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Plmnb - the journey continues now with ST-A.
RE: Plmnb - the journey continues now with ST-A.
(02-21-2020, 12:12 PM)Sleeprider Wrote: 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

On Vauto her min EPAP was 14 and increased at least as high as 18(only roughly half a dozen days of data available to review), now we have it set at 12. These moments of flow limitation seem to be more present so far in the ST-A results (have occurred in every sleep/nap even though they have been short periods whereas it appeared to only be occurring once in a while on Vauto). Admittedly we don't have a good night of ST-A data yet and perhaps the issue is due to reasons beyond machine capability. 

My main thought is that if these flow limitation events are occurring more regularly and continue to do so it is most likely because of the decrease in EPAP.

Edit: From Resmed titration guide.

"Increase EPAP by ≥ 1 cm H2O every ≥ 5 min to eliminate obstructive apneas, hypopneas, snoring and flow limitation"
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RE: Plmnb - the journey continues now with ST-A.
Coffee Good morning truted advisors, Sleeprider & Geer1 and all.


There is something to the getting MORE "sleep" time.  After my first session last night I was tempted to hang up the mask and tackle some chores.  But I forced myself to get some more time in the sack so I was able to double my time "asleep" last night.  Yup, wise decision.  Feel a bit more chipper this morning.  Not quite as foot draggy.  But alas, the tired is still there.  So let us see what we can do.

The night before last, and last night, I noticed something uncomfortable with the actual breathing.  I don't think it is PS related.  Actually, if I need more pressure, I'm pretty sure I could handle it.  But what I'm talking about is the following: (It seems like when I put the mask on and start the machine this problem is worse.  But I just tried the mask with the machine on to see if I could replicate the problem and it doesn't seem quite as irksome as when I first start up, still there but not quite as bad).

I start to take a breath in, continue to breathe in, but then the machine appears to want me to breathe out sooner than I am ready to do.  Usually it almost feels like a double bump of out.  Does that make any sense to anyone?  I could try a nap a little later before work and try to create a better description, but not sure I will have time.

The reason I didn't mention it yesterday is because I thought maybe this is the way things are supposed to be and it was the way I am supposed to breathe.  But since it happened again last night and it was so annoying, I figured I might as well ask.  If this is SUPPOSED to be the way it is, please let me know.

I am posting two charts with almost all the readings in case they are both needed to figure things out.  I haven't done any zooms yet this morning because I was thinking someone would ask for a particular period to zoom in on.

   
   

EDIT:  Thank you for letting me know about the flat top Mask Pressure waves!
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
We can see it was during your second session that you kept bumping against the TiMax, and that is the setting that makes you feel like the machine is cycling prematurely. You can increase that setting to 2.0, and it should not be a problem. You are getting a full breath in the time set for inspiration, and we have seen where longer inspiration time results in more inspiratory effort with lower flow rates (flow limitation), and I don't want to encroach on your expiration time. Your sleep disturbed breathing issues are unusual, and I'll be the first to admit I don't understand them well. I am working under the assumption that your extreme flow limitation results from when you do not spontaneously cycle to expiration without being kicked out of inspiration. We know this pattern is intermittent, and it is still visible in the charts, but with iVAPS you are getting booted out of inspiration without sacrificing minute vent. Your AHI is as low as I have seen, so I'm not inclined to make big changes. There are three distinct patterns in your sleep respiration at 2:00, 3:00 and 06:00. What do you see going on at those times?

As to still feeling tired, I'll congratulate you on getting 4:45 of therapy, but if you think that amounts to anywhere near enough sleep, you need to adjust your expectations.
Sleeprider
Apnea Board Moderator
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RE: Plmnb - the journey continues now with ST-A.
(02-22-2020, 09:11 AM)Sleeprider Wrote: As to still feeling tired, I'll congratulate you on getting 4:45 of therapy, but if you think that amounts to anywhere near enough sleep, you need to adjust your expectations.

Yes. Science says adults need from 7-9 hours of sleep. 

I'd encourage you, Plmnb, to read Matthew Walker's book "Why We Sleep" for more insight on how important this is.

Somehow, we need to find a way for you to get there.
Caveats: I'm just a patient, with no medical training.
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RE: Plmnb - the journey continues now with ST-A.
Heeeey Sleeprider, good morning to ya.

Crap, one of the nights I don't have the camera on.  Sorry   Oh-jeez

I don't have an iota of a clue what happened during those times.  I'll be sure to have the camera on from now on.

I will go now and set the Ti Max to 2 so that I don't forget later.

As to length of "sleep" period, I know, I know.  It's just that there are times I wake up and KNOW I have to go back to sleep or I wouldn't be able to function and there are times I wake up and could just lie there with my mind running amok but decide not to and get out of bed and start my day.  If I could just get to at least an absolute minimum of 5 hours I think that would be good for me.  ESPECIALLY IF IT WERE GOOD SLEEP.  I was about to say that as you get older, you require less sleep.  But I just looked this up and found that it is a misconception.  According to my Google search, as we get older we may have more trouble falling asleep and sleep less deeply.  For me, I have absolutely no trouble falling asleep, it's the staying asleep that is an issue.  As to depth of sleep, I think I can be pretty deep in sleep because my husband usually can't wake me up to lie back down when I do my leg raises and "yoga sleep".  

Appreciate your feed back as always,

Plmnb
Phoebe

PS: No zooms?  I like to do zooms, lol

Shy
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
You are welcome to zoom into those times I mentioned, but I'm looking for you to interpret what is happening rather than have me tell you. I think we both learn more that way.
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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RE: Plmnb - the journey continues now with ST-A.
Okidokie.  Zooms with my own limited analysis coming soon.  Dang, wish the camera had been on. You are correct, it is better for me to learn doing more so than being told...but it sure helps having your input.  And my math skills are 0, so all help is appreciated when having to do... yuck, math!  (Ratios, %, etc.) 

Best Regards,
See ya shortly,
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
(02-22-2020, 09:11 AM)Sleeprider Wrote: do not spontaneously cycle to expiration without being kicked out of inspiration. 

Hey, does this help us at all?

I'm going to read it more closely to see if I can glean anything, but with you being more familiar you can tell me if it is wasted time to read it?

Googled the quote and found this

Dont-know
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
Thank you slowriter.  I will definitely check this book out.  Appreciate the recommendation

Plmnb.
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
Here are zooms sleeprider of the three time periods you mention.  What about these particular times piqued your interest?  Sure, they show some irregularities, but there are other areas I am curious about.  For instance, the Hypopneas that are listed are do not appear to be "SWJ", unless they were caused by my husband inadvertently "waking" me up.  What is curious to me is that they appear at intervals that make me believe they were NOT caused by my husband.

Also, I have just realized that the break (between 4:03:10 approximately and 05:50:30 approximately) between the sessions is about two hours at a time my husband is sound asleep.  This means this is NOT one of my normal breaks in sessions.  My breaks in sessions have historically (almost always, but not always always), been my getting up to spend time with my husband.  THIS break is my waking up, realizing I don't have my mask on, (it's on the floor), and then putting it back on.

This is one reason I gave up on therapy over 7 years ago because I ALWAYS woke up with the mask on the floor and I didn't have this board to help me, my doctor at the time was clueless and useless.

These zooms are to get us started on my trying to interpret their meanings.

           



Back soon!
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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