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Jadazu treatment thread
#21
RE: Jadazu treatment thread
Although fixed pressure can be helpful for some people you also are significantly lower than the titrated pressure (only 60% of it). I personally would use APAP or titrate fixed pressure up slowly to see if the higher pressures continue to help (seems like it does compared to early thread info). Your doctor more than likely doesn't look at the data we are seeing which shows the flow limitations and periods of inspiratory restriction and this setting isnt that much different then before.
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#22
RE: Jadazu treatment thread
Yes. I am wondering about the inspiratory restriction. Some of the inspirations were interrupted to where the machine stopped the ramp-up from epap and then started again, like two short breaths. FWIW, I just noticed that the snore channel showed medium snore values, and I almost never see anything on that (I don't usually look at it...).


   

For the years prior to me using Oscar to view cpap data, the only nightly data I had was pulse-oximetery strip charts. I would get similar hypoxias a handful of times per month. I think this is something similar.

At this point, I've ordered a Wize camera, to have a bedcam, to try to see what is going on.

Thank you,
Jim
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#23
RE: Jadazu treatment thread
If you look back at other days do you have snore quite regularly? That is just another sign of further restriction that needs to be treated.
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#24
RE: Jadazu treatment thread
Dave,

I have a couple of more nights of data now. The static pressure seems to be an improvement. The other good news is that this doc is willing to communicate by messages on the hospital web based health care management thing, and let me do the adjustment!

Geer,

No, I have no snoring reported on other days. Sometimes I'll have one or two small hashes on the graph, for the minimum duration that is marked.

Looking at this more, I think that I am having some inconsistent airway restrictions, that I'm still having some kind of positional problems. Now that I'm using the soft cervical collar, I don't have any reported OA's, and the flow restrictions have been reduced to about a quarter, or less, than the amount before i was wearing the collar. So the major obstructive issues have been obviated by wearing the collar, I think. And I think that most of the time, a relatively low support pressure is all that I need (when I'm in an 'average', or 'good', sleeping position). The de-saturation I posted above, I guess, is an edge case, where my position was almost, but not quite, bad enough for me to have a significant enough obstruction to have the string of OA's, like i used to have. In the subsequent two nights' reports, I haven't seen a hypoxic episode like it.

I'll post below a report from the night three before the the one I've posted above. I think this shows the success of wearing the cervical collar.

   

(This was prior to the new doctor's new prescription of 11cm cpap with 3 epr.) The obstructive issues seem to be under control, even at a pressure of 8cm. The new doctor suggests that the periodic breathing (the saw tooth parts of the SpO2 channel) is indicative of REM sleep, and not something to worry about. Without EEG, he doesn't know if it's disrupting the sleep stage, but suggests that the duration of the periods of probable REM suggest the they are not disrupted...   (It bothers me when I wake-up in them, breathing hard...)

   

So, the more that I'm learning, the less that I know about my disrupted sleep breathing...

Thank you, all, for the help. Without the forum, I would not have known about Oscar, and soft cervical collars. (The PSG sleep tech, the RT, and the new sleep doctor didn't/don't know about these. The sleep tech and dr were skeptical about me wearing the collar for the PSG. The dr asked why; I showed him a Oscar report of my sleep without the collar. I think it made an impression.) I feel like I can now start to consider my treatment successful.

Thank you,
Jim
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#25
RE: Jadazu treatment thread
You will always have the odd one off weird periods of apnea, flow limitations, snore etc. If you record yourself sleep like I have then you will realize that some of these instances are just plain old weird situations where you roll over and have your head cranked into the side of a pillow etc. Things like the snore are only an issue if they are a regular occurrence.

Your case is a bit complicated as there is an obvious positional aspect and a potential central aspect. Your doctor has an opinion but as stated he hasn't confirmed this opinion as it requires more data (EEG etc). We can actually see a bit more in OSCAR data than what he is using to create his opinion so keep on documenting results and if we see red flags will let you know.
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