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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
With your Ti Max set to 2.4, if you take a l-o-n-g slow inhale that lasts longer than 2.4 seconds, you will feel the pressure drop.  Like the above post states, Ti Max extends the maximum length of time that pressure will maintained at the inhale pressure level. Likewise, Ti Min is the minimum time allowed to lapse before the pressure drop is allowed to occur. If you have your Ti Min set to .8 (seconds) then the CPAP will not allow your pressure to drop to the exhale pressure setting before this time is reached.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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RE: Looking for some help - almost 5 years and not feeling a lot better
(10-29-2020, 11:41 AM)Crimson Nape Wrote: With your Ti Max set to 2.4, if you take a l-o-n-g slow inhale that lasts longer than 2.4 seconds, you will feel the pressure drop.  Like the above post states, Ti Max extends the maximum length of time that pressure will maintained at the inhale pressure level.  Likewise, Ti Min is the minimum time allowed to lapse before the pressure drop is allowed to occur.  If you have your Ti Min set to .8 (seconds) then the CPAP will not allow your pressure to drop to the exhale pressure setting before this time is reached.

Thanks again.  My Ti_min is default, or 0.3 seconds.  Do you think there is a need to change it?

Proceeding with your recommendations tonight.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Just leave it alone at this time. If you see that you are taking short rapid breaths, then maybe play with it. I'm playing with mine to see what impact it may have. The manual stipulated a .8 setting for a 20 breaths per minute rate and that is where I had it set. I have increased it to 1 second to see what happens.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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RE: Looking for some help - almost 5 years and not feeling a lot better
Sorry for some of this navel gazing...  Guess that happens when you can ponder about things.  What does it mean when flat spots occur on the expiratory portion?  There's no flagging of snoring.  

Aside: Why does OSCAR autoscale the popup?  Just means I have to rescale it.  Why is the date in the popup today's date, instead of the date in the summary?

On the left side is the stuff I am talking about.  On the right, I have gone back to my "normal" breathing pattern.  My "normal" pattern seems to be expiratory mouth breathing.  What is the stuff on the left?

Here's the picture:
   
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RE: Looking for some help - almost 5 years and not feeling a lot better
I believe your chart is showing your airway closing.  This is probably due to chin tucking.  Also, everything above the red line is an inhale and everything below the line is an exhale.   I may not be understanding correctly about your graph limits.  If you right-click on the graph label, select Y-Axis then change it to Override and set your upper and lower boundaries.  It should maintain these until you change them or select another boundary type.

EDIT:
I just re-read your post. Ignore what I said about the graph.  What you described is being looked into for a future OSCAR release.   Comprehension is not my strong suit today.

The stuff on the left still looks like chin tucking. It also looks like a hypopnea in the making. Notice your flow values have almost diminished to 60% compared to the ones on the right.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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RE: Looking for some help - almost 5 years and not feeling a lot better
(10-29-2020, 02:42 PM)Crimson Nape Wrote: The stuff on the left still looks like chin tucking.  It also looks like a hypopnea in the making.  Notice your flow values have almost diminished to 60% compared to the ones on the right.

It happened at least five times last night, but none were flagged as hypopnea, nor user flags.  
For reference: My user flags are set to UF1 20% t>9 sec, and UF2 50% t>9 sec.  

PEEP should help address this exhalation issue, by keeping the expiry portion more pressurized, correct?

I am wearing a 2" soft collar.  It's neither loose, nor is it tight.  If it's tight it feels like it's cutting off my airflow.  It does seem that it would prevent chin tuck, maybe I'm not doing it right?  Or the wrong size?
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RE: Looking for some help - almost 5 years and not feeling a lot better
Don't go looking for trouble. It will find you easily enough.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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RE: Looking for some help - almost 5 years and not feeling a lot better
Knock knock it's me trouble.
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
Trouble who? Smile
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RE: Looking for some help - almost 5 years and not feeling a lot better
Crimson Nape, you were right, some "trouble" did come find me.  And no, SarcasticDave94, it wasn't you!

Results of last nights changes.  The changes were large enough to "upset the balance" previously achieved.  My quality of sleep was worse, both in terms of feeling and numerically.  The increased pressure has caused more leakage into my eyes, resulting in noticeably bigger and fuller eye bags.  My eyes were very watery this morning.  This is not good for my dry eye conditions.  This is despite the fact that my median leak rate was lower last night than the previous night.  Except for last night, using the ResMed has resulted in dramatically smaller eye irritation than my Respironics.  Might be due to how the pressures are managed.

So CA's are up.  OA up slightly, no H = same.  UF2 about the same.

I'm dragging as of this writing.  Yesterday was a lot better.  My lungs sort of feel filled, or kind of expanded.  It's an odd sensation, but I noticed this with the ResMed at the higher PS.  Headache is slightly less, but not by much.  Median Tidal Volume actually is slightly less than the night before, despite the pressure rise.  Last night 340, previous night 360 - go figure!  I seem to be a contrarian...

I have been getting dried out in the evening, so I'll be using the humidifier this evening.  It's been relatively cold here, and the heat has been on, lowering the humidity quite a bit.  This morning it's snowing.

I'm guessing as what to do next.  It seems it takes a while (for me) to adjust to the changes, so it might be prudent to simply leave it alone and see what happens.  Hopefully the CA's will come down again.  Might change to Trig=Very High, as everyone has suggested and see if there's a change.

Compared to the previous night, the expiratory issue I noted, is far less frequent.  I only found a single instance last night, it was just after sleep onset (respiration rate was at median) and the duration was for 2.5 minutes.  This is a bit of progress.

A minor step backwards in the journey.  Hope for more forward movement in the future.  Please advise.  Thanks in advance for everyone's advice and insight, as it's all been very helpful.

   
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