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

New Here - Could use some help
#41
RE: New Here - Could use some help
Going to move pressures to up one point to 10-12.5 to see if I can lower AHI, as that's 2 nights in a row in  the 8's and while there is some leaking, I don't see any large leaks.


Attached Files Thumbnail(s)
   
Post Reply Post Reply






Donate to Apnea Board  
#42
RE: New Here - Could use some help
Things are getting worse, but I believe this time it's due to leaking from the mouth, my nose was clogged and I woke up with dry mouth.

I'm still using the nasal mask, I do have the DW FullFace mask but am having trouble getting to seal with a beard.

Best AHI so far was with lower pressures, so I don't believe changing pressures it going to help.

Thoughts?


Attached Files Thumbnail(s)
   
Post Reply Post Reply
#43
RE: New Here - Could use some help
I don't want to be the bearer of bad news, but apnea has been increasing with increased pressure and now looks like complex central/obstructive apnea. Your best results were back at about 8.0 minimum pressure with a CAI of 2.7 and OAI of 2.0. As pressure increases we now find at a minimum pressure of 10.0 a CAI of 5.56 and OAI at 1.77. This progression has been nearly linear with each 0.5 increase in pressure above 8.0. Your original pressure of 5.0 on 1/19 was actually worse, but mainly because the machine increase pressure to over 15 cm. With centrals increasing with pressure faster than obstructive events being reduced, we are faced with the dilemma that CPAP no longer looks to be the most viable therapy, and you may be heading for ASV.

I'd like to take you back to a lower pressure, and make it fixed CPAP. As a one-night trial, lets try minimum 8.0, maximum 8.0, or 8.0 in CPAP mode.
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.
Post Reply Post Reply
#44
RE: New Here - Could use some help
Wow, I really hope that is not the case as I'm not sure CPAP machines are returnable after purchase and ASV machines are very expensive. I'm also 99% sure Insurance will not buy two units in less than 30 days.

I'll set pressures back down to 8/8 and see what happens, thank you.
Post Reply Post Reply






Donate to Apnea Board  
#45
RE: New Here - Could use some help
There is not certainty at this early stage, but with the mix of events, and trend for higher pressure, I think a fixed pressure trial is worthwhile. As far as insurance coverage, if your diagnosis changes, insurance will usually cover the change in equipment based on it being "medically necessary". Doctors are very reluctant to diagnose complex apnea, so, it is way to early to go there.
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.
Post Reply Post Reply
#46
RE: New Here - Could use some help
Roger that, I did speak to my doctor and she was actually impressed that I was data driven and making adjustments based on the data, she encouraged me to continue our efforts and she would monitor the CPAP data from a distance and intervene if she saw fit.

She will most likely want to be more hands on and have a larger sample size before making that sort of decision.

Last night I did not use Afrain for my nose, instead earlier in the day I used Nasacort, but as I understand it, Nasacort takes time to work, funny thing is my nose does not clog all day, not until ~ 1hr before bedtime..very strange.

Let's hope pressures of 8/8 work out tonight.
Post Reply Post Reply
#47
RE: New Here - Could use some help
If the doctor changes diagnosis and scripts ASV if that indeed does happen, yes insurance will be on board with a new machine if all the i's are dotted and the t's are crossed. In other words if the proof is there for ASV and doc does his job to write it up properly then you get what's needed.

Your part is to give accurate and full symptom and complaint list to doc and the doc must then listen to you.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  
#48
RE: New Here - Could use some help
Much better at 8/8, AHI only 6.6, though Hypopnea's are over 4.5

Using small Nasal cushion seems to have sealed the mask a bit better as well.

I noticed on the 24th with my AHI around 4.x that my pressure was mostly at 9, and Hypopnea's around 1.7, should I set the CPAP for 8/9 to see what happens?


Attached Files Thumbnail(s)
   
Post Reply Post Reply
#49
RE: New Here - Could use some help
Fixed pressure helps. The trick now is to increase pressure from 8.0 to a higher pressure that reduces the hypopnea and OA without triggering a disproportionate amount of CA. It's going to take some finesse to find the sweet spot, but you're on your way. If you over-shoot, then back-off in 0.5 cm increments.
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.
Post Reply Post Reply
#50
RE: New Here - Could use some help
ok, I will try 9/9 tonight, thx !
Post Reply Post Reply






Donate to Apnea Board  



New Posts   Today's Posts






About Apnea Board

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