Please help with treatment review

[dapal]

Hello all. I ‘ve been reading this thread hopefully give me some knowledges of how to do it right with any sleepy device. From what I learn is Bilevel Machine ,especially s10 curve askv is the way to go no matter of who you are of dealing with sleepy problems! ? My impress of this might be wrong, I dun know yet. But sure to me what Davel has been doing is like a quarterback trying to win Super Bowl no matter of what it take  .
Mostly I see Davel just match his 95% in his chart to next setting make he feel good, then back it up of minimize setting , monkey around with EPR from 3 to 2 then 1. _For example the previous night his minimum pressure setting is 8 but if he see 95% result is 9.5 then he would set the minimum of next day to 9.  As I read Davel’s last result, his ahi and flow limit come to a perfect
Any one with same thought could give your inputs that would help me and any one reading this. 
Thanks
Note: I am just a novice, trying to adopt with res med auto machine . So pls do not think what I am thinking is what Dabevel’s thought. Thanks

[Gideon]

dapal, the best bet is to post your OSCAR charts in your own thread.

[DaveL]

dapal thanks for your comments.

Confession.
-I'm learning too.
-I've done this a long time; about 35 years. I was afraid of my sleep doc but he's retired.  He threatened to pull my driver's license if I didn't keep doing things his way.

-my S10 is brand new. My Knightsbridge strap is brand new.  I mouth breath; I'm claustrophobic in a big way.  I've tried a whole bunch of full face masks.  The only one I could keep on my  face a while was the ResMed F30. It leaked terribly on my face. It was a trial mask and i took it back.

-I have a new sleep doc..

All the help comes from people here! My auto pap machine is set at min pressure 13; max pressure 19.  I've started using EPR--suggested here.  Setting is two.

It's really simple. Find a mask that works.  Find a way to get the pressurized air down to keep the airways open. Listen to your body.  Stuff happens...like swallowing air, or opening my mouth to breath. I played a lot of football; broke my nose a few times.

I live in Ontario Canada.  British Columbia has a much better health plan; better medical care.

These are wonderful people.  Look how many people ask for help. I just learned that 100 people a day ask for clinician's manuals for their machines!  That blows my mind!




I believe it's really important for me to manage my own health care.

After all if I have to wear all this crap, it had better work.


Dapal, suggest you put your comments in your own thread.  Then when you post again, use the same thread.  These people are so knowledgable  If you stick in one thread they can look at how things are when you start to post, and compare future posts.  I'm told it's not about numbers.  It's about feelings.  So for me it's about sleep quality and healing.  I know I have sleep apnea.  I just want to sleep well

[DaveL]

Feeling
-blah....

Not well rested....

Hypopnea....

Hypopnea (sometimes spelled hypopnœa) is a medical term for a disorder which involves episodes of overly shallow breathing on the order of 30-50% of normal respiration or an abnormally low respiratory rate. This differs from apnea in that there remains some flow of air. Hypopnea events may happen while asleep or while awake.
During sleep, hypopnea is classed as a sleep disorder. With moderate to severe hypopnea, sleep is disturbed such that patients may get a full night's sleep but still not feel rested because they did not get the right kind of sleep. The disruption in breathing may cause a drop in blood oxygen level, which may, in turn, disrupt the stages of sleep. 
Hypopneas may be obstructive in nature which means that the airway has closed to some extent. Hypopneas may also be "central" in nature where the airway is completely open. Continuous Positive Airway Pressure can be used to alleviate obstructive hypopneas but will not help if the hypopneas are central in nature.
A hypopnea is scored as a central hypopnea only if none of the following conditions are present.

• Snoring during the event
  
• An increase in the flatting of the nasal pressure flow or PAP flow signal
  
• Paradoxical breathing (The chest wall moves in during inhale and out during exhale)
  

The above requirements are from the AAST website from an article entitled "Scoring Obstructive Hypopnea VS Central Hypopnea."
Daytime hypopnea events are mostly limited to those with severely compromised respiratory muscles, as occurs in some neuromuscular diseases. Similarly, daytime hypopnea can also cause a drop in blood oxygen level."
Apnea: 80% to 100% reduction in airflow for >= 10 seconds
Hypopnea: 50% to 80% reduction in airflow for >= 10 seconds
Flow Limitation: <50% reduction in airflow for >= 10 seconds

[DaveL]

I want to thank those who have helped me here.

Advice to me:
-don't obsess about numbers.
-Consider how I feel!

Yesterday I had a perfect score. I felt well rested. Score: 0! First with the S10

Today score was awful. I didn't feel as rested. Score: 2.0

In the past I would have been a terrible state, wondering what had changed.

I'm not in a state at all. My thought--leakage was an issue.

Change:
-no change in gear from yesterday

-S10; all settings the same.
-ResMed N20 large; I slacked off the straps when I put it on....perhaps shouldn't have done that.


-Knightsbridge Dual Strap. Put it on carefully, and I was lying down when I put it on

[Sleeprider]

Dave, I don't think I have made substantive changes in my therapy in a couple years, and rarely look at my charts. According to OSCAR:

The last time you used your ResMed AirCurve 10 VAuto...
was 30 days ago (on Friday, August 21, 2020)

Your machine was on for 10 hours, 18 minutes and 0 seconds.
You had an AHI of 0.68, which is over your 7 day average of 0.56.
Your machine was under 10.2-14.2 cmH2O for 95% of the time.
Your average leaks were 5.01 L/min, which is over your 7 day average of 4.86.

Well I never miss a night, but like I said, I don't look very often, and as I recall, that last record was not one of the good ones after a bit too much wine or something (I don't go 10 hours very often when I feel good). I have good and bad nights and how I feel during the day. I think that is called normal, and whether you use CPAP therapy or not, is just something we all deal with. It beats the alternative. Without the bad nights, you'd have no frame of reference to appreciate the good ones. We're glad you bring your experience to the forum with the sincere desire to help others, and it's okay if you are still looking for answers. I'm glad to tell you we have a lot of answers, but they're not always right...we do our best. God bless and keep well.

[DaveL]

Thanks Sleeprider!

I often go a month. However, the S10, Knightsbridge strap and mask are new to me

Guess I’ll sleep on it!

[OpalRose]

Guess I’ll sleep on it!

Dave, I think you are doing great, but I do relate to not seeing consistent results every night. I think that's normal for many of us. There will be a span of days where my AHI is between .5 to 1.0, and then for no particular reason, it will be over 2.0

I try to concentrate on comfort and getting enough sleep.

Keep up the good work!

[DaveL]

Guess I’ll sleep on it!

Dave, I think you are doing great, but I do relate to not seeing consistent results every night.  I think that's normal for many of us.  There will be a span of days where my AHI is between .5 to 1.0, and then for no particular reason, it will be over 2.0

I try to concentrate on comfort and getting enough sleep.  

Keep up the good work!

Thanks Opal Rose!

I was good at using my S9, N20 medium mask and home made cushion under my chin.


I had a week of reported AHI being 0.0 every night!

As a tuner I used to change one thing, see how that went before I made another change.  This time I changed everything!

I'm grateful to have an S10, and I'm happy using it as an APAP. Every improvement suggestion has helped.  

Although I've been compliant for over 35 years, I used to live in fear of being caught "practicing medicine without a license". That was Dr Inouye's threat...He wasn't interested in sleep quality at all.  Good thing he retired.

Thanks for the kind comments OpalRose and Sleeprider!

I didn't start learning until I came here.

[DaveL]

Feeling like crap. Checked the S10--it said 5. Thought, darn leakage. But...

Leakage is under control.  Right now i'd be happy with a 2!

I look at what OSCAR shows me, and I think, what the....; I see where breathing is so shallow. Figure, I'm 74 now. Maybe that's normal. I don't think I was mouthbreathing. Wearing my Knightsbridge strap. Using my cpap pillow. Did the night before too when reading was 0.2

Time to go within. Not my energy....

I'm grateful when I wake up! I'm grateful every day.