Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Need guidance for complex sleep apnea and leaks follow-up
#81
RE: Need guidance for complex sleep apnea and leaks follow-up
And get some oximetry data.

John, are you on supplemental O2?
Post Reply Post Reply
#82
RE: Need guidance for complex sleep apnea and leaks follow-up
(03-09-2022, 05:01 AM)Rubicon Wrote: And get some oximetry data.

John, are you on supplemental O2?

Cause back then you posted

"On my first sleep study I just marginally crossed the threshold of desat which at that time (7 years ago) justified O2 at 2 l/min. I had 2 follow-up overnight pulse oximetry studies over the years while on BIPAP in an effort to get off the O2, but seemed to stay just barely over the min threshold. In my recent sleep re-study, I was slightly above the threshold, and with the new more stringent insurance criteria, O2 was no longer recommended. I've toyed with the idea of getting my own oximeter, but in a cursory search it seemed most models were for spot checks only. Is a self-owned recording monitor feasible for those of us who are OCD enough to want to have more data?"

I wish all the old images were still there.  A lot of your machine wingin' entailed having aggressive backup rates.  I wonder if you indeed have compSAS or are those centrals simply a result of arbitrary selection of machines and settings.
Post Reply Post Reply
#83
RE: Need guidance for complex sleep apnea and leaks follow-up
Why do you keep talking to yourself and spamming posts? 15 of the last 21 posts have been your own (not to mention however many were deleted) and many times you are just posting random thoughts to yourself... Read all the data, make a single post and wait for a response, no reason to keep spamming the thread.

To me it is very clear what is happening in that data. You can play it out and it makes sense. First couple recovery breaths are large quick inhales with no exhale as he tries to suck air into his lungs. As he gets some air inside he starts to relax and inhales become less powerful and he starts exhaling. After 5-6 breaths he has washed out CO2, lungs are full and he starts having a long slow exhale which eventually turns into a central apnea.

I don't know that it is palatal prolapse or just mouth breathing. The flow rate waveform shows exhale being cut off (4 exhales after 00:32:30 for example) and there are leaks also present at that time indicating he is probably exhaling out of his mouth at that point. The question is why his body is doing and if it is because of just a natural reaction or a palate restriction.

The flow rates recorded by these machines are very accurate, I guarantee you they aren't confused about where 0 flow rate is. My description above is what is happening, the only question is why.
Post Reply Post Reply
#84
RE: Need guidance for complex sleep apnea and leaks follow-up
[Admin note:  Edited out comments unrelated to thread]



In re: "First couple recovery breaths are large quick inhales with no exhale as he tries to suck air into his lungs" that is not true.  See pressure waveform.  Those are machine breaths that didn't go anywhere.

Your guarantee of -0- baseline accuracy is also untrue.  In another of the OP's graphs that includes leaks you can clearly see entire breaths occurring bellow the -0- line as it reorients itself following LLs.

See you tomorrow.

Maybe.
Post Reply Post Reply
#85
RE: Need guidance for complex sleep apnea and leaks follow-up
5 of breaths below -0- during LL:

[Image: YpqYklE.jpg]
Post Reply Post Reply
#86
RE: Need guidance for complex sleep apnea and leaks follow-up
I'm struggling with my Technology Deficit Disorder.  

I find that someone had talked me through starting a DropBox account spring of 2017, and I posted some data then.  But I need an Idiot's Guide to DropBox, as I do not recall any significant discussion and haven't re-discovered how to open and share files.   As I recall most of the consensus then seemed to be why my doc was so slow in putting me on ASV for my complex sleep apnea.  If I can get DropBox figured out I will be more than happy to post my entire SD card for whoever wants to review it.  

In 2009, after first sleep study I was started on 2l/min O2.  I think my lowest O2 sat was mid-80's with average in mid-90's.  I wasn't really followed by a sleep-doc first few years, and I stayed on the concentrator long enough for insurance to buy it for me.  I later had a couple of overnight oximetry studies prompting doc to discontinue O2.  I haven't missed it.  

I have a new CMS-50E but am having trouble getting it synchronized with Oscar.  More to follow.  

I am ashamed to admit my BMI is over 50, height 6' 3", weight stable for years between 425-450.  Mobility impaired by severe DJD 3 of major weight-bearing joints which won't be getting better (and I'm not a surgical candidate). 

I'll try to collect data more meaningful than this word-salad.
Post Reply Post Reply
#87
RE: Need guidance for complex sleep apnea and leaks follow-up
Well, I think I can point you in the right direction on learning Dropbox.  Here is a step-by-step how-to on the subject.  Be forwarded, it has a bunch of "look-pretties" among the instructions.  It should get you across the finish line.
https://www.cloudwards.net/how-to-use-dropbox/

- Red
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.
Post Reply Post Reply
#88
RE: Need guidance for complex sleep apnea and leaks follow-up
I figured you were a larger guy considering your high ventilation numbers and choice of avatar image. It supports that obstruction is likely to be an issue and that you may require more pressure than most to overcome those obstructions.

If you haven't tried my previous recommendation of Min EPAP = 14, Max IPAP = 30, Min PS = 1, Max PS = 10 yet I think that is good trial to try some higher pressures and see what happens.

Onedrive is another hosting option you can look into if you are having trouble with dropbox.
Post Reply Post Reply
#89
RE: Need guidance for complex sleep apnea and leaks follow-up
Another example where the machine is confused about where -0- baseline is.  In this case a mouth exhaler:

[Image: dMP2POU.jpg]
Post Reply Post Reply
#90
RE: Need guidance for complex sleep apnea and leaks follow-up
Is that from the OP or just some random image you are posting? I am guessing the latter.

Frankly I think you are more confused than that machine is. You often see a negative flow rate like that on mouth exhale/palatal prolapse because a portion of the exhale still passes through the nose/machine and gets recorded as such.

If that example is from the OP I believe he uses a full face mask in which case that would have to be an example of palatal prolapse without mouth exhale and it would be showing long flow restricted exhales on multiple breaths prior to the arousal and recovery breathing that starts at 04:29:38.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  New to CPAP, looking for guidance and advice iamJB 16 296 6 hours ago
Last Post: Expat31
  Apnea has gotten worse recently, I have no sleep study, can I just buy a cpcp? replayablecontent 12 241 Yesterday, 12:38 PM
Last Post: replayablecontent
  Evora FFM Phantom Leaks psinderbrand 6 284 03-26-2024, 08:56 AM
Last Post: psinderbrand
  Collars for positional sleep apnea Jimasripper 17 352 03-25-2024, 10:05 PM
Last Post: Deborah K.
  Invisalign to help sleep apnea and dental extractions as a cause of sleep apnea SingleH 10 615 03-24-2024, 07:00 PM
Last Post: stevew168
  Sleep Apnea or Something Else? RoughriderTR 6 292 03-23-2024, 04:43 PM
Last Post: ButtonNoseBarbie
  Obstructive Sleep Apnea After Stroke Help MB123 1 75 03-23-2024, 01:08 PM
Last Post: Dormeo


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.