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I have f'n had it! HELP my final effort!
(08-24-2016, 10:56 AM)Daisylouu Wrote:
(08-23-2016, 08:11 PM)surferdude2 Wrote: My observation based on the graph you showed is that your obstructive events are occurring in well defined clusters. That could possibly mean that you are changing positions, which is a common cause of clusters like that. There are other reasons for clusters of events as well but since you mentioned having a problem with your back, that gives some credence to sleeping position change as a factor.


No, I do not move much at all during the night. I sleep on a recliner, so there is very very minimal movement.

What makes you sure of that since you are ostensibly asleep? I can get a lot of movement in very confined spaces when I sleep.

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Your head may well be rolling to the side.

We want to help you please take our ideas that way. Success stories are what we want at the end of every request for help.

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Even if it is positional you have to get the min pressure up near the level that will prevent them. Right now your too low. U may have to raise max too,if it keeps going to 16 and sitting there.
But once your min press is closer to a level that actually does anything im guessing it wont hit 16 much.
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Your max pressure is at 16 and your 95% pressure is 16, so you are at max a lot of the time. The pressure graph shows you at 16 ALL OF THE TIME.

If it were me, I would probably move the minimum pressure up to 9 or 10, and open up the top end of the range to 20 and see what my 95% pressure goes to over a few day period. It is showing some centrals so I would watch that as I increased the pressure. If the machine moves the 95% pressure up to the max of 20 and I were still having issues, it may be time to think about a BiPap that would be able to give me more headroom, if that's what I needed.

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I will download the manual for my machine and start raising the bottom number (gradually). And try to prevent my head from moving, looking for a smaller soft collar.

I think I compressed my latest chart as instructed, and have attached it.

Thank you so much for your help and advice, I am beyond frustrated as I just saw the nurse practitioner and she brushed off my concerns saying this is probably as good as I will get.

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The new graph is much more revealing and I doubt that your problem is connected with you changing positions.

It's pretty clear that you were wakened by the three clusters of OA's that are shown. Analyze the graph in each case where the clusters appear and you will see how that happens. First your respiration rate and tidal volume decrease as you fall asleep. Next the pressure rises when you start having flow restrictions. The pressure maxes out at 16 cm and it is insufficient to prevent the OA's which results in the cluster of events that wakes you up, whereupon your tidal volume and respiration rate rise. Then you eventually go back to sleep and the process repeats itself another two times.

It would seem obvious that raising your top pressure in small increments until the clusters are prevented would be the correct course. I would recommend 16.5 cm to begin with and wait a week or so to see if you need to up it another .5 cm until you get it under control. As an alternate method, you could choose to set the top to the 20 cm. maximum and possibly get quicker results. That may also cause some other issues to crop up however so if it doesn't show immediate relief, without other issues that disturb you, then you can return to the slower incremental method.

I will add that when/if you can get out of that recliner and sleep on your side in a bed, you'll find that the cpap pressure can be much lower while events are better controlled. That may require a special memory foam mattress pad and/or pillows placed to help with the back pain but it will be worth the effort. Sleeping in a recliner is tough at best.

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Do not let the nurse get you down.

I would go with Dude's ideas they speak to me like a caring and informed person. I would guess that he has taken the time to understand his condition. The reading of your charts is an education for us all.

Please keep us informed of you progress even after you have seen lots of improvement. What works for you can help others. I am sorry you are having such a hard time it will get better.


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Raising the max may be needed but its not going to help the clusters.

The min pressure is to low. The trick is to get the min where it will prevent most apneas to begin with. And not have to climb so far , while OAs are occuring to reach a benificial level. Giving the max a bit of head room wont hurt. But having been in this spot of clusters happening the max press wont head them off.

Once your min is up to s theripudic level your max will likely not go as high as 16.
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When I change my pressure, I usually take a large jump and end up waking during the night not tolerating it. I then, on the same night, decrease in 1cm steps until I can tolerate it again. The next day I look at the graph and see if I still think I need higher pressure, if so I now start small 0.2cm steps. For me the difference of just 0.2cm can decide if I can tolerate the pressure or not.

Do not give up until you have tried everything, regardless of what the professionals say.
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Yes the low pressure need to come up.

I started with a low of 5 and now have it around 12 or 14. I use the ramp starting at 8 for 5 minutes to be able to get my mask on and settle down. It is working well.

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