see attached. I had to break out the MS Paint skills because my screen is too small. Cool


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#19
RE: Experimenting with CPAP titration for my wife
Glad to hear we're on the track. I'll plan on getting the ASV exchanged with an APAP next week and bump this post in a few weeks to let ya'll know how she's adjusting. It sounds like EPR 2 and Min 6 Max 10 cmH2O will be a good place to start.

Everyone here is such a knowledgeable resource, thank you so much for your help and patience with us newbies! The apnea community is blessed to have this forum and an open sourced software like Oscar. We'd honestly be lost if it wasn't for all of your help!

Thanks
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#20
RE: Experimenting with CPAP titration for my wife
(10-17-2019, 08:16 PM)walkingdead Wrote: You got it, see attached. I had to break out the MS Paint skills because my screen is too small. Cool

Very well done.   

And now the Event recorded 9:13 is is clearly not a "True CA".  

From 9:13:22 to 9:13:35
  • The Respiratory Rate was pretty good, around 14-15 breaths per minute and slightly increasing throughout.
  • Tidal Volume was reasonably strong though-out.  
So maybe that period was combination of a continuation of the flow limit seen 10 - 20 seconds earlier and / or a Leak, each not big enough for the ResMed machine to report them.  

You saw SuperSleepers confirmation that the Autoset for Her looks like a good path.   I think that settles it.  


In the interim while awaiting that new machine any more questions for us?

WillSleep

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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