Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
#11
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
Hello Mr. Bonjour... thank you for your time and any further guidance you can offer (and anyone else out there too).  I'm continuing to struggle with awakenings (almost like clockwork, which makes me wonder if there's some kind of circadian rhythm issue going on or if I have some kind of issue transitioning between sleep stages/cycles)... don't know.  Posted here is my sleep lab test from mid-Juy when still trying to figure out optimal CPAP settings.  Just one night of data here so I'm not sure we can conclude that much.
   

Since the lab test, it seems that the soft cervical collar has been the most effective element contolling my OSA regardless of CPAP settings.  Leads me to wonder if I should even be bothering with a CPAP machine at all.  Guidance?  Trouble is, I'm continuing to wake up multiple tmes every night... roughly at 90 minutes after sleep onset, then either about hourly or somewhat randomly thereafter... up until about 3:30a when I can't get back to sleep.  Lately, I've been pausing the CPAP when I awake as a way to get a timestamp in my results so that I can go back and see if anything interesting (like an apnea event) was occuring before my awakening.  But with the collar in place, the apnea events are so reduced/eliminated that there are no events to correlate... which is good... but leaves me wondering about the cause of the wake-ups.  I've posted here also last night's OSCAR results.  I can see some kind of flow limit changes/disturbances happening leading up to my wake-up events, but don't know what that means or what to do about it.  Looks like respiratory rate and tidal volume also pick up before wake-ups.  After my wake-ups, my pulse ox readings are highly unstable, showing spiked desats while I try to get back to sleep (I think explaining my high ODI?)... but again no correlating apnea events and total time < 88% is less than 5 minutes per night, so that's seems alright too.  Once my breathing goes stable, then everything seems fine... until the next awakening, and so it repeats.  These awakenings have been happenings for years/decades... have continued while refining CPAP... and continue on with the collar too... seemingly completely independent.  I've been reading about sleep maintenance insomnia and also about circadian rhythm disorders for clues (ASPD?)... and have therefore recently been experimenting with light therapy before bedtime and with taking melatonin every time I wake up... so I'm getting about 20mg distributed through the night but really can't tell if having any effect at all... no more or less tired than before and awakenings continue.  I've also turned off EPAP altogether... need more night's data to see if that matters.  So on the surface, my AHI is doing really well and I'm not having the huge desat events... and I'm grateful for that... yet I'm still fragmented and tired every day.
   

Here's a summary of wake-up times over the past few nights:
   
Post Reply Post Reply






Donate to Apnea Board  
#12
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
you have an interesting pattern of starting sleep sessions with snores and ending them on flow limitations.

it would help to see the left side of the daily tab with pie chart and calendar removed. you may benefit from more min pressure and/or epr.

also, it looks like you are using ramp. notice how sloppy your flow rate is at the beginning of the sessions as it rises from 4 cmw to 12. turning off ramp will give you more consistent treatment and will likely remove much of the snores.
Post Reply Post Reply
#13
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
Thank you sheepless.... I appreciate your time and thoughts re: my situation.  I'd mistakenly wrote that I turned off "EPAP", when what I mean to type was "EPR".  I'd recently gone from FULL TIME to RAMP ONLY upon reading of others who responded better to not having EPR on.  I'm not sure if has made any difference in my case... seems that nothing does.  I've also tried NO RAMP vs. RAMP with various durations... but not sure I've tried NO RAMP since also having the cervical collar, so will try that tonight to see if that helps clean up the breathing patterns that I think are responsible for high ODI (if that matters for me... not sure)... though, again, these follow the awakening events so are after the fact anyway... but I'm trying to do everything I can to improve matters across all hours of the fragmented nights, so I appreciate your suggestions.  Picture attached of last night's OSCAR results w/ pie chart showing.  All-in-all, I think I'm getting maybe 4.5 hours of sleep per night... been this way for as long as I can remember, but am concerned about cumulative toll.  I think it's the fragmentation more than the shortened overall duration that's hurting the most re: daytime fatigue.

Bob
   
Post Reply Post Reply
#14
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
you should be able to turn off the pie chart in file/preferences/appearances; upper right side check box.

also, you mentioned other replies plus I think I've seen your username before: they tell us we should keep anything related to our own treatment in one thread so responders can see your history.

for example, are you using a fixed pressure because of central apnea? have you tried higher / lower / range of pressures?
Post Reply Post Reply






Donate to Apnea Board  
#15
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
rbellamy, your 30 minute ramp seems to cause you some respiratory distress as indicated by the large recovery breaths (tall flow spikes) that are especially bad at the beginning of ramp from 4 to 7 cm, then your flow rate follows the ramp until you reach 12. If you must use ramp, consider starting at a higher pressure of at least 6 or 7 and use the auto mode. I suspect if we looked closely at your flow rate during ramp, you are actually experiencing OA and H events that are not recorded during ramp. Your therapy looks pretty good here, and I think if you like EPR, you should put it back into your therapy at a setting of 1.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#16
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
Thanks Sheepless... I thought I had posted as a continuation of the previous ongoing posts (exchanges w/ Bonjour mostly), but apparently I messed that up... struggling... sorry about that.  If search for "Event Duration, O2 Level, Lag", then should see the history.
Post Reply Post Reply
#17
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
no problem. it's not that hard to search for other threads. it's up to the mods if they want to combine threads. anyway, you're in better hands now with Sleeprider's reply.
Post Reply Post Reply






Donate to Apnea Board  
#18
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
Thank you Sleeprider... I've had ramp on and off trying to figure out any tweaks that might help reduce frequent awakenings, so will try to turn off again.  There's a separate thread (that I'd intended to post against as a continuation), but I somehow messed that up... Bonjour helped steer me towards a cervical collar that has been very helpful re: AHI... but my awakenings continue regardless.  (If search for "Event Duration, O2 Level, Lag" then will find the rest of the history).  Thank you for you time in offering guidance... has been a journey to say the least, though it seems my awakenings may have nothing to do with apnea... I don't know... frustrating.
Post Reply Post Reply
#19
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
Your July sleep test indicated significant PLM, are you doing anything about that?
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
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.
Post Reply Post Reply
#20
RE: Event Duration, O2 Level, Lag, Vib. [Chart Review Request]
my charts have been just as fragmented with frequent awakenings. there are many things that can cause awakenings but in my case I believe most are due to periodic limb movement. if you have reason to think plm might be disturbing your sleep, I can show you what my respiratory response to plm looks like in the flow rate chart. or you can search the site. I've posted plm screenshots in several threads including my own primary thread that begins '18 months of apap....'. if you're interested I can attach a representative screenshot in this thread. it took me a year to get around to seeing a doctor about it after trying gabapentin, which didn't seem to work. in the last two weeks I've been taking ripinirol / Requip with some considerable success in reducing plm and increasing sleep session duration (hallelujah!). other members have used different meds and/or certain supplements (like iron and magnesium, I think), apparently successfully.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [CPAP] New to the Forum - Please help Review OSCAR chart SinoAngTatayMo 20 378 3 hours ago
Last Post: staceyburke
  Data Review Appreciate! youbetcha 15 479 10-27-2020, 03:32 PM
Last Post: bonjour
  Feedback on Oscar, ReScan Chart; Dry Mouth Humayun 10 204 10-18-2020, 06:25 PM
Last Post: Humayun
  [split]AirCurve 10 CS PaceWave Analysis Request Bolsen 31 828 10-16-2020, 12:48 PM
Last Post: SarcasticDave94
  How much should AHI increase from sea level to 6500 ft altitude? garyrgraham 16 341 10-15-2020, 12:53 PM
Last Post: garyrgraham
  New to CPAP -- OSCAR chart arcav 11 382 10-03-2020, 11:02 AM
Last Post: arcav
  Please help with treatment review DaveL 294 7,722 10-01-2020, 08:36 PM
Last Post: DaveL


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.