Looking for some help - almost 5 years and not feeling a lot better

[happydreams]

I had a discussion with a medical provider today.  At the end of the conversation I said, "I don't want to continue to be tired, headachy, energyless and unrefreshed (after a night's sleep).  I want to change things in a positive way.  If I don't do this for myself, who will?"  This evoked a positive response.  

Thanks to everyone here for giving me the confidence and (some of the) knowledge to proceed!

@bonjour's settings recommendations are programmed in for this evening.

IPAPmax = 12
EPAPmin = 8.4
PS          = 3

Trig      = High
Ti min  = 0.3s
Ti max = 2.4s
Cycle   = Med

[happydreams]

Trying to report in.  Can't show you any data, OSCAR won't import it!  Have reported this on the Software Forum.  It is a timestamp issue in the sw, not an SD issue.  The data is on the SD card, but OSCAR is misinterpreting the date into the future and refusing to import.  OSCAR 1.2.0.  Debug log on other thread.

Some qualitative notes.  Felt very easy and relaxing at the settings last night.  Felt easy to drift off to sleep.  This morning I got up earlier.  Not much fog, although still a headache just over my eyebrows.  Headache is a steady pressure.  (My body's indicator that something's up with my sleep.)  No aerophagia.  Eye bag size reduced by 1/3 from yesterday.  However, my eyes were tearing in the morning.  Lungs don't feel quite as sore, so that's good.  Hope that feeling goes away, as it's not comfortable.  Been up a few hours and doing things.  

My dumbo ResMed indicated a 1.8 for the night.  Jeesh, the ResMed has a really poor data review, practically nothing but two clown faces.  For me anyways, the faces are liars - they indicate all is well, when you feel lousy.  It's a pity they are only gross indicators.  The "more sophisticated" data only seems to be long term averages.  (That or I'm misinterpreting it!  If so, please let me know.)  OSCAR is so much, much better.  Hope I can get it to import again!

Have to say, I don't feel good yet, but so far today is significantly better than yesterday.  More than willing to spend a few days at this setting to see if there will be further improvements.  (Body adjustment to change.)  Or even tweaking a little now.

[happydreams]

Can't tell you how this worked, but after closing OSCAR and restarting it, the import was successful.

AHI = 1.86, CA=1.11, OA=0.74, UF2=0.49.  Everything else 0.  Median TV=320.  TV is lowest number I have had on the ResMed, but is pretty close to my 5 year long term average.  I'm not concerned.

8 CA, 6 OA, 3 UF2 (17 events)while asleep.  This compares with 19 CA, 4 OA, 13 UF2 (36 events) the night before.  Over 50% better!  TTIA = 04:27.  Previous night: 06:05.  Going in the right direction!

CA's seem normal, not seeing big clusters.  Had an OA CA OA event around 1:20am.  The last OA was 49 seconds.  Seems like that's a long time not to breathe.  Next longest OA was 24 seconds.

Had several events where the machine was unable to correct as it was pegged at IPAPmax.  (Example: 1:20am)  

Still some expiration flattening as previously shown, but as long as the number of events are way down, I think they are of minor importance.  The cure for expiry flattening (high pressures) felt way worse than the issue itself.  Nonetheless, I will keep monitoring it.

If you need a screenshot, I'll post it.  (Used up 2/3 of my storage allotment so far...)  Thanks!

Got my video to work again.  Wanted to check on body movement vs apnea events.  Still around 50%.

Last night
Body Movement: 10 occurrences captured on video
Total Events:       17
Apneic events:     11  (CA, OA, H)
UF2 events:          2  (flow <= 50% for t>=9.0 seconds)
Micro events:        4 or 5 captured on video.  Micro arousals in waveform that corresponded to body movement.

Comments?  Repeat tonight with same settings?

[SarcasticDave94]

I'm inclined to continue with no changes. I know it's not some Eureka breakthrough moment, but there are improvements. As for attachments, if you run out of room, it may be necessary to delete the oldest few. And you mentioned that you think IPAP max is hindering taking care of a few events. Are these single apnea event or clusters as in positional? The last IPAP Max I see is 12; that observation you gave that the PAP machine can't go high enough to combat events is probably true.

[happydreams]

IPAP flattens a few times since it is limited by IPAP max. No rapid fire clustering of events this night!  Here's a screenshot.  
   
As noted earlier, about 50% of the events are positional.  It amazing how much movement there is.  A couple movements are almost straight sitting up in bed.  Then I grab the covers and pull them around me and settle back in bed.  Don't understand, as my sleep studies indicated practically no movement.  Prior to the event, I was covered, so don't understand the need for movement.

Perfectly content to try this again...  Hope it will get even better.

[happydreams]

Today (last night) was worse than the previous day.  Although the headache is better, I'm a bit wearier.  
IPAP is hitting the limit a few times, so it seems I should up IPAPmax a little, so there's some room to help with the OA's.  
Yesterday  9  ca, 6 oa, 4 uf2
Today      11  ca, 8 oa, 7 uf2

I'm considering IPAPmax = 13, PS=3.2, EPAPmin=8.4.

Clusters at 3:08, 4:47, and 5:30 seemed to be positional.  Video shows a lot of body movement.

Comments?  Suggestions?
   

[SarcasticDave94]

You could try that and see. I honestly do not know what direction to advise. With relatively low numbers as here, it is based on feel. And you indicate you're not getting better for the therapy. Is there anything else interfering?

[happydreams]

@SarcasticDave94 Don't honestly know, if there's something interfering.  Certainly not obvious.  Didn't go to bed angry, or anything like that.  No more stressed than normal.  Didn't eat late, no late snacking, etc...  

Oh, I know!  Had 2 warts nuked with liquid nitrogen yesterday.  Hurt like hades.  Periodically the pain would come up during the day.  Don't know if it would have interfered with sleep though.

Despite the numbers today, did a lot.  So much so that I'm a bit sore from the exertion.  Lots of leaves!  Equivalent of 20 yard bags full.  Cleaned out the garden as well.  All in a couple of hours.  Last week, with the extreme sleep disruption, I couldn't do much at all.  Seems positive.  Durn frozen warts still hurt today.

I'm not looking to change settings a whole lot, but still need to make a few tweaks to lower my total apnea time.

[SarcasticDave94]

OK understood. Change settings as you feel you need to. I myself don't see what's preventing good therapy.

[sheepless]

see if v high trigger brings your ca down. I'd leave ipap max at 12 or under consistent with your how-I-felt chart above. besides feeling better at lower ipap, increasing ipap may increase ca. after a night w v high trigger, you may need to adjust ti settings depending on how it feels to you.

edit: ca is higher so I'd try to deal with that first but if you're determined to address oa, raise epap a hair.

edit2: your chart looks pretty good. if you still feel poorly, I'd look into the movement you often mention. movement causes arousals, even if we're not aware of it.