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Plmnb - the journey continues now with ST-A.
#91
RE: Plmnb - the journey continues now with ST-A.
I have reviewed the footage from today's nap.  At 13:32 = Husband is coughing and turning over.  I don't wake up per se, but I do adjust my covers.  13:33 = Husband moving about, but I appear to be sound asleep, I am not moving at all.

13:40 ish = Visible, deep jerky type of breaths.  No movement from me except chest, stomach movement.  No disruption from husband.

13:58 ish = Stretch, touch my mask. (H) No disruption from husband.

14:12 ish, 14:15 ish = Noticeable rise and fall of my covers which indicates to me deep breathing. No disruption from husband.

There appears to be many deep breathing periods.

Just had a message from an acquaintance who said with me on iVAPS, I shouldn't be concerned with flat top on mask pressure waves.  This is pretty much the way it should appear.  What say you all to this?

THE BIG QUESTION:  Keep all settings as they are and see what happens with a "full" night under my belt with the hybrid mask?

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#92
RE: Plmnb - the journey continues now with ST-A.
Phoebe, considering how you feel and the hypopnea, increase PS min to 5.0. Therapy looks okay, but you have really reduced the PS you used to have and seemed comfortable with.
Sleeprider
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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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#93
RE: Plmnb - the journey continues now with ST-A.
Thank you very much Sleeprider.  I will do so.

Will report back in tomorrow.

Sleep Well!

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#94
RE: Plmnb - the journey continues now with ST-A.
Coffee Good morning Sleeprider and all.


I at least remembered to put the SD card back in the pap machine last night.  I set the PS back to 5 as suggested by the trusty Sleeprider.  Although I only slept for a very short time, I believe there is enough data to draw some information from.  (I didn't include the nap portion from yesterday because I already posted it yesterday).

The reason last night's sleep was so short was I was up waiting for my husband to come home from work, ate dinner with him, hung out for a while until I just HAD to go to sleep.  I awoke pretty early and took the mask off and at just about the same time had an attack of my Meralgia Paresthetica (aka Bernhardt-Roth syndrome, haven't had an issue with this for about 10 years).  At this point, all thoughts of putting the mask back on and continuing therapy were not in my thoughts.

I saw my primary care doctor the other day and she has me referred to a neurologist for my sleep disturbances, hopefully to address both, the possible parasominia of what I now call "yoga sleep" and the resurgence of the Meralgia.  Can't hurt to try to attack this sleep apnea from all directions.


It seems like going back to my hybrid Dreamwear mask and changing the PS back to 5 may have yielded better therapy?  Not sure with the presence still, I think, of the "car compactor" waves.  I spent a good portion of the morning combing my video clips for clues.  Other than a couple of instances of my husband interfering with my sleep, hence I believe the lone hypopnea, the rest of the video still shows me with a fair amount of footage of "labored"? breathing.

As I believe I mentioned yesterday, I have been informed that with me on iVAPS the flat tops of the Mask Pressure wave forms is to be expected and not really anything to worry about.  Hope that is indeed true.  Now, though, the unevenness between portions of these wave forms are of interest to me. 

So, for what it is worth...I present last night's "sleep" chart portion:

   

Regards,
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#95
RE: Plmnb - the journey continues now with ST-A.
Kind of hard to judge 1.5 hours of therapy, but if you feel better, that's a plus. I think the PS min should go to whatever feels best to you, and we don't need to over-analyze it. I notice that minute vent and respiration rate all stabilize where you hit that TiMax on inspiratory time, and this is also where we see an interesting pressure support response from the ST-A. From a purely respiratory perspective, that seems better than supporting overly long inspiration times which seem to turn into the extreme flow limits, and it shows how PS is working to maintain respiratory volume in what was previously a chaotic respiration prior to iVAPS.

Good luck with the other doctors. Get more sleep!
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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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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#96
RE: Plmnb - the journey continues now with ST-A.
ST-A (stay) the course, add sleep time if possible, best wishes for success, this is looking far better than other machines data-wise
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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#97
RE: Plmnb - the journey continues now with ST-A.
Thanks guys.

I’m going to try to stay the current course for a bit at PS 5 and see what happens.  Yeah, LONGER sleep would be great!  I look forward to the next round of dr. appts. next week.  I’ll update as needed.

Regards,
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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#98
RE: Plmnb - the journey continues now with ST-A.
I think you're probably at the stage with the ST-A to attempt to build a good, positive trend that adds sleep/rest. I'd like to see what trend you and the ST-A could make, obvious that we'd want some positive trend. Setting edits are likely to be between nothing to very small steps IF a need arises that must be addressed. If nothing needs attention, ST-A the course as already mentioned.

Sleep-well
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#99
RE: Plmnb - the journey continues now with ST-A.
To answer your question yes tue because of the way things are programmed the flat top pressure waveform is normal and expected.

I could be wrong but I don't think that moment of breathing Sleeprider is referring to is actually good breathing and would like to see a zoomed in view of 1:45 to confirm what we are seeing. I interpret MV and respiration rate as being steady because it is the machine doing its job and ventilating you. In other words I believe the graphs are smooth because the machine is working to maintain your breathing. It is nice to see that the machine is doing its job and maintaining this but as mentioned I would like to see a zoomed in example to try and understand why the machine is working so hard during that time (if that is a moment of flow limitation etc).
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RE: Plmnb - the journey continues now with ST-A.
Geer, we've seen inspiration track like this with the Vauto as well, and when TiMax was extended to 2.5, it resulted in some bizzare I:E ratios and extreme flow limits. I did say breathing looks pretty good in this section, but more accurately I think this is one of those episodes that was formerly extremely flow-limited where the video also observed extreme respiratory effort (chest rising and falling). I suspect the respiratory flow rate is not all that pretty here, but the stability of Vm, Tv and BPM are better than what we saw on Vauto and CPAP.

Before we get into flow rate analysis, please consider what you want to do with the information. I'd rather avoid over-analysis and reactionary setting changes at this point
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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