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New to forum and to data analysis
#81
RE: New to forum and to data analysis
That is the issue with CA, especially if altitude has compounded it. It's going to be a lot of consistently inconsistent CA events. That's one roller coaster I'm not going on. Hopefully, you'll get that new sleep study soon, and some answers from the doc, as the one posted was from 2014. 6 years can change a lot of things apnea.
Dave

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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.
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#82
RE: New to forum and to data analysis
The new pulmonary doc is looking further into ASV needs.  She has a echocardiogram scheduled for this coming Saturday. However the soonest sleep study is Dec 29, with a requirement of having a Covid 19 test 5-7 days prior. Hmmm, XMAS may be a bit of problem with scheduling but we will find out. We will watch the data over time to see if CA's continue to rise and fall. New mask tomorrow, hopefully we get less leaks which is messing up the data. Thanks for the input.
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#83
RE: New to forum and to data analysis
new nasal pillow mask seems to be working well. Phillips Nuance Gel nasal pillow.  I forgot to set the mask to pillow for the first day, so the leaks may not be reported correctly. Are the AHI values correct or not. The second day had the proper Pillows setting and things look good.
She has been getting more Hypo than OA, but this last night showed more OA than Hypo. Might just be a coincidence.


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#84
RE: New to forum and to data analysis
Events can vary per night, so that in itself isn't an issue worth being concerned. I think Flow Limits as shown in chart view #3 can be an issue for hindering comfort. This can be tackled by a bit higher pressure, if it is in fact disturbing sleep.
Dave

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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.
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#85
RE: New to forum and to data analysis
I think we are avoiding EPR and using fixed pressure due to flow limitations. With the nasal pillows I think you can actually drop pressure to 8.0 and have similar results to what you had with the larger mask.
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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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#86
RE: New to forum and to data analysis
I was thinking of changing max pressure to 9.2 and let it figure out where it wants to run most of the time. We can then hone in a fixed pressure. In the past, the pressure it ran at most of the time was 9, then it worked its way up to 10 and then a little higher. That is when things were not working so well. With the new machine and still letting it find a place, the pressure tended to be 9 most of the time. But it was runing up high periodically and I guess causing a lot of the CA's. We came down to a max of 8, and then saw that it needed to go up a bit so we moved the 8/8 min/max up to 8.4/8.4  It seemed to work well but it also looked like maybe a little more pressure would get rid of the Hypop's, and now they shifted to OA's. 
She is sleeping better. She wants to leave pressure alone for a few days so she can get used to the new mask. We will be able to look at a few days of data and then make a change.
Thank you all for your input.
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#87
RE: New to forum and to data analysis
OK my mistake, I'd forgot the CA avoidance, so strike what I said earlier. However, the good thing with ResMed is that pressures need not be on top of pressure need as a Respironics requires, so a bit lower may not hurt.
Dave

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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.
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#88
RE: New to forum and to data analysis
Here is last night. She is getting more used to this mask. a lot less leak rate. I have been chasing the wiki for more info on the flow limits. I don't understand what it is and how the resmed is using it to vary pressure.


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#89
RE: New to forum and to data analysis
Think of Apnea, Hypopnea, and Flow Limits as a continuum oh events, The first two have a time limit (at least 10 seconds) the third, Flow Limits are not timed but are still restrictive to your breathing.
A normal breath has a curve that is well rounded, very sinusoidal. A flow limited breath has a flattened or sloped top. ResMed reads this via a "Flatness Index" and uses this in their algorithms as an indicator for upcoming hypopneas or apneas and raises the pressure in response.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#90
RE: New to forum and to data analysis
Thank you that makes sense the way you described it well. So for my wife's situation, it is a double edged sword, as her CA count tends to go up with higher pressure, and currently she is getting OA and H events but low in the scheme of things. So raising pressure may just shift the count of AHI to more CA's and not effectively reduce things. I think I also understand the technique of setting min=max and then the machine can't raise the pressure just to handle flow limits. That is where we were before with a Max of 20.
Leaving settings the way they are for now as she is under 5 AHI to see if things remain the same or stabilize to something else is probably the best course for now. I can see how going up or down in the pressure would be a good test to see how things shift. But stabilization is probably more important than further testing at this point.

This is pretty advanced stuff. I'm retired now, but my career was tuning large mainframe computers so I understand the data means lots of things, but you also need to understand how the "machine" acts/works with the data. Thank you very much for the education.
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