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In anticipation of my BIPAP Re: New Thread
RE: In anticipation of my BIPAP Re: New Thread
WOW ApneaQuestions, I'm really learning what to look for.  I had no idea about the short caterpillar looking humps just before the indication of an OA blockage. In all the data I have been viewing I didn't notice them.  I don't know if you read my edit to previous post, but this caterpillar is of much interest to me.  I don't see a Flow Limit issue at the time of this occurrence, what is the significance of that, if any?

To repeat and paraphrase my edit, will the eventual future tweaking we do to the settings alleviate this blockage?  Are we talking about an actual, physical blockage like my tongue, which the dr. said is too big (Class 3), and the machine currently can't force the air into my system because of a physical obstruction? Or am I totally off base here and something else is going on?

I swear, if it seems like I'm getting frenetic again, I'm not.  I'm just excited to really learn what I am learning.

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
The additional tweaks upwards on PS will tend to improve any residual flatness of some of your worst waveforms. 
It may not make them "perfect", but it will improve them and they should look less flattened and more rounded.

In addition, the few remaining obstructive apneas may disappear because the extra bit of pressure support may allow your breath to "break through" and avoid the apnea happening in the first place.

When you say you didn't see a flow limit... I would paraphrase that and say that "the machine did not seem to be reporting a flow limit".  After all, if there's no flow to begin with (it didn't get above zero) then there's no flow to be limited.  See what I mean?  It's one of those spectrum things again... an extreme case of a flow limitation is a total flow blockage. To me they are just shades of grey on the "my breath isn't flowing smoothly spectrum".

Since you have just had an opportunity to see in depth what happens during an apnea, take a look at a recent post I made showing how the ASV machines responds slightly differently to an apnea.  I captured the image just the other day (and annotated it in my usual way).  One thing you'll notice is that the ASV machine keeps pumping during the apnea to try to encourage me to breathe.  In your case, the VAuto just passively stops and sends a ripple instead. The tendency of the ASV to keep pumping is called a "backup rate".

http://www.apneaboard.com/forums/attachm...?aid=18856

EDIT: whether the flow is being limited by your tongue or your soft palate or maybe even the narrowed nasal passages is not something we can say for certain. It may be some or all of them.
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RE: In anticipation of my BIPAP Re: New Thread
Cool  ApneaQuestions.  I'll check out your ASV post and respond if I have questions.

My plan for now:

A couple more nights at the current settings, then possibly adjust PS.

Attempt better sleep hygiene, especially longer sleep time.

Review ASV as an appropriate step, if tweaking settings in the future does not alleviate the VAuto passively stopping.

That should about do it for now.

Appreciate all your time today, feels like I've been monopolizing you.  Shy

Regards,
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
Sounds like a plan.

BTW I don't think that an ASV is going to be necessary for you.

It may be marginally beneficial as a fine-tune experiment for your final waveforms.. but you won't be able to sell it to the insurance folks and I doubt if it's worth the cost to you.
Remember, from an insurance perspective, they need to see a LOT of CAs before they will even begin to entertain an ASV.
Once we got a breakthrough on your car-compactor waveforms, the ASV became somewhat moot.
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RE: In anticipation of my BIPAP Re: New Thread
Okay

Good to know I can cross that off my list.


Have a great day!

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
I wanted to comment on how flow limitation has changed with the higher PS in this image.  This is a section of breathing that used to barely rise above zero and would decline before expiration, looking more like a chair, or as I once observed, like a car crushed by a wrecking compactor.  We see the onset of flow limitation but a continuing steep increase of flow rate until the onset of expiration in this image below. This is a very significant improvement.  Thanks also for re-scaling flow limitation and leaks.  Even with re-scaling, the flow limitation index is barely above zero with this improvement.

[Image: attachment.php?aid=18948]
Sleeprider
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Smile 
RE: In anticipation of my BIPAP Re: New Thread
Thumbs-up-2

Good Morning.

I'm doing things a little differently this morning as far as posting the charts.  (AHI DID go up, doubled from yesterday but still low at 2.21, I do feel a bit more unrested).  But I'm NOT worried. 

I have been doing my own research, (about time, right), and trying to get all the concepts into my head so that I am TOTALLY clear about deciphering these OSCAR charts.

In the meantime, I feel like I have struck gold:

[attachment=18970]

NO FLOW LIMIT ISSUES AT THE POINT
PRESSURE STEADY AT 21.36
LEAK RATE JUST BELOW 5, WELL WITHIN ACCEPTABLE LEVEL
CURRENTLY STILL AT PS 6.4

I WANT MORE OF THIS!!!!  I AM GOLD DIGGING.

BBS,
Plmnb

PS.  Thank you Sleeprider for your reply last night.  I'm digesting it.  Wink
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
Nice!
Is that why you took the mask off 30 seconds later to celebrate? ;-)
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RE: In anticipation of my BIPAP Re: New Thread
Lolabove


Yeah, I did wonder about that, but I was so happy to find those little nuggets in the chart this morning that I had to create a photoshop image and post it.  Dielaughing

I'm in the middle of reviewing my video.  Will update shortly.

BBS

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
The video system is motion activated.  I apparently was perfectly still during these beautiful breaths.

Then, the camera activates and shows me tossing around, it appears as if I am struggling to breathe, (The camera does capture my entire body, so it can even capture the rise and fall of my stomach.  I have noticed that at some "bad" times you can notice my stomach rise and fall VERY much.  Like I'm trying to draw deep breaths and very fast).  It looks like this happened here.  I eventually wake up fully, sit up and take my mask off.

I also find it interesting, and am wondering about the following:

These great looking breaths took place in between what I have come to call "caterpillar" Flow Rate wave forms.  I have tried, very hard, to learn about these particular wave forms.  Yesterday, (and on other days too), I have had around 2 or so CA.  As flagged by OSCAR.  I have been told, more than once, that I should not worry about my CA because they appear in such small numbers and are of the insignificant type, from what I am learning these are probably "junk" CA events.  Now, in today's chart I have a few of what appear to be the same shape wave form.  Two are flagged by Oscar and the others are not.  The other similar wave pattern/shape are NOT flagged btw in Oscar.  (Probably because they did not last at least 10 seconds, correct?)

Please know, I am NOT being very concerned about them because you guys told me not to be, I'm just curious about these waves and what they DO indicate.  I believe I read on the internet that they can occur just prior to a full arousal.  But I'm confused if they do this even if they are "junk"?

I also am confused as to the flow limit being ok at the point of the "caterpillar".  I don't know, I'm just interested.

Here is my overview chart for last night:

[attachment=18971]


Thank you everyone for your continued interest!
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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