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Is this normal or my APAP is simply stupid?
#31
RE: Is this normal or my APAP is simply stupid?
in my last post I posted two screenshots where it says PSG has flow limitation

but also  it is 4 KILO Hz which would be 4000 Hz basically it is 4000 more than Dreamstation?

I see here it has ability to automatically associate arousals to flow limitations?

Could it be that the data can be viewed on the computer more in detail and this is simply the print that we receive?
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#32
RE: Is this normal or my APAP is simply stupid?
I missed the flow limitation result in the report.  I don't know how it is measured, but that should be similar to what we are trying to address.  It's hard to draw conclusions on how useful the data is based on the single example provided, but it may indeed be useful.  Earlier in this thread you posted the image below. I don't know what else you need to know. This is flow limitation and seems to be the root cause of the variable breathing, arousals, RDI and other issues you have.  We have suggested this can be resolved with pressure support that counteracts the upper airway restriction, and would result in normal respiratory volume.  ASV is an option that costs much more and may resolve the problem or add disruption to your sleep.  Your flow limitation is not very severe, but you have recovery breaths and occasional periodic breathing from cycle of flow limitations and recovery breathing. 

Is the purpose of looking at the PSG device to do another test?  Do you think it will tell you more than you already know?

[Image: attachment.php?aid=23743]
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#33
RE: Is this normal or my APAP is simply stupid?
Very good question! What is the meaning of this sleep study...

Indeed we see here flow limitation as you say and I have seen it in the book and I agree it looks just like diagrams in the books. So you were 100% right from the start.


The reason why I want to get the sleep study is because my parents are saying "no wait, don't buy it yet, get a proper sleep PSG with this doctor and see if it's flow limitation."

So... They already sent me the money but they convinced me to wait, even though I must admit, when I have a bad night I wake up with extreme anxiety and it gets lower by the end of the day, althought concentrating gets harder. 

One such night was last night heh...

I think what I would want to know if increasing the pressure would cause centrals and if maybe from the start on that ASV  machine would be better?!

Like there is some chance I might have complex apnea... idk?! That's what I read.

But I guess you are right I should just buy that machine on Monday. My parents made me not buy it yet and wait "a little bit"... 

Sorry I don't want to be annoying 
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#34
RE: Is this normal or my APAP is simply stupid?
also I thought mandibular advancement device could be covered by insurance?! If he concludes that it is my tongue or whatever that is causing this so I thought proper PSG is useful
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#35
RE: Is this normal or my APAP is simply stupid?
We see quite a few that get the MAD devices and still have need of CPAP machines. So you may have to obtain 2 devices, MAD and CPAP, or just CPAP class of machine. Me personally, a CPAP device is more likely to be effective.
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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#36
RE: Is this normal or my APAP is simply stupid?
I don't know. I had similar AHI and similar CA events on CPAP back when I used it. I have OSCAR data going back to 2014 and my AHI was very similar to yours, using a Philips Respironics System One Auto CPAP, generally over 1.0 and less than 3.0 with CA being from 07 to 1.3. I experienced an increase in CA events when I moved to a Philips System On BiPAP Auto and had better sleep with AHI about 1.5 with mostly CA, but it was less disruptive to my sleep than the obstructive or flow limitation related events on CPAP. Later I moved to the Resmed Aircurve 10 Vauto, and initially had AHI less than 1.0. Over time, CAI increased, and I found I could control that by using a higher trigger sensitivity on my Vauto, so I'm back to generally less than 0.5 AHI.

No one can predict how you will respond to therapy, and you won't find out by taking another sleep test. I can tell you that with 100% confidence. You won't learn anything useful. Spending the money on an Aircurve 10 Vauto I can guarantee will result in improved comfort, and probably better results. Any residual issues will be different from the flow limitation and arousals that affect you now. The Vauto is flexible enough to ensure your therapy will not be worse, and can simulate auto CPAP or provide any level of pressure support you need to thread the needle between flow limitation and CA. There are tools available that don't exist on any other machine. I just wrote the "nagging low-level central events" section of the Optimizing Therapy wiki to show how trigger sensitivity can reduce CA http://www.apneaboard.com/wiki/index.php...y_Clusters

I think you're wasting your time and parent's money with another study, and will find the Vauto meets your expectations for therapy, provided your expectation is realistic and not perfection. I feel like your parents think there may be some stigma to using bilevel. To me it is like the stigma of driving a Ford vs BMW or Audi. It's that much better. If you move forward with a study keep us posted, but I don't see much benefit in analyzing the machine being used when we already know what we need to know. I have never seen any clinical sleep study used for anything other than to score AHI and RDI to determine the need for CPAP therapy. Your desire that it will tell you you need bilevel or ASV is a complete fantasy unless that therapy is being provided during the test.
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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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#37
RE: Is this normal or my APAP is simply stupid?
Monday morning, I am buying the machine. You are 100% right

I do have one question for you....

I noticed this:

first half of the night on this image, where tidial volume does not dip, I woke up and I felt great. I did not see the results. AHI was 0.7 and tidial volume had nice space below its line.



Then second part of the night I went to sleep and as you can see, tidial volume becomes mess. IT dips so much, the "line" simply disappears because it is going up and down. 

Does that have any meaning? Because to be honest after the first part of that night I felt sooo good and had no anxiety at all. After the second part I had sever anxiety in the morning and it did not go away for at least 5 hours. 

So does this tidial volume getting messy really collerate with that sleep quality I percieved or that is just my imagination?
Because I did not see the results. I told this to my brother and he said it's funny, because in the first night tidial volume looks nice like a line and second part it's just mess.

So could it be placebo? I didn't even see the results lol


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#38
RE: Is this normal or my APAP is simply stupid?
Your machine doesn’t give us any idea of what is going on in terms of flow limitations without looking close at the flow rate. I think you know what to look for in terms of flattened inspiration waves. Just scroll through the flow rate chart and tidal volume at a close zoom and see if there is a pattern or correlation.
Sleeprider
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____________________________________________
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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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#39
RE: Is this normal or my APAP is simply stupid?
Here I picked out two interesting things.... maybe they make sense Smile

I have noticed that drops in airflow rate are connected to those dips of tidial volume, so maybe that is why I feel bad after having that sleep with weird looking tidial volume.


and in  the other attachment I have RERA I guess? But my machine did not lable it as one. IT looked like one of the RERAS I've seen in some articles.

Also they happen quite often but the machine does not lable them at all. In the entire night, it labled 1 RERA


Also I really got my AHI low by inreaching the pressure  back to 9.5 and maxing C FLEX at highest...

It swings between 9.5 and 7 now I think? I guess with more pressure support will  be better.

Lol i hope i did not say something wrong... this is all new for me


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#40
RE: Is this normal or my APAP is simply stupid?
I have no problem with using both, pap machine and mad
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