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In anticipation of my BIPAP Re: New Thread
RE: In anticipation of my BIPAP Re: New Thread
I am cautiously optimistic.
Once the final settings are in place, give it a few days of consistent results and hopefully you'll feel the benefits.
I don't want to tempt fate by making overly-enthusiastic predictions.
If you are running on empty due to a prolonged period of poor sleep... it can take a few days to get over the chronic jet-lag.
I'm crossing every finger and toe and even my eyes for you. :-)

https://www.youtube.com/watch?v=IKnnh8VDULs
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RE: In anticipation of my BIPAP Re: New Thread
AWWWW!  I love Jackson Brown, Thank You!

I was just wondering, is all going well for you in your apnea quest?  I am going to read your threads to catch up.  I have felt a little selfish.

All my best,
Phoebe
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Pretty amazing, but you finally cracked the flow limitation barrier with PS 7.0. That was not CPAP mode, it is Vauto 14-25 with PS 7. I actually don't mind seeing the centrals and am really excited to see your worst wave-form looks better than anything you ever had before. This change actually increased your tidal volume and minute vent, which may have led to the CA events due to lower CO2. I agree with Slowriter's suggestion of 14-25 PS 6.4 and I hope that provides similar relief without the centrals. It was frustrating not seeing any change in your results with increased PS and other experiments, but this is a hopeful sign. How did you feel?
Sleeprider
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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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RE: In anticipation of my BIPAP Re: New Thread
Good morning Sleeprider!

I believe I feel better upon awakening than I have in the past, a very good thing.  And ApneaQuestions advised me on still feeling tired during the day, so I am looking forward to my body catching up.

Should I expect that I will start to have less total awakenings during the night, the kind that has me sit up and fiddle with things until I feel like laying down again?  This is as annoying as anything else.

Do you think that I should not expect to get my Flow Wave forms looking as good as in some of the examples of good waves?  Or, I probably will in the future as the tweaks become more appropriate?

After this mornings comments I am very excited to know that the proverbial light at the end of the tunnel is approaching...ALL DUE TO YOU ALL...

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
If you can avoid having your inspiration squashed flat into unrecognizable figures that resemble a car in a compactor, you will have come a long way. No one has perfect respiratory wave all night, certainly not I. There appears to be a threshold where your breathing mostly normalizes , and this is why we have been advocating the consideration of ASV. It can provide that pressure support when needed to maintain tidal volume, but it gets out of the way when it isn't needed. Whether the improvement of last night can be maintained will take time to demonstrate, but it was the first hopeful sign of a solution I have seen.
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.
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RE: In anticipation of my BIPAP Re: New Thread
Coffee Coffee Coffee

OH MY! MY AHI!  1.71!!!!!

I think this is the lowest I have had or at least one of.  I feel pretty good this morning, although strangely , not QUITE as good as yesterday morning when my AHI was higher.  Yesterday I do believe I was able to get through the day without feeling like I was going to collapse from exhaustion.  I fell asleep sitting up in bed doing something, my husband had to wake me up so I could go to sleep properly adorned in my "spaceman outfit".  But, baby steps, at least this was later in the evening than usual for me for passing out.

Couple of things of interest, at least to me, lol, about last night....

First, I have determined, I wonder if correctly, that I am NOT a candidate for sleeping in a more upright position.  I tried to correlate my video to my charts on this.  The time stamps are not exact, so I am only 95% sure.  I had purchased, a couple of days ago, one of those winged back bed pillows.  Again, last night I felt I was having difficulty sleeping and removed it.  I am going to stick with my original pillow arrangement, a soft, squishy pillow on top of a slightly harder pillow.

Second, and of more interest to me, I caught on camera, the sitting up in bed, sound asleep, cross legged, with my head dropped down activity!  This is the activity that has been of great concern to my husband.  I never knew I had been doing this until he told me.  I had asked the sleep lab to watch for it and they said they did not see it during my studies.  If anyone is interested in helping me figure this bit of shenanigans out, let me know and I will try to pin down at what point this occurred.

Third, again, why the CA events?  I have been informed that the very few I have are nothing to worry about, but tell me why again I have them at all?

Fourth, I think I should lower the PS a tiny bit more?  say from the 6.4 to 6.2?  Would that make any kind of a positive impact?  The current Max pressure setting seems to be pretty spot on, I just barely reach near 25 a few times.  Sleeprider and ApneaQuestions, would these be appropriate for me?  Any other adjustments you think we should consider?  Or do you think we have reached the best we can do?  Am I still a candidate for ASV? or should we no longer consider it a need for me?

Here are last night's charts:

[attachment=18919][attachment=18921][attachment=18920]


Really excited to hear everyone's comments!

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Good results!

As predicted.... by getting rid of the leaks, those apneas from yesterday disappeared.
Also as predicted.... by lowering PS your CAs pretty much disappeared.

The "bad" waveforms still have a little flatness to them, but compared to the car-compactor shapes you were getting before, this is very good progress.
I suggest you keep all of your settings constant for a few days to see if we can get consistent repeatable results like these.
After that, you could fine tune the machine a little further but you will be experimenting with a trade-off..

1) Increase PS slightly to try to get the "bad" waveforms even rounder... however this may re-introduce CAs
2) Decrease PS a little bit to try to totally eliminate the CAs... however this will tend to lose some of the gains we've made on the shape of the waveforms.

All in all, your current settings seem good enough for now (at least for the next few days)

The small number of CAs you are getting are insignificant and not worrisome.
Read my recent post here on this thread explaining treatment-emergent CAs to get an understanding why they might be appearing in ones and twos. (Think CO2).
http://www.apneaboard.com/forums/Thread-...#pid328312
Also... sometimes the machine will flag something as being a CA when in fact it's more likely to be an OA.  You'd need to really zoom in on the waveforms to decide if the CA classification seems right or not.

Finally, your body can adapt to lower CO2 levels over time which means that any small number of residual treatment-emergent CAs you have today may spontaneously fix themselves over the coming days and weeks.   That certainly happened in my case.

EDIT: The final thing to try to resolve is the couple of times where you seem to have the mask off for 30 minute or so during the night. If you can figure out why you are doing that, you may soon be able to sleep through the entire night without any mask removals.
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RE: In anticipation of my BIPAP Re: New Thread
Thanks ApneaQuestions, knew I could count on you to respond quickly.   Okay  on leaving settings where they are for a couple of days, even though my fingers are twitching. Rolleyes

But, not to beat a dead horse.....I REALLY would like to know why I do, and how I can stop, the sitting up in bed asleep activity.  Any insight, comments, suggestions on this or should I quit wondering about it?

Most Respectfully,
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
This is a bit of a cross-post, but I'll leave it as is.

I also think, given your enthusiasm for figuring this out, you're ready to internalize the logic of the recommendations we've made.

You raised your max IPAP to give your machine more room to deliver higher pressure, as needed. It turns out it needs all of the 25, as you noted.

We found PS 7 gave you the pressure support needed to reduce your really bad FL. It did that, but caused quite a lot of CAs.

So we reduced the PS a bit to see if we could get the benefits without the costs.

Two CAs a night is not worth worrying about; at all.

So let me turn the question around Plmnb. Given all of this, what do you think you should do for next few nights, and why?
Caveats: I'm just a patient, with no medical training.
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RE: In anticipation of my BIPAP Re: New Thread
Coffee Good morning Slowriter.


Hmmm...uh oh, I think I'm back in college and the professor has asked me my reasoning,  Laugh-a-lot


Well, things are starting to make more sense to me, so let me see.....

I was feeling pretty good about coming to the realization that the Max IPAP can stay at 25 by scrolling my mouse over the OSCAR chart for pressure all on my own  Big Grin So there's that.

I was pretty sure you guys would say don't worry about the CAs, but I had to ask, cause that is the way I roll. 

I feel more comfortable now to adjust the PS up or down based on results without having to check with everyone every two seconds.

And obviously, as I have always known, but difficult for me to control...It is best to not change a million things at once so that we can determine the best course of action.

And it is best to see, over a few nights, if the adjustments and results are flukes or not.

Did I pass?  Thinking-about Dancing (Love you guys!)

BUT.....what about the dead horse issue??? lol.

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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