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KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
#31
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Chapter 14, Tue, Nov 14 night

No setting changes.  (Mask size small, Large nasal pillows, Standard hose)

It took me about an hour awake/sleep. Finally went on my back and slept deep.  I woke a couple of times.   A couple of times woke up breathing deeply.  I felt like there was no pressure, I realized I was congestion so went on my back. When I finally woke up and took off my mask I felt a bit groggy.)   I was surprised when sleep report showed 0 AHI. (I forgot to turn down heater before bed.)

I need to figure out how to keep Spont Cyc high.

Well after 12, time to check OSCAR.
The flow rate peak around 3am (2AM) was me taking.
The some of the snores seem to correlate with the leaks.   I checked other nights, in which leaks did not show snores.  The leak rate was under 10 Lmin.  Sat, Nov 12, I had higher leak rates with very little Flow limitations and Snore events.

I would like to increase IPAP.  Not sure if I should increase EPAP a bit and also the PS a bit or just the PS. I want mzx IPAP be set above the max pressure is reached..

I included a scan that almost was an event.  FOT was used.


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#32
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Correction from previous post:  Chapter 14, Tue, Nov 15 night  {not 14}

Chapter 15 - Wed, Nov 16

I wanted to increase IPAP for the snores the previous, but I did not want to increase the PS by 1 cm, so I increased both PS and EPAP.

PS       5.0 -->   5.4 cm
EPAP  14.0 --> 14.6 cm
IPAP   20.0 --> 22.0 cm

When I woke up during the night I felt congested and felt it was hard to draw a breath on my side so went back on my back which felt less congested.  Maybe sinuses drained better.

I felt like I got deep sleep without many wake ups, at least do not feel like I stayed awake a lot. 

Thursday during the day felt tired and feverish.

Oscar only includes the session I was sleeping. Not the 1 min, before taking mask off and the 30+ minutes in the morning trying to go back to sleep because I was tired.

----

Chapter 16 - Thur, Nov 17

Made small changes.
 
PS        5.4 -->    5.6 cm
EPAP   14.6 -->  14.4 cm
IPAP    20.0 -->  24.0 cm

Before falling a sleep I felt I did not have enough time to take my breath in again.  It was a while I felt like that.

I got deep sleep.  The hose came off my mask (first time), put it back on and went back to sleep.  I felt congested on side and went on my back.  I woke up tired and foggy.  I blamed it on not feeling well.  I was surprised the hose was off for 30 minutes and I did not notice the noise next to me.

I so hope the deep sleep is partially due to the fact that I am slowly getting CPAP treatment settings right for me; and not just my body fighting something.

--

I am debating whether I should adjust pressure while sleeping heavier now or wait to get bug out and maybe sleeping lighter or adjust now to eliminate arousals and than adjust down slowly.

I am thinking of putting EPAP back to 14.6 cm and  PS 5.8.  I wonder if higher the PS the more time needed to inhale.


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#33
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
I am posting an OSCAR, I am thinking the flow limitations are during inhalation and should be increasing IPAP/PS rather than EPAP.


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#34
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Yes... I think, by (ResMed's) definition, flow limitations are calculated during inspiration.

And, yes, usually flow limitations are handled by increasing the Pressure Support (or EPR). (Which may increase the CA)
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#35
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Thanks pholynyk.



Chapter 17 -  Fri,  Nov 18 Night

I increased
PS by 0.2
EPAP by 0.2

I switched to ClimateLineAir again.  I don't know if it makes a difference.  I had trouble pacing the breathing before falling asleep.  Did not sleep as deep as last wo days, but I think better than before.

I am still slowly working on reducing flow limitations since they disturb my sleep.

Once again last night, I put my hand in front to see if there was any air coming out.   I remember the air can move something a couple of feet away.  (Now I am wondering with the gap in OSCAR around 6:30 am maybe coincidence.)


I worry that  I am making my lungs work less if I keep upping PS, don't know if that makes sense.  I usually jerk my head and gasp awake when I doze watching TV.  This pass week, I noticed I did not do that. I don't if that is a good thing or not.


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#36
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Chapter 18 - Sat, Nov 19

Last night I lowered the Trigger Control from Very High to High.  I did not get many events.  I  plan on switching it back to Very High for a few days.  Next time I switch to High I will make sure I amusing the Standard hose and see if the lower velocity of air will keep enough CO2 in the mask.  I did not realize when I lowered the Trigger Control I was testing the Climate... tubing.

I did not change anything else.

I remember dreaming during wake ups.  I have not remember dream this pass week or so.

Feeling very tired. Just want to close my and sleep tired and fuzzy, even though I have been awake awhile.

Breathing calmly is still an issue during some wake ups.


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#37
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Hi,
_ amazing case: feeling bad with such rather beaultiful waveforms and high domain pressures. Keep following your case with much attention;
_ keep having flow limitation (flat flow rates) with PS: 5.6 is impressive.
_ you have very low CA, RR, and tidal volume;
_ therefore, there would plenty of room to increase PS, in my modest opinion. If were me what I would try keep EPAP at some 12.00 and gradually increase PS until some 10 (or up to CA explosion) and see what happens. It might work, eventually.

good luck all the best
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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#38
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Mper,

LOL, at "impressive".  


I am not ready to decrease EPAP.  I am hoping to decrease flow limitations/arousals before I max out the VAuto.  I am prone tp migraines which sleep disturbance brings on.


***********


Chapter 19 - Sun, Nov 20

Trigger Control back to Very High.

I increased PS to 6.0.  AHI = 0, with some flow limitation and snore.

Chapter 20 - Mon, Nov 9

Was very tired in evening do I increased PS to 6.4

Usual wake ups.  A couple of times in early morning woke up and noticed I was exhaling by my mouth.   I put my mask back on in the morning.  I woke up trying to breath and very bloated.  I noticed I was congested.

Qurstion:

I am posting two events, which I think may have happened after I woke up, but not sure.  Is this considered wake junk?


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#39
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
In the most recent whole charts you've posted, your flow limitations are minimal. I would not recommend further increases to your PS. I'm also not sure why you've been increasing your EPAP. I would encourage you to settle in with some comfortable settings and stick with them for a month or two.

On the zoomed-in recent post, you held your breath for a fair while, then had the chaotic-looking breathing typical of being at least partially awake.
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#40
RE: KeepSmiling’s Book 2, ResMed AirCurve 10 VAuto Adventure/Treatment
Dormeo,

Thanks for info my scan. 

I was increasing EPAP because when I had increased PS to much I had gotten a migraine so I was using both PS and EPAP to giver a higher IPAP pressure.

_______


 Chapter 21 – Tue, Nov 22

Unfortunately I did not put SD card in again.

I woke up congested and dehydrated. I took off mask to drink water.  I fell asleep without mask on.  I woke up about 45 min later and put it back on.  I have not done that in a long time. 

_____

Chapter 22 – Wed, Nov 23

I remembered to lower the heater.  Made a difference on my nose.

I used my weighted blanket for the first time.  I did not realize how heavy it is.  I just bought the least expensive one.  I figured $30 was worth it to try it.  

I felt like I got into a deep sleep (slept for a longer period of time or not staying awake to remember waking up). 

I tried falling back asleep after going to the bathroom.  At one point the eye pulling was not going to go away so I got up to take a migraine pill.

Sleep was to short and a couple of wake ups.   I feel groggy (maybe the migraine) and brain fog.  

IPAP was not high enough for the flow limitations.


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