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Mild Sleep Apnea (but still tired)
#21
RE: Mild Sleep Apnea (but still tired)
That's great. Hope you are still feeling great today. 

Do you still see some flow limitations in your breathing (flat-topped flow curve on the inhalation)? The machine doesn't report any significant flow limitations on its chart but I don't know how good is the algorithm at scoring small flow limitations correctly.
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#22
RE: Mild Sleep Apnea (but still tired)
(09-17-2019, 04:37 PM)brainf0g Wrote: ...I had an opportunity to purchase a lightly used AirCurve 10 VAuto. I’ve only been able to use it once so far (second screenshot), but with the settings nearly identical to the AirSense 10, I was amazed at how much easier it felt to breathe. I woke up a couple times at the end of sleep cycles, but I was shocked I felt no temptation to tear the mask off my face. (Min EPAP 4cm, Max IPAP 12cm, PS 4cm). I also feel "okay" today, but that is much better than straight death! I returned the AirSense 10 to the DME (as it was still considered a rental).
 
This feels really promising and I’m hoping to do more self-titration before my appointment in 4 months. As a side note, I also ordered nasal pillows to try that out and hopefully improve the leakage when they arrive.

Looks indeed promising.

The other nice thing about the VAuto is you can experiment with fine-grained tweaks of your PS. So 4.2 and such.

BTW, you might look into the Bleep mask. Really easy to eliminate leaks with it. Only real downside is if you're paying out of pocket for the "cushions."
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#23
RE: Mild Sleep Apnea (but still tired)
The P10 pillows arrived the night before I left on vacation. They are way more comfortable than the nasal mask (less inclined to tear it off in the middle of the night) and seem less prone to leakage. So I only have two nights of data with the pillows (full night then zoomed in to the biggest flow limitation of the night which registered as 0.22 both nights).

AHI is up but I haven't done much tweaking... still trying to understand the effects of the new settings (Ti Min, Ti Max, Trigger, Cycle) before I actually touch any of them. Zooming into some "events", looks like the machine can wait up to 16-17 seconds of no breathing before it increases the pressure.


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#24
RE: Mild Sleep Apnea (but still tired)
Probably the worst LOOKING night I've had since having any PAP device, but I feel "okay" today. Not really sure why the pressure gradually ramped up from 8.0 to 8.8 from starting the night until the first CA event?


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#25
RE: Mild Sleep Apnea (but still tired)
....ramping up on account of OA (some, If not all, false).
....tens of arousals/awakenings; no wonder you felt awful.
....for a better understanding of your case, could you, please repost this night, these charts/scales below, and some ten-minute windows covering tidal volume contrasts? From top downward:
_pressure_Resp rate_flow rate (-120 to 120)_FL_tidal volume (max 1200, with the median reference line); leak
Good luck
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#26
RE: Mild Sleep Apnea (but still tired)
....in time: do you have Lab studies you could eventually post?
Good luck
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#27
RE: Mild Sleep Apnea (but still tired)
Apologies...this first part msg was not sent (non-native, usually bring from word)

Hi, brainfog
I am particularly interested on UARS and/or PLM's cases in this forum, my essential sleep drawbacks. It looks yours may eventually have something to do with mine.
Preliminarily, your charts suggest:
....ramping up on account of OA (some, If not all, false).
....tens of arousals/awakenings; no wonder you felt awful.
....for a better understanding of your case, could you, please repost this night, these charts/scales below, and some ten-minute windows covering tidal volume contrasts? From top downward:
_pressure_Resp rate_flow rate (-120 to 120)_FL_tidal volume (max 1200, with the median reference line); leak
Good luck
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#28
RE: Mild Sleep Apnea (but still tired)
@mper6794 I think I understand what you're asking for. I posted a couple zoomed in areas from last night where there was a lot of tidal volume contrast and arranged in the order you specified. I do not have a lab report beyond the "at home" study results I posted in the original post. I currently have no sleep doctor, but if the Stanford doctor I'm seeing in January orders a lab study, I'll be sure to share the results.

I'm still learning how to read OSCAR, but it looks like there are quite a few "UARS-style" breaths immediately before the recorded CAs and OAs.


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#29
RE: Mild Sleep Apnea (but still tired)
Hi, brainfog
That's my modest opinion thus far.
Please, if somebodyelse have different opinions, let us know.
- yes, indeed,  it looks to me your poor sleep quality would be associated with too many awakenings and consequent low sleep efficiency, maybe less than some 70%;
_ I would love to see more pictures, however the overall context already suggests your awakenings, including those during REM's, would be associated with flow reductions, either flagged as minor OA's or not. You appear to be very sensitive to those reductions;
_ you don't have significant true CA's;

Therefore, I think you could eventually benefit from some more EPAP. My suggestion would be keep the same inhale/exale pressure gradients, that is keep PS:4.0, while increase your EPAP to 5.0. You could do this in just one step or gradually. I am myself familiar with those changes, either way with no drawbacks, yet each one is each one!

Good luck
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#30
RE: Mild Sleep Apnea (but still tired)
(10-02-2019, 07:40 AM)mper6794 Wrote: Therefore, I think you could eventually benefit from some more EPAP. My suggestion would be keep the same inhale/exale pressure gradients, that is keep PS:4.0, while increase your EPAP to 5.0. You could do this in just one step or gradually. I am myself familiar with those changes, either way with no drawbacks, yet each one is each one!

To add a bit:

Strategically, you (OP) want to raise the EPAP until you eliminate the OA and H events, but keep the PS constant for now.

You can worry about PS (if you even need to) once the EPAP is dialed in.
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