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Looking for some help - almost 5 years and not feeling a lot better
RE: Looking for some help - almost 5 years and not feeling a lot better
@bonjour - thank you very much.  If I am following this well enough, then EPAP = IPAP - 1 - PS.  That would make for the following settings.

IPAPmax = 15.4
EPAPmin = 10
PS = 4.4
IPAP can vary between 14.4 and 15.4 to allow some correction in flow rate

I will try this tonight.  

As I told @sheepless, I'm irrationally avoiding a retry of the "million dollar day" settings, for fear it won't work again.  There were a lot of flow rate issue on that day, but I felt better that single day than I have in probably five years.

Hoping that the added PS of your recommendations will help me.  Thanks again.

For some reason, there is at least a 10 minute delay between when there is a change on AB and when I get the email notification.  Weird.
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RE: Looking for some help - almost 5 years and not feeling a lot better
great you can report how you felt at each setting! conclusion: you felt better whenever ipap max was 12.

try bonjour's suggestion. if it works, great. if you're not thrilled, readjust, keeping whatever epap plus ps (ipap) you set at 12 or below.

don't worry that you're getting a variety of suggestions; it's all about trial and error and afaik the worst that can happen is that you feel lousy. btw, there's no harm and on the contrary some considerable logic to going back to a setting that felt good. sometimes it works, sometimes it doesn't though. no rhyme nor reason I can tell. we just have to try and try again; eventually you'll find your sweet spot.
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RE: Looking for some help - almost 5 years and not feeling a lot better
I think you understand but your terminology is wrong
IPAP = EPAP + PS always, IPAP and EPAP are actual pressures, not settings and by definition IPAP = EPAP + PS.

your formula should have been EPAPmin = IPAPmax - 1 - PS as EPAPmin and IPAPmax are settings.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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RE: Looking for some help - almost 5 years and not feeling a lot better
@sheepless, appreciate your confidence in my ability to dial this in.  I will get there, it's a matter of when.  AB members have been methodical, which helps me feel better about the process, even if it's not as deterministic as I had hoped.  

Feeling lousy hasn't been a one day event for me, it's been over a much longer time span and it saps a lot of your life force away.  I'm longing for a time when I feel the life force coming back.  Plugging away at it, sorting through the new information as it comes in, even though I have been struggling to stay awake today.  I was feeling tired at 10am, and it hasn't improved.  Not one of my better days.

Looking forward to tomorrow and hoping it's better.
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RE: Looking for some help - almost 5 years and not feeling a lot better
I hear you happydreams and know how it is all too well. most of us are or have been where you are. even old hands still have awful days on occasion.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Fred, I'm sure what you wrote will make sense to me in the morning, but it sure doesn't tonight.  No fault of your own, I own my blockheadedness tonight.  So you can see what sleeplessness does to me.  Robs my reasoning and the ability to communicate effectively.  Sorry to put it on such public display.

Hope I got the settings right, as I stuck them in the machine.
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RE: Looking for some help - almost 5 years and not feeling a lot better
28 CA events after sleep onset. 2 OA, 0 H, 8 UF2.  Really feel pretty beat up today.  Quite sleepy, groggy, somewhat out of touch.  Don't have a classic headache but more of a squeezing pressure on my temples.  The titration is tough on me.  Is this normal?  Lungs feel almost sore, more inflated than before.  Feel over-ventilated, if there is such a word.  Median TV = 340, same as yesterday.  (Pretty much the same as it has been for 5 years.)  

Of note, is the integrated time of the "expiry prolapse" last night was actually longer in duration than yesterday's with lower PS.  (By that I mean sum of all the events during the night is a greater time in seconds than the night before.)  Don't know if this is significant, but I mention it.

Unfortunately I have no video for me to check anything.  Zero events captured last night.  Yesterday, I probably messed up the record settings.  App seems to have changed due to an update.  (Updated to crazy backwards logic, I might add.  My settings were record on motion from 2000 to 0700.  App changed it to 0700 to 2000!  Saying t1 had to be greater than t2!)  Had recording during the day, but none at night.  I hope I have fixed the video problem by enabling recording all the time 0000 to 2400.

So, if we are to talk about feelings, today is no good, about as terrible as I have felt in a long time.  The only good thing I can say is I am on the correct side of the ground, but most other indicators went the wrong way.  If it's even possible, blockheadedness is a bit worse.  

Aside: This pains me since I have long made a living out of creative work.  Lowering the blockhead index is a key metric for me!  Bad sleep does not help me one bit.

What do you recommend, my friends?  Seeking a few bits of your wisdom.

  1. Give it a day at the same settings hoping for improvement?
  2. Same as #1, but Trig=Very High?
  3. Back down on PS?  To what?  Over what range?
  4. Try to duplicate the "glory day setting" and work/fine tune from there, despite lower pressure levels and support?
  5. Something else?
Notice there's no option to quit.  To be honest, I feel like it at the moment.  However, I am determined to see this through to a positive conclusion.  Trying to remain upbeat.  But it was a bad, bad night, and it's already a long day at 9:35AM...

   
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RE: Looking for some help - almost 5 years and not feeling a lot better
I myself would not like these results with higher CA. I know the overall CA was 3.x but if the count is 28 events, that is likely the source of it being a bad day now. What to suggest? I'm going to have to defer, as the only thing I think is maybe pretty much straight CPAP to Avoid/treat the CA. By doing so, it's likely all the other events kick upwards. Let's get a coffee and hash it out.
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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RE: Looking for some help - almost 5 years and not feeling a lot better
I'm going to say another night, just to make sure it is not a fluke. If the same is true then revert

PS=3.0 over 8.4-12.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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RE: Looking for some help - almost 5 years and not feeling a lot better
Thanks for the guidance @bonjour.  It was a tough night, but if I have to score at this moment, yesterday was slightly worse.  

Some additional observations in a following post.
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