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My doctor suggested patience
#11
RE: My doctor suggested patience
Although I haven't followed you from the beginning, I see that the centrals have settled down, and that's good. Your AHI is excellent, but you still have a lot of flow limitation which drives the pressure up and in turn wakes you up.

Look at the second graph.  See where the Flow Limitation caused the pressure to rise a little after 4am.
You also have some leaks going on at the same time.

I think you would do well to move your minimum pressure to 7cm with an EPR of 2.  This will help with flow limitations, but you will need to watch for the return of centrals.

Another thing, do you use a pulse oximeter during the night? I can't say what the dizziness is from, but it may be a good idea to keep tabs on your oxygen levels.
OpalRose
Apnea Board Administrator
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OSCAR Chart Organization


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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#12
RE: My doctor suggested patience
(08-08-2020, 11:20 PM)Annecelesye Wrote: Hello,
while I was ready to post a success story, I experienced a problem during the last week and I am once more addressing the board for help. I try to sleep on my side and switch sides from time to time.  Last night I woke up feeling a lot of air coming through the mask and I realized that I was on my back.  I tried to fall asleep again but I was panicked and felt a restriction on my chest.  Now I am awake still feeling restricted and dizzy and I am afraid of getting back to sleep.  I had three such events last week.  I post my last night's chart and while it is evident how improved it is in comparison to the initial ones, I seek your advice.
Thank you

Your therapy looks pretty good and it appears the symptoms you experienced last night can be largely attributed to an anxiety attack.  I'd like to limit your maximum pressure to 10.0 cm because you just don't need more than that.  We should stick with the current minimum pressure of 5.0 with EPR 1 for now, but once you have used settings of 5-10 EPR 1 for a while, I may ask you to try 6-10 EPR 2 in order to address residual flow limitation.  I don't want to get you back into having CA events.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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 doctor suggested patience
Thank you very much for your responses.  I will get a pulse oximeter as soon as I can and I will change the settings gradually.  If my symptoms are due to anxiety, is it possible that an anti-anxiety medicine will help or it will worsen sleep apnoea?
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#14
RE: My doctor suggested patience
(08-09-2020, 07:48 AM)OpalRose Wrote: Although I haven't followed you from the beginning, I see that the centrals have settled down, and that's good.  Your AHI is excellent, but you still have a lot of flow limitation which drives the pressure up and  in turn wakes you up.

Look at the second graph.  See where the Flow Limitation caused the pressure to rise a little after 4am.  
You also have some leaks going on at the same time.

I think you would do well to move your minimum pressure to 7cm with an EPR of 2.  This will help with flow limitations, but you will need to watch for the return of centrals.

Another thing, do you use a pulse oximeter during the night?  I can't say what the dizziness is from, but it may be a good idea to keep tabs on your oxygen levels.

I don't have a pulse oximeter. I want one.

What model works well? 

Have they been compared on this forum?

DaveL
DaveL
Compliant for about 30 Canadian years

I'm just a cpap user like you. I don't give medical advice. I hope to learn from you, and share my experiences with you. 
Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#15
RE: My doctor suggested patience
With the help of the forum, I seem to have improved a lot since the beginning.  I have sporadically these bad nights when I wake up with panic attacks and I cannot fall asleep again easily.  Last night I had a similar event but because I was so tired I slept after a while.  In the morning I saw in Oscar that I had an OA of 30 seconds duration. In another thread, it was mentioned that apneas longer than 19 seconds are too long.  Today I feel dizzy again, tachycardia and chest restriction.  I will visit my cardiologist, but I think that it might be anxiety.


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#16
RE: My doctor suggested patience
(03-04-2020, 02:05 AM)Annecelesye Wrote: What I miss more are my dreams.  Although they were on the nightmarish side, it is sad not having any.

My understanding is you only remember a dream if you wake up immediately out of it, and are then awake for at least two minutes.
 
Not remembering dreams could actually be a sign you're sleeping better.
Caveats: I'm just a patient, with no medical training.
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#17
RE: My doctor suggested patience
Your event rate is very low, and it's hard to know why you have a longer duration event. Your pressure is at an absolute minimum at this point with a minimum of 6-cm and EPR at 2 you only get 6/4 pressure. If you want to head off the obstructive events a minimum pressure of 7 or 8 should not be uncomfortable, and may prevent the few existing events.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#18
RE: My doctor suggested patience
(09-07-2020, 09:48 PM)Sleeprider Wrote: Your event rate is very low, and it's hard to know why you have a longer duration event. Your pressure is at an absolute minimum at this point with a minimum of 6-cm and EPR at 2 you only get 6/4 pressure.  If you want to head off the obstructive events a minimum pressure of 7 or 8 should not be uncomfortable, and may prevent the few existing events.

Thank you very much for your advice.  I have improved very very much since the beginning mostly thanks to the forum.  I will make the changes today and I hope for the best.  I wish everyone here a good night's sleep.
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#19
RE: My doctor suggested patience
My chart looks good even to my eyes but I still wake up with a terrible feeling and I am unable to fall asleep again.  This is from tonight. The last part is from my attempt to fall asleep.  I am sorry to bother the board all the time since I got so much help up to now.


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#20
RE: My doctor suggested patience
I'm sorry to hear you are still having these experiences in the night. Did you ever get a pulse oximeter? I think it might be time to talk with your doctor, and some O2 information might be good to have before that appointment.

One piece of advice: when you talk to the doctor, don't describe these as panic or anxiety attacks. Maybe they are; maybe they aren't. Diagnosis is what the doctor is supposed to do. Your job is to describe the experience, its frequency, its duration, and the way it affects your sleep. If you have O2 information, present it.

An additional thought: if you have this experience and know when it took place, could you post a chart for the night with a zoom in on the time before, during, and after the experience? Maybe about ten minutes?
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