Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Lingering fatigue: trust Resmed sleep report?
RE: Lingering fatigue: trust Resmed sleep report?
(09-15-2019, 07:19 PM)Dormeo Wrote: Hello, gcritchley, I'm responding to your problems with the ballooning cheeks.  

I think in my case, little bubbles of air sneak around my imperfect tongue seal over a period of minutes and pile up until (a) my cheeks puff up or (b) I swallow the air or © I loosen a corner of the mouth tape and let it out.

I experienced this problem whenever I made pressure increases both with the Airsense ResMed 10 Autoset that I used to use and with the Vauto I use now.  I doubt you'd see any difference switching to a Vauto.

What always seemed to help was just to raise pressures very slowly, staying at each new pressure for at least a week (usually longer).  At each new pressure, I would renew my attention to the position of my tongue and jaw.  (I used a collar for a while, though no longer feel the need.)  Over time my body would somehow learn to adapt. I hope time will be on your side too.

Thanks dormeo - i will try the idea of making slow adjustments with lots if time to adapt - thanks the that suggestion. What made you switch machines?
Post Reply Post Reply






Donate to Apnea Board  
RE: Lingering fatigue: trust Resmed sleep report?
(09-15-2019, 08:01 PM)bonjour Wrote: Let's start with you causing the air blowing out of your mouth to occur "on demand".  Put your mask on, under pressure, any position is ok.  Open your mouth while still holding the seal, no air should escape your mouth.  Now, consciously, open the back of your throat bu moving your tongue.  I had to, at least initially, shut the machine off to stop it.  

Another exercise is to talk while under pressure.  That too takes some time to get it down.  Do this frequently and you will learn how to handle it, eventually stopping it without turning off the machine.  I can assure you that this doesn't happen overnight.
Your suggestions with the exercises have been helpful - i think I've finally figured out how to make my tongue seal the airway escape (i tried all of the above last night).. I'm going to try a night (or at least a few hours) without tape and see it my sleeping tongue stays in place. That would be awesome.
Post Reply Post Reply
RE: Lingering fatigue: trust Resmed sleep report?
(09-15-2019, 10:24 AM)mper6794 Wrote: Hi, gcritley
Well come back. Your curves, If i may:
1_poor nights' sleep, very S.E., due tens of arousals/awakenings. What is causing the arousals? Will see soon, i believe, in ten-minutes windows calibrared by audio-recording;
2_flagged FL yet not totally under control; provoking arousals/aw.
3_unflagged Air Flow Reduction (AFR) may be a big issue; provoking arousals/aw;
4_both 2 and 3, and high pressures drawbacks, could very much be benefit from going to BPAP;
5_Plm's-associated arousals/awakenings keep on going as strongly suspected.
To start with: could you please post some ten-minute duration windows embracing arousals/aw?

Lot to learn with your case; similar to mine at the beginning.

Good luck

Looking at tonight as the test night if i can get the infrared camera and recording software working. I'll be back to report on that - thanks again!
Post Reply Post Reply
RE: Lingering fatigue: trust Resmed sleep report?
(09-16-2019, 08:05 AM)gcritchley Wrote:
(09-15-2019, 07:02 PM)bonjour Wrote: I don't believe that flow limits are the source of your issues.  I believe that they are well enough managed at this time.  Yes you could marginally improve them, but as I said I douby that that will resolve your issues.
Thanks Bonjour - I appreciate definitive statements like this, and I know you've seen many other cases with flow limitations as a factor. I've been following waketired's thread and have read your comments there, and hoped you'd weigh in. Thanks for all you do - your help here with me, and with the others in this awesome forum.

I keep seeing everyone talking about flow limitation, but I'm not exactly sure what that means......... Can anyone give me an easy to understand definition? I know I'm still extremely tired all the time, and from my sleep study, I know I also have a LOT of RERA's. I also wake up every two hours like clockwork. I just switched to a nasal pillow from a cushion, so that's helping with leaks (that had gotten ridiculously high), so I'm hoping it helps...
Post Reply Post Reply






Donate to Apnea Board  
RE: Lingering fatigue: trust Resmed sleep report?
Flow limitations. There are more words and definitions behind this stuff. But simply

Apnea. 80 - 100% reduction
Hypopneas 50 - 80% reduction
Flow limits ?? - 50% reduction in airflow

You could argue the actual cause or the word restriction or reduction but in our CPAP world all of these are measured by flow so reduction.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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.
Post Reply Post Reply
RE: Lingering fatigue: trust Resmed sleep report?
(09-16-2019, 09:20 AM)bonjour Wrote: Flow limitations.  There are more words and definitions behind this stuff.  But simply

Apnea. 80 - 100% reduction
Hypopneas 50 - 80% reduction
Flow limits ?? - 50% reduction in  airflow

You could argue the actual cause or the word restriction or reduction but in our CPAP world all of these are measured by flow so reduction.

I will add to the above by saying that flow limitations can be a cause for arousal from sleep, so while they technically aren't part of any obstruction events, they can contribute to daytime sleepiness, and are worth looking into if possible
Post Reply Post Reply
RE: Lingering fatigue: trust Resmed sleep report?
HI - I know I'm due to continue this thread with some video evidence/audio recordings to look for proof of PLM or other reasons for awakening, and how that possibly relates to Flow Limitations. I've had some issues getting my IR camera online, and having that all in place, and have been too occupied elsewhere.

Oddly enough, I have felt a little better the last few days. Full disclosure on all that's new - I started something called LDN (low dose naltrexone), which I found touted on a facebook group (if it's on the internet...) as a miraculously helpful medication for all sorts of things (mostly inflammation based issues), including, for some, sleep, but for others, anxiety, Fibro, chrone's, depression etc. That seems to be kicking in, or at least the placebo effect might be - I have a deeper feeling sleep, and more dreams in the last few nights, and my usual daily nap only happened one out of the three nights. Also, my blood tests came back normal (according to my conventional doc), but my TSH thyroid levels were on the high of normal, and he suggested iodine, which I started and which might be helping. I'm looking further into the thyroid thing, since "normal" isn't necessarily optimal, outside of the conventional approach. Also, sitting still for a couple of weeks without changing up my machine settings too much might have allowed things to settle in that department. As you see it's a multi-tired approach to feeling more rested.

To that end, on the PAP side of life, I found an amazing deal on a Resmed VAuto BiPAP, and it was too good to turn down ($300) so I decided to get it and at least try some of its options. At least if there's no benefits, I can sell/donate it, and/or the other one. I thought about starting a new thread with my specific question for today which is this:

Can anyone here please help me set my initial settings on the new to me Aircurve Vauto, based on my current settings on the airsense 10 auto? In that way I can "kind of" start at the same point I am now, and then make adjustments to the PS and other settings etc moving forward - to further see if some of the remaining Flow Limitations will respond.

I attached a screenshot of last night's sleep.

My current settings on the Airsense machine are as follows -  I'd like to start on the new machine tomorrow night (It arrives tomorrow)
Mode - APAP
Pressure Min - 9.40 cmH2O
Pressure Max - 12.20 cmH2O
Antibacterial Filter - No
Climate Control - Auto
EPR - Full Time
EPR Level - 3cmH2O
Humidifier Status - On
Humidity Level - 3
Mask - Pillows
Patient Access - No
Ramp - Off
Smart Start - Off
Temperature Enable - Off

Thanks - I will be reporting with camera/audio findings soon when there's not too many things going on at once. I'm excited about this new machine.


Attached Files Thumbnail(s)
   
Post Reply Post Reply






Donate to Apnea Board  
RE: Lingering fatigue: trust Resmed sleep report?
Hi, gcritley
wondering If Could we go with some 6 ten-minutes windows involving contrasts, spikes, noisy, on the tidal volumes.
GL
Post Reply Post Reply
RE: Lingering fatigue: trust Resmed sleep report?
(09-19-2019, 11:02 AM)mper6794 Wrote: Hi, gcritley
wondering If Could we go with some 6 ten-minutes windows involving contrasts, spikes, noisy, on the tidal volumes.
GL

Thanks mper6794!! I think we should wait until I'm using the new machine, and see what is still there, no? That way I can make adjustments based on your own successful history? Do you have suggestions for my settings on the Aircurve machine?
Post Reply Post Reply
RE: Lingering fatigue: trust Resmed sleep report?
Looks fine... .. However, looking into a bit more into details on your charts, would eventually help at making better base to suggest parameters. For instance, your flagged FL is pretty much under control with EPR: 3.0. But, I would like to see about existence or not of not of unflagged flow reductions, which also could account for some of your tens of awakenings (it appears not, yet have to confirm on 10min-windows).... involving contrasts, spikes, noisy, true CA's, reason for wake up 5:30, on the tidal volumes.
GL
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Do sleep aids effect sleep study results wking 5 81 59 minutes ago
Last Post: SideSleeper
  A deep report on sleep treatment racprops 35 1,290 10-21-2020, 07:05 PM
Last Post: racprops
Question First time poster, long time CPAP user with an OSCAR report. Afasterme 8 203 10-13-2020, 09:29 PM
Last Post: Afasterme
  Requesting Sleep Report Analysis & Second Opinions omariumprime 31 687 10-10-2020, 01:32 AM
Last Post: omariumprime
  Leak rate - What does Resmed Airsense 10 report? elliotg 5 203 10-03-2020, 12:32 AM
Last Post: elliotg
  [CPAP] Help understanding OSCAR report Dodgie 7 167 09-24-2020, 09:11 PM
Last Post: Dodgie
  Oscar Report bossfan50 9 193 09-24-2020, 08:42 AM
Last Post: bossfan50


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.