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Over 2 years in and still tired w/Oscar charts
#11
RE: Over 2 years in and still tired w/Oscar charts
There's some jagged looking stuff on January 31st as well, but not as much it seems.  The only difference I can think of is nasal congestion, which has been a problem on and off for the past several weeks.  I'm going to try some Afrin the next night or two and see if that makes any difference, possibly trying something like Flonase as a longer term solution.
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#12
RE: Over 2 years in and still tired w/Oscar charts
Yeah, you posted new nights and those breaths are very decent, and have no response bounce, like you would see if you posted the prior charts when jagged breathing was happening, only with showing mask pressure. You will see the difference right away, as the machine actually boosts the pressure more times because it is sensing a slight inhale and jumps into action.

QAL
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#13
RE: Over 2 years in and still tired w/Oscar charts
Two things, the Afrin kept my nose flowing well all night, and, I had adjusted my pressure yesterday morning so these charts reflect a slightly increased min and max.  I think I feel a bit better today, though perhaps it is too early to tell.  I still see jagged breathing patterns as well as some more uniform stuff strewn throughout. So, am I to understand that the jagged nature of my flow chart is actually the machine responding in a not so smooth manner to my flow limitations?

 I've looked at some bilevel machines and something like a Vauto is around 1100.00 refurbished.  That's a big gamble, taking a shot that it'll actually provide me some relief.


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#14
RE: Over 2 years in and still tired w/Oscar charts
So first off a hiss noise coming from humidifier is not normal and probably the source of your leak. It might be the seals between machine and humidifier or outlet elbow/seal. Try cleaning all of that well (you can take elbow out) and when inserting humidifier you can try to pushing a bit harder to see if that helps. Otherwise try a different humidifier tank and if needed seals.

I want to try and get that fixed before doing some tests with pressure to see if it helps this breathing. A vauto has a few features that would be helpful for you and this breathing, the only thing we don't yet know is if we can fix it with fixing this leak issue and/or pressure adjustments.
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#15
RE: Over 2 years in and still tired w/Oscar charts
Might it be the oblong nature of one of these seals?  Can this be user replaced?  Can such a small leak really have any impact on treatment?  It's only audible if I put my ear right up to it.


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#16
RE: Over 2 years in and still tired w/Oscar charts
The outlet piece can be replaced by pushing down on the center tab until it releases, then it slides out the back.

The inlet on the tank is a matching oval.
The inlet 'gasket' is part of the blower surround and padding.

As a temporary fix I have smeared silicone plumbers grease or brasswind slide grease on the gaskets. ..

The gasket placement is on the tank in the AS11, so an improvement, I think.
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#17
RE: Over 2 years in and still tired w/Oscar charts
The elbow easily pops out so you can clean it by pressing the tab that secures it in place and pulling out where hose attaches. You have to first fully rotate outer hose attachment clockwise fully.

The other seal coming from the blower looks like it might be a little deformed (bottom right of lip seems curled inwards) and might be your issue. I am not aware of a way to remove or replace it though. I would try cleaning it and see if that helps, maybe can manipulate back in shape by hand.

Although in theory the machine works harder to make up for small leaks your current leak levels aren't that low and potentially could have an effect on treatment by requiring blower to run constantly to overcome.
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#18
RE: Over 2 years in and still tired w/Oscar charts
I’ve cleaned them both with some warm water on a Q tip today. It seems like it might’ve helped a bit, based solely upon what I can hear. If this isn’t successful I’ll be in a bad spot.
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#19
RE: Over 2 years in and still tired w/Oscar charts
The cleaning seems to have helped somewhat (see attachment), though I suspect it needs new gaskets on both ports.  This wasn't a great night of sleep after around 3AM, though, I don't feel awful today, surprisingly.


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#20
RE: Over 2 years in and still tired w/Oscar charts
You can see how the respiration rate chart shows very high RR at times, that is when your breathing has that odd shape and is passing back and forth over zero flow multiple times per breath. It is the prevalence of this breathing that I would think is having a negative effect on how you feel, the hard part is treating it though.

Ideally I would like to try higher pressure support but your machine on EPR 3 is already maxed out in that regard. All we can really try is higher or lower pressure and seeing if that has any effect. If trying higher pressure you could try 11-14 range. If trying lower pressure you could just drop min to 6.

Since this isn't indicated by apnea/ahi you have to go off how you feel and based on how often you are seeing this weird shaped breathing and if the setting change appears to have improved it or made things worse.
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