Lorrubdb Therapy Thread: Fine-tuning therapy with Oscar

[Lorrubdb]

Say hi to Louie

[SarcasticDave94]

I see you're concerned with these Centrals that increased a bit on this OSCAR chart. I wouldn't give it much thought, they aren't a big factor, and aren't worthy of your time. If you use a concept I've done myself, put into mind to ask "what trend am I dealing with here?". To me regarding anything Apnea, a trend is some data happening or event that is 3 or more days worth.

I know Central Apnea and you need to be mindful that there's a consistently inconsistent factor at play. They will naturally be up and down in frequency per night. Trust me there's no need to concern yourself about these CA, they're a very low concern at this level.

I want to convey something I had to learn about Apnea and treatment. The word I used earlier, trend, is vitally important. Notice in your data something that affects your therapy and sleep that is present 3 or more consecutive nights. On one hand, take each night by itself alone. If you slept well, then peek at the data to see what it looks like, note its look and pattern, a mental image of it, and move on. If something occurs 3 nights that take away from that good night feeling attribute, only then do you investigate the data with more intensity. You'll see something different consistently that's not the same as the good nights of recent. This could be pretty much anything, Apnea, Hypopnoea, flow limits, leaks, sleep duration, oxygen level, and so on.

The thing about Central Apnea is that consistently inconsistent factor means they will for most not meet the trend filtering. Unless your CA are like mine, you can safely disregard. And I see the CA pattern you possess and you fit in the safe to ignore CA category.

It'll take time, but learn the trends that generate the feeling of a good night's sleep by observing OSCAR data. Watch for things that steal from the good night look and take no action until after 3 nights. With a bit of practice, you can begin to picture what OSCAR charts will look like before viewing just by association with how you feel upon waking. I can tell by how I feel if leaks, CA, oxygen percentage, etc. were a bad night pattern and then I'll investigate, and only after 3 consecutive bad nights do I take action. Bad night one is not a trend, consecutive bad night 2 is worth looking at, consecutive bad night 3, see what the data tells and act against that forming trend. But anything less than 3 nights means no action but looking.

This process gives those that practice the trends method a few things. Peace of mind being the most important, because you can tell if there's a concern or not quickly. Do not let Apnea treatment rob you of enjoying life. Some Apnea sufferers, myself included, begin to stress over the data daily, when it's far better to learn this trend method. Take control of Apnea therapy is necessary, but do not allow it to take up too much time that you cannot enjoy life. If it feels "off" then take a look, otherwise get a great coffee and go about the day. I had to learn this myself several years ago for these exact reasons. Be in control in a way that will guarantee success, the trends method just works.

Hope it helps with your therapy. The historical view seems fine. Peek at the data, a deep cleansing breath, and go get the all important mug of .

[Lorrubdb]

Thanks  Dave, you sound so much like me as I do obsess daily about my results and sometimes let it rule my day. So I appreciate you sharing your experience and solutions that have worked for you. I'm sure it took a lot of trial and error and it's nice of you to pass it on to me. I will definitely use your 3 day wait and see formula. Glad you think all looks good and I have the don't worry central apneas!

I can see (now) how irrational it is to worry about one or twp nights as everything is so variable and dynamic with so many influencing factors.  Actually therapy  is going really well and I'm feeling so much better.   Remember I talked about feeling like I couldn't breathe during the day and having little to no energy. Well thankfully those days are over! I feel so much better and even went to the market the other day. Unthinkable prior to cpap. Truly a success story!  

Sleeprider has really helped me so much and is mostly responsible for my therapy success.  He got my settings just right, I had them all out of whack and he monitors my progress.  So when I have a bad night or two, I panic that oh no, now it's not working and I'm downsliding back to square one and lying on the couch lol.  Sounds so silly when I write it down-a bit dramatic lol! So I send it to Sleeprider and he says NO everything is good, it's just a bad night and don't change anything. So I stop worrying and go on with my day,  But just hope I'm not being too annoying and burning him out. I truly appreciate all his help and guidance and never doubt he will do what is best despite my meltdowns (over nothing).

BUT now I have your 3 day trend formula so that will definitely stop the needless over reaction and will focus on all the successful days. Today I felt good when I woke up and knew my chart would be good-and it is! Better than yesterday when I didn't sleep well and felt awful all day. I feel confident I understand your plan and it is perfect for me in controlling my anxiety.   

Thanks again for your thoughtful and sensitive advice. I'm enjoying a mug right now! 






[attachment=40421]

[Lorrubdb]

Sleeprider...seems like I'm always having to apologize but hope I didn't offend you with my attitude again as you mentioned before. Just responded to Dave's post but wanted to reach out to you as well as haven't heard from you. My data looks great today so know now to wait a few days before I panic and send it to you. Mostly every night  is good anyway so I have nothing to stress/complain about, just wonder how high centrals should be to warrant worry about them?  I already posted my chart but will post it here again, to show off!  My flow limits are almost nonexistent, pressure looks steady and the event cluster seems to have happened when I was messing with my mask/tubing.

attachment=40422]

[SarcasticDave94]

You're welcome. Even this chart is excellent in events. A bit of scattered CA but it's not a sea of purple flags, so nothing to concern over at all. Just go about enjoying the better state of sleep with PAP.

FWIW rabbit holes like obsessing over the data can lead you into places where Mad Hatters are having tea parties, rabbits running all over the place, grinning cats, weird caterpillars, and so on, so all kinds of crazy stuff.

[Sleeprider]

Looks great. I don't get offended. No worries.

[Lorrubdb]

Hi sensei, my charts have been looking great with AHIs under one and last night actually had ZERO centrals!  Wow, a first. As you can see there were lots of leaks towards the end of night, not sure why. Think I'm pulling it tighter, probably it's worn out and need a replacement. Plus its uncomfortable, digging into my face.  I did order a new one to see if that helps. it was ok before.  But this morning my face looks like it went through the washer and dryer without softener.!  I mean I already had some some wrinkles but this is on a whole different  level - deep dents and lines, red marks etc. Although it does fade some during the day.   I'm probably the only person who likes wearing a mask in public!

 Anyway , do you think it's wise at this point to try a nasal or some version of t to prevent all that-and be less intrusive? I definitely am a mouth breather so it'll be a challenge.  It's not the look I had in mind but breathing is obviously much important than appearance. The last thing I want to do to mess anything up when my therapy is going so well and I'm feeling much much better.  

So do you think I should try a new mask now or wait  for a longer history of consistent good results and am more stable? Also wondering what you think of my charts as I don't look at the other respiratory values.

Thanks Lorie

[Lorrubdb]

Awaiting a reply to my post, any chance to get one sometime soon?

[Sleeprider]

I'm a big proponent of nasal therapy and both my wife and I use the Resmed Airfit P10. As long as your mouth remains closed at night, controlling the air pressure is easy, and it is a much lighter and less disruptive mask. Your results may vary. I think it's a great idea.

[Lorrubdb]

Awaiting a reply to my post, any chance to get one sometime soon?