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My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
#11
RE: My Apnea Story (Includes DS2, HI, RERAs) - Help!S9, low A
yes i am not well


I had a check up. The doctor said that my values are good. I do not use any medicine. I also went to several doctors. my problem is sleep apnea :/
I tried many pressure combinations but found the solution to increase the pressure.
I increased the S9 one by one and came up to 12. I felt good for 1 week each time I increased it, then the effect decreased again. I can't increase it anymore, it's annoying. Should I get an asv? I'm also considering getting Oniris The Anti-Snoring Orthosis these days. Say what? My psyche is broken. My room has been messy for a long time. I'm sleepy during the day. I still couldn't solve my sleep apnea. How about ASV? am i uars?
  My flow limits don't seem to be showing
I increase the pressure by 1 degree and get well for 1 week -but I was really good-, then the effect subsides, then I increase the pressure again and I'm fine, these should be big clues in determining my problem but it has not been solved./
  My S9 sd card data is here

waiting for your help; thank you very much
SIXTH REMEDY 
   O brother who thinks of the pleasures of this world and suffers distress at illness!
If this world was everlasting, and if on our way there was no death, and if the winds of separation and decease did not blow, and if there were no winters of the spirit in the calamitous and stormy future, I would have pitied you together with you.
But since one day the world will bid us to leave it and will close its ears to our cries, we must forego our love of it now through the warnings of these illnesses, before it drives us out.
We must try to abandon it in our hearts before it abandons us.
   Yes, illness utters this warning to us: "Your body is not composed of stone and iron, but of various materials which are always disposed to parting.
Leave off your pride, understand your impotence, recognize your Owner, know your duties, learn why you came to this world!" It declares this secretly in the heart's ear.
   Moreover, since the pleasures and enjoyment of this world do not continue, and particularly if they are illicit, they are both fleeting, and full of pain, and sinful, do not weep on the pretext of illness because you have lost those pleasures.
On the contrary, think of the aspects of worship and reward in the Hereafter to be found in illness, and try to receive pleasure from those.
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#12
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
Without seeing a screenshot (F12) of your latest Daily screen, we all would be guessing. Please provide this information.
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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#13
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
Hello, I'm not an advisory member but I think I might have something to contribute. Your study seems to indicate that your RDI was 14.5. What was your AHI score? From what I've read, a low AHI score and a high RDI score indicate UARS.

You probably would also want to zoom into your flow rate and look for any irregular breathing patterns that may indicate flow limitation. Flow limited breaths are usually flattened on the inhale. Perhaps you could post some close up pictures of 2 or 3 minute intervals of your flow rate graph.

I started using a CPAP a few months and it was going not too bad until recently when I started to feel very tired. I couldn't really find any cause because my data looked good, but once I zoomed into my flow rate I could see periods of flow limitation. I have now rented a bilevel device to see if that improves my sleep and so far it does seem to be helping. If flow limitation is really what you're facing, then pressure support is needed to treat it, which bilevel machines offer. Your current machine offers pressure support right now under the EPR feature but that can only go up to 3. A bilevel machine will enable you to set higher pressure support levels which would help reduce flow limits.
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#14
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
gadgetmaniah and for others - The Advisory Member level is not about CPAP expertise, but to help advise on how Apnea Board functions.   Please don't feel that your membership level prevents you from offering help.  In fact, offering help is one of the cornerstones of becoming an Advisory Member.   Remember, we were all New Members at one time. Smile
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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#15
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
Oh ok, thanks - that's encouraging. I was just a bit afraid that the more experienced members might not like newer members giving out advice. But yeah, you're right, we were all once beginners and have to start from somewhere.

To the OP, I looked through some of the close ups of your flow rate that you've attached in your first post (sorry, I missed that before, though it'll still be useful to post more screenshots from your recent data). I can see a bit of flattening of the inhalation curve before some of the mini arousals that can be seen in the screenshots, which can suggest flow limitation. These machines have limited capability to identify flow limitation so we really do have to look at the flow rate in detail.
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#16
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
@gadgetmania, please expand on what you mean by limited capacity for the machine to identify flow limitations? Looking at cathyf's OSCAR chart, it's showing significant flow limitations throughout the night.

If one has signficant flow limitations, shouldn't it reflect like cathyf's OSCAR screenshot? The waveforms should correspond to the flow limitation level detected?

In terms of bipap vs a regular autoset with EPR of 3, isn't the only difference that bipap provides is the greater exhale pressure level? So, if inhale phase of the flow rate is flattened, I don't know how a bipap would be better suited. I thought bipap improves the exhale pressure level.
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#17
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
Sure. I only have a surface level knowledge of this topic, but what I do know is that CPAP machines don't have the ability to accurately measure flow limitation. So, this means that the machine may show little to no amounts of flow limitation even though flow limitation may be evident when we zoom into the flow rate. To accurately measure flow limitations, different techniques are used in lab sleep studies. OP's sleep test seems to show a high RDI though and a low AHI, which indicates UARS, and the main element of UARS is flow limitation.

Yes, bilevel machines can provide greater exhale relief. What we need to treat flow limitations is pressure support, which is the difference between the inhale pressure and exhale pressure. Resmed CPAPs such as the S9 or Airsense 10/11 only offer EPR (exhale pressure relief) of 3, which means that you can't go beyond a pressure support of 3. For UARS, typically a pressure support of 4 and above is required. I believe most UARS patients benefit from a pressure support in the range of 4-6. So, since bilevel machines and not normal CPAPs/APAPs can provide such levels of pressure support, bilevel machines are preferred.
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#18
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
3 screenshots attached, 10 screenshots in this link.


Attached Files Thumbnail(s)
           
SIXTH REMEDY 
   O brother who thinks of the pleasures of this world and suffers distress at illness!
If this world was everlasting, and if on our way there was no death, and if the winds of separation and decease did not blow, and if there were no winters of the spirit in the calamitous and stormy future, I would have pitied you together with you.
But since one day the world will bid us to leave it and will close its ears to our cries, we must forego our love of it now through the warnings of these illnesses, before it drives us out.
We must try to abandon it in our hearts before it abandons us.
   Yes, illness utters this warning to us: "Your body is not composed of stone and iron, but of various materials which are always disposed to parting.
Leave off your pride, understand your impotence, recognize your Owner, know your duties, learn why you came to this world!" It declares this secretly in the heart's ear.
   Moreover, since the pleasures and enjoyment of this world do not continue, and particularly if they are illicit, they are both fleeting, and full of pain, and sinful, do not weep on the pretext of illness because you have lost those pleasures.
On the contrary, think of the aspects of worship and reward in the Hereafter to be found in illness, and try to receive pleasure from those.
Flashes - 270
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#19
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
is my flow limit 6th class at the attachment


Attached Files Thumbnail(s)
       
SIXTH REMEDY 
   O brother who thinks of the pleasures of this world and suffers distress at illness!
If this world was everlasting, and if on our way there was no death, and if the winds of separation and decease did not blow, and if there were no winters of the spirit in the calamitous and stormy future, I would have pitied you together with you.
But since one day the world will bid us to leave it and will close its ears to our cries, we must forego our love of it now through the warnings of these illnesses, before it drives us out.
We must try to abandon it in our hearts before it abandons us.
   Yes, illness utters this warning to us: "Your body is not composed of stone and iron, but of various materials which are always disposed to parting.
Leave off your pride, understand your impotence, recognize your Owner, know your duties, learn why you came to this world!" It declares this secretly in the heart's ear.
   Moreover, since the pleasures and enjoyment of this world do not continue, and particularly if they are illicit, they are both fleeting, and full of pain, and sinful, do not weep on the pretext of illness because you have lost those pleasures.
On the contrary, think of the aspects of worship and reward in the Hereafter to be found in illness, and try to receive pleasure from those.
Flashes - 270
Post Reply Post Reply
#20
RE: My Apnea Story (Includes DS2, S9, low AHI, RERAs) - Help!
@xxxxqwe, my flow rate looks similar to yours. Based on what I see online, that wave forms seems typical.

@gadgetmania, what can you do on bipap that you cannot do on a regular apap like the a10? Is there a difference between what EPR is and what a 'pressure support' is besides being able to increase the exhale pressure relief beyond 3? What actually improves the flow limitations? How does it improve the flow limitations?

I thought being able to increase pressure relief beyond 3 would help when you get to really high minimum pressures when EPR of 3 would make exhale very difficult. So a bipap would help when one needs high pressures and need fairly good exhale relief. So, my thought would be that it would help with exhale, but I don't see how it helps with inhale phase of the flow rate?

Can you show any examples of waveforms that gotten better flow rate from 'pressure support?' Before and after shot?
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