Lorrubdb Therapy Thread: Fine-tuning therapy with Oscar

[Sleeprider]

Well your leak rate is excellent until the mask gets pulled away, then the result is predictable. This explains why leaks in your case are mostly associated with arousal and movement.  You are doing much better with these lower pressures and more EPR.  Good job!  Look at those steady  pressures and low event rate. 

[Lorrubdb]

Yay! Thanks couldn’t  have done it without you

[Lorrubdb]

Not sure what happened, but last night's  chart doesn't look very good to me despite low AHI.

 Is it from all the leaks? Didn't even know it was leaking but had a restless night.

Thanks Lorie












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[Sleeprider]

There will be good days and bad days. There is not much we can change in settings to resolve uneven respiration and leaks. My advise is, before you look at your data, ask How do I feel about last night. You may be surprised that there is a disconnect between how things "look" and how you feel.

[Lorrubdb]

Okay got it. Just disappointed after night before was so good and thought great, that's it I'm fixed forever!  But  no. 

I hear what you're saying about checking how I feel before looking my stats but actually, I felt kind of awful when I woke up, I checked my oximetry first because I was having drops to the low 80s and usually feel terrible when that happens. But it looked great with no desaturations at all. So then I checked my chart, expecting also that it would look great and was surprised it looked so bad. I wore the same face mask as when I had low leaks but this time it leaked, weird because I didn't feel it blowing like I usually do and start tightening, taking it off and on etc. Exhausting really. Wanted to ask you-I have a deviated septum so does that mean the nasal masks won't work well for me? 

Thanks Sleeprider

[Sleeprider]

Nasal pillows usually open the nasal passages and make breathing easier. Nasal masks will work as long as they don't press inward on already restricted parts of the nose. Deviated septum seems pretty common, it's a matter of degree.

As you observed, last night was not as good as the night before. What was different? It wasn't the CPAP, so the task is to start to look for other aspects of our sleep and health.

[Lorrubdb]

Thanks will try the nasal mask again tonight.

So you're saying the cpap data looked ok to you and wouldn't cause discomfort the next day? I'm just asking because I really don't know what to look for and just saw erratic lines which I thought can't be good. But you're right, there could be other causes, thinking I tried to go to sleep too early which disrupted my cycle and up a lot during the night so tired. Probably TMI but stomachaches don't help.

But I feel better now, so will go walk my dog and see how it goes tonight

[Sleeprider]

Your breathing varied a lot from breath to breath giving the flow-rate a very "brushy" appearance. I don't personally experience that, and I don't know why it happened for you, and certainly am not going to say it might not be disruptive to sleep. What changed from the night before?

[Lorrubdb]

Well yes you're right- there was something different- I got an oxygen concentrator and hooked it up to the cpap hose. Could that be it? Maybe that's why my sats looked good but breathing was off. Just looked at it and it's up too high at almost 3l, should be at 1 or 2.

So do you think I'm better off without it?  Maybe I don't need it since it seems to be altering my breathing. I asked my doc for it awhile back, but my sats have been good lately with just cpap and new settings. It was actually my idea, not his so don't think he would mind if I don't use it. Felt gasping for air when I got up, maybe it's working against the cpap.

Not asking for medical advice just your thoughts on what to do given your extensive knowledge and experience-I mean you knew right away something was different.

[Sleeprider]

An oxygen bleed to CPAP is conventional for someone that needs it, but I expect it to be done at the direction of a doctor, and through a proper oxygen bleed port in the tubing or mask. How was yours hooked up? Why do you think supplemental O2 is needed. Your welcome to read my Oxygen Bleed With CPAP article here http://www.apneaboard.com/wiki/index.php..._with_CPAP

It would be a great help to both of us if you would try to keep conditions as constant as possible, and especially adjust your attitude towards CPAP that it is mostly you that controls the variables, not the machine. If you find something that works, then it makes no sense to just throw something else like a new mask, different pressure or oxygen into the mix as if it has no effect. Not being critical, but I can usually tell when someone is messing with their therapy.