Please help with treatment review

[DaveL]

I've clicked on all those switches (I think)

Does this screen shot show what you need to see?

[DaveL]

This shows respiratory rate...

[Sleepster]

Do you wear a chin strap?

[DaveL]

Thanks for asking...I didn't wear my Dakota wedge. That was the first night I went without, out of frustration.
Reason...I wear it so tight that its very uncomfortable.

[mper6794]

hi,
1-please plot some 10min and 2min windows during your cluster of flow limitations, always including FR, leak, FL, and tidal volume..
2_ Only CPAP during these 30 years?

good  luck

[DaveL]

No.  Last night was the first night in years I didn't wear a chinstrap.
Reason: frustration.  For a year I've been using a Dakota wedge. I have to do it up very very tight to prevent mouth breathing. Then the underside of my chin feels awful when I wake up; feels awful (rubbed) for hours after day starts. In fact, well after I go to work. Say mid morning...

I've used a chinstrap for years. The one I settled on isn't available any more from my DME. Chin straps slip on my bald spot, and then don't work; the one I had used circled the ears, and didn't slip. However, it stretched, I had to replace it often, and was expensive. I can't buy it now....

I found it more comfortable than the Dakota wedge the way I'm using the Dakota. (I have a double chin.)

A couple of posts up suggestion was to consider RERA's. And hint was to turn on all my events to see if RERA was cause for tiredness.

I did that; this screenshot shows lots of mouth breathing. 

I don't know how to interpret whether RERA is a contributing factor to that.

[DaveL]

hi,
1-please plot some 10min and 2min windows during your cluster of flow limitations, always including FR, leak, FL, and tidal volume..
2_ Only CPAP during these 30 years?

good  luck

Thanks.
Don't know how to do that. 

Yes.
Ontario Canada.
I have a new sleep doc....
I can only buy a cpap. That's the only prescription I can get.

(My old sleep-doc-from-_ell accused me of practicing medicine without a license when I said I was going to change pressure on my machine. He threatened to pull my driver's license. That was years ago. My new sleep doc seems much better. I discussed other machines; however, he will only write a cpap prescription.)

[mper6794]

Oh! This is serious and sad! In my case, two-year user, better life quality came only when i assume control of my therapy, while moving from basic CPAP, AUTOSET, and  the current bilevel VAUTO. My doctors generally take into consideration numbers, analysis, etc, i have been performed, yet, i notice, not decisevely for them.
I am afraid  is going to be hard for people here truly help you this situation. Hope so...
ALL the best.

[mper6794]

Dave L,
Going back and little deeper in your charts and writings:
1_in terms of apneas themselves, it appears you are in good shape...,,regard FL's it is not clear yet...
2- based on your tidal volume and flow rate, and comparing with my experience on my wake-up calibrated graphs, it appears you have a very disrupted sleep (either shortly waking up or not going into deeper sleeps);
3_ your wrote: "I have untreated wrestless leg syndrome. That was diagnosed over 30 years ago when I was first diagnosed with severe sleep apnea" . 
This is something!!! RLS/PLMD  is my still-remained main issue after a two-year therapy. I have already gone into details of my case elsewhere in this blog. During 1.7 years I strugled with CPAP, AUTOSET, masks, mouth breathing, and so on. Finally, since april, 2019, I moved to bilevel VAUTO and FFM airfit f20. Pretty much worked out FLimitations, PML's were highlighted. Even after significant improvements and better life quality, FL+PLM's still wake me up some 3 to 4 times/hr. However, I realized, after very careful observations, data plotting, medical literature, this number of awekenings are not so much important for my HDYF (how do you feel index), while SleepEfficiency (SE: % of time sleeping/time in bed), yes, it is. With SE of 85 to 90% I am dancing in the streets rather than walking. Therefore, these days I am totally focused on getting higher SE, either trying and evaluating medications, supllements, and hard working on sleep hygiene.

GL

[DaveL]

Thanks.
My watch tells me that I transition to light sleep a lot.