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One month in, trying to improve
#21
RE: One month in, trying to improve
Exactly. If you were on fixed CPAP pressure, the 90% pressure is typically where we set fixed pressure. You really need minimum pressure to be at least within 2-cm of that with the Philips because too low and you will have events before the pressure recovers. This will cycle over and over with the minimum pressure set too low. Many people think auto pressure means they don't need to worry about the setting, but nothing could be further from the truth. You will become more accustomed and comfortable with the higher pressure. Just give it time.
Sleeprider
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#22
RE: One month in, trying to improve
An update on the past few nights. I have varied comfort settings some but can't seem to to lower my AHI, it still remains around an 8-10 range and that's about the best I can do. I have kept the lower limit at 7.5, which has been raised from the 5.0 originally prescribed. I have tried A Flex, C Flex, both set to 1, and Flex off. C Flex sends my OAs through the roof. A Flex keeps my OAs down but my CAs and periodic breathing go way up. When I turn Flex off, breathing is uncomfortable but it does bring down my CAs and periodic breathing drastically, but my OAs again go up so my AHI remains high. Tonight I will return to Flex off and try the cervical collar again to see if that helps. 

I finally received my detailed sleep study info which I am attaching here. I ran out of space here and had to delete some past attachments to attach this. I did a 2 night home study but the first night was a fail due to the the fact that I wore the nose cannula incorrectly. So I am only attaching the second night. Apparently the signal quality on the belts were a big fail, not sure what that means to the results. If anyone can help decipher the report, I'd appreciate any help. Thanks again for all the help!


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#23
RE: One month in, trying to improve
Looking at your study of your 21 AHI some of that was Mixed/Central apnoea particularly on your left side. SO it is not surprising you have CA’s during treatment. This would indicate your CA’s are not treatment emergent.
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#24
RE: One month in, trying to improve
The fact that the belt signal is poor means that the numbers for mixed and central apnea are suspect.

The other thing that jumps out is the length of some of the events - an obstructive apnea of 76.4 seconds can't be good for you! This demonstrates that AHI is a very crude measure of the severity of sleep apnea and we need to look more closely at the details.
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#25
RE: One month in, trying to improve
So here's my latest data from last night. Turned Flex off and wore a cervical collar. I am used to the exhale pressure with Flex off now and the collar seems OK, so it was a relatively comfortable night of sleep. Definitely helped control the CAs a just 2, but the OAs are up to 24 and still a fair amount of periodic breathing. Leaks were up a little too, but I'm guessing different pressure on the pillow from having the collar on.

I guess my question now is whether I should keep Flex on which seems to help keep OAs down at the expense of CAs, or turn it off to control CAs at the expense of OAs. As always, any thoughts or input appreciated.

I called my doctor and have moved my appointment up to this Monday to discuss. It will be a telehealth appointment from home over Skype due to Covid 19. He will still be able to access my data remotely so should be OK to do it that way. I'll report back after that.

Thanks all for the continued support and advice!


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#26
RE: One month in, trying to improve
Ask your doctor if he can switch you to a Resmed Airsense 10 Autoset. You obviously have problems syncing with the Philips and the Resmed delivers pressure and exhale pressure relief in a completely different manner that resembles bilevel, and the pressure is much faster to respond to flow limitation ahead of obstructive events and actually prevents them. I doubt he is going to be enthusiastic about switching machines, but the number of people with results like this, that do better on a Resmed is something we have seen a lot.
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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#27
RE: One month in, trying to improve
(04-04-2020, 09:17 AM)Sleeprider Wrote: Ask your doctor if he can switch you to a Resmed Airsense 10 Autoset.  You obviously have problems syncing with the Philips and the Resmed delivers pressure and exhale pressure relief in a completely different manner that resembles bilevel, and the pressure is much faster to respond to flow limitation ahead of obstructive events and actually prevents them.  I doubt he is going to be enthusiastic about switching machines, but the number of people with results like this, that do better on a Resmed is something we have seen a lot.

Thanks, I'm am going to discuss what has been happening and see what he says. Unfortunately, the meeting is with the office PA and I won't even be able to get to the doctor at this point. The medical supply co. he uses only uses Phillips so to get to a Resmed machine I would have to use a different supplier. I doubt he will be open to this, but I'll try to stand my ground. I'll report back Monday evening how it goes.
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#28
RE: One month in, trying to improve
Is the supplier connected to the doctor's practice?
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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#29
RE: One month in, trying to improve
(04-04-2020, 10:47 AM)Sleeprider Wrote: Is the supplier connected to the doctor's practice?

Not directly as far as I know. The doctor's office had a variety of machines on display, including the Resmeds. So I think it was probably just that particular supplier that  was Phillips only. So hopefully I will have some options. I do know that I LOVE the Phillips Nasal Cushion mask, so I hope I can still use that on the Resmed if I change. I don't see any reason why I couldn't do that.
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#30
RE: One month in, trying to improve
Any mask can be used with any full size machine (The resmed mini is not so flexible)
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