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RE: In anticipation of my BIPAP Re: New Thread
RE: Plmnb - the journey continues now with ST-A.
FWIW I had mask removal times that developed from habit with uncomfortable therapy while on CPAP and BPAP. I then had the same habit while beginning ASV just due to not keeping the mask on with prior poor therapy experiences.

The thing that broke my habit of mask removal was putting it back on as soon as I was aware of it, and not quitting the therapy. Believe me, there were frustrating times with the ASV despite good therapy. I felt like quitting, but fought against it and it did pay off.

ST-A the course.
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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RE: Plmnb - the journey continues now with ST-A.
your situation is way beyond me. I like that you're looking for a silver lining but I'm not sure the mask on forehead is anything other than a function of some kind of discomfort. you have to keep working on mask fit & finding the right machine & machine settings.

idk how it would work relative to the settings help you're getting but when my pressure related leaks get out of hand I have little choice but to reduce pressure; usually max pressure but epap as well if above a certain threshold. leaks not related to pressure in my case are usually associated with deeper sleep & back sleeping so I work on staying off my back. or I need a new mask cushion. to my amazement I've managed to lose 10 or 12 pounds recently. doesn't seem like enough to make much difference but leaks & ahi were so bad last night I'm wondering if a different size mask cushion is necessary. it seems like it never ends but take it from a guy that's been struggling to feel better with pap for more than three years: don't allow yourself to get too discouraged. it may be a slog & it might take a while, but it does get easier & it does get better.
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RE: Plmnb - the journey continues now with ST-A.
Sleeprider, okay, I'm going to go with the discomfort of the tightness of both the headgear and mask scenario...for now anyway.  Unfortunately, in my situation...and I'm sure for others...we know not what we do.  Therefore, how to modify a behavior we have no idea we are doing?  When I met my new husband he had an awful habit of referring to himself in the third person.  I would point it out to him almost every time he would do it.  Eventually, he would catch himself doing it, and now it has been at least a year since he has done it.  I don't have anyone to tell me I am putting my mask and headgear on my forehead and on top of my head.  (Well, actually with my husband's own sleep issues you would think he could try to wake me up and tell me, but that ain't happening because about 100% of the time he can not wake me up).

So, now what?  Some sort of an alarm attached to the equipment?  I don't think that will work because I barely hear the leak alarm on my pap machine it is so low so as not to awaken my husband.  I have actually just turned it off.

A virginity belt sort of gizmo?  Something you would have to unlock with a key to open and therefore get to the straps, etc.?

I already tried just simply tying a soft belt around my other mask, but I found it on the floor next to the bed.

Some sort of buzzer thingy that would give me a tiny electric shock if I touch the mask and head gear. (I'm serious, lol)

I just don't know what to do.  PLEASE...anyone with suggestions, I'd love to hear them.  Something perhaps that has worked for you.

Sincerely,
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.
mittens? tape the mask to your face so it hurts a bit when removed? frankly, I'm a little jealous you sleep so hard. I wake at the drop of a hat.
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RE: Plmnb - the journey continues now with ST-A.
(02-23-2020, 08:16 PM)SarcasticDave94 Wrote: The thing that broke my habit of mask removal was putting it back on as soon as I was aware of it, and not quitting the therapy. Believe me, there were frustrating times with the ASV despite good therapy. I felt like quitting, but fought against it and it did pay off.

ST-A the course.

Hi SarcasticDave, nice to hear from you again.

The very few times I do find it off during sleep time I do put it back on.  However, the majority of the time it is when I get up for the day and there is the little sucker, lying beside my bed, resting comfortably on my dang floor.  Sad

I guess it may just take longe than I had hoped.  My first experience with pap therapy was so long ago, around 2003.  Total failure as I have previously said.  I had no Apneaboard.com to help me through and my docs had no clue.  So after the failures with the apnea surgeries, I quit.

I am DETERMINED NOT to quit this time.  Even if I sort of want to.  All I have to do is come here for moral support and technical support, yes...sleeprider...still needing the holding of the hand...my big girl you know whats are needing suspenders.

I-love-Apnea-Board 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.
gorilla glue...no don't try it Smile
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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RE: Plmnb - the journey continues now with ST-A.
Lolabove

I'm considering it!!!
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.
Without seeing OSCAR data we are just guessing at what may or may not be the issue.

My offer still stands to review the data if you upload it to the link I sent you, I would like to see both Vauto and ST-A data in order to draw conclusions from both. If you upload the data I can post a link here so anyone else interested can download, review it and give their thoughts as well.

We are running around in circles chasing our tails here. We need more detailed data to draw conclusions from.
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RE: Plmnb - the journey continues now with ST-A.
Geer1,

I REALLY appreciate your wanting to help, two heads can definitely be better than one.  However, I do apologize for your not being able to see the data you are asking for as quickly as you like.  I have already tried to copy the data to a new folder.  Actually, copy was not given as an option, duplicate was.  I did that.  I just haven't been able to get as far in the process at the moment as you need, to draw your conclusions.

Please realize that the data you are asking for WAS reviewed IN DEPTH numerous times by those who have followed this thread, and my other two main threads from the beginning...back in December.  I do believe progress has been made, especially with the latest help from Vsheline who actually is using the same machine I am.  I personally do not feel that tails are being chased here.  

I have had many issues, which my original advisors here are aware of, in addition to the sleep apnea, it hasn't been just the charts.  I have had very poor sleep hygiene issues.  Again, addressed numerous times previously.  I also have Bipolar and was not on my medications for over 2 years.  In addition to that psychological condition I have diagnosed severe anxiety disorder and ADHD.  I have just now been back on them.  I have a very unpredictable work schedule which makes getting to bed at a decent and regular time impossible.  I have a new husband that I feel I need to spend some quality wake time with. I have extremely low Vitamin D which is linked to Bipolar and even have to take prescription strength D for this.  I have been dealing with the dang "yoga sleep" which does not show up in any charts, just my video and word of my husband. I had an original sleep doctor this time around who was dr.duck and I had to beg, in tears for a different doctor. AND I had originally gone in asking for the BIPAP and they still sent me home with CPAP.  So a whole month wasted. I have a DME that is trying to rip me off, and have developed arthritis in my knees.  I have had multiple surgeries to help with the apnea, all failures and extraordinarily painful.  There is a bunch of other stupid s**t i won't even get into.

So, if you would still like to see that data, I will get it to you when I can.  I certainly do not want to be rude, but when you say "we" in connection with chasing tails, I just don't think that is fair.

Sincerely,
Plmnb
Phoebe
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.
(02-23-2020, 09:21 AM)Plmnb Wrote: Yes, it is very encouraging to have someone that is in your shoes helping out.  I look forward to hearing more from Vsheline.

Hi Phoebe,

I think the ResMed ST-A is probably the most optimal machine for you, but I really can’t claim to be in your shoes, since I think my case is far simpler than yours, without the intermittent periods of severe partial obstruction your data shows.

I have moderate obstructive sleep apnea with mild therapy-induced central sleep apnea.  
When it was time for a new machine after five years on ASV therapy I asked for a ResMed ST-A because ResMed iVAPS treats central apneas similarly to ResMed ASV and offers an adjustable floor for how much air is breathed per minute (Minute Ventilation). ASV machines don’t have that adjustable floor. 

With ASV I had noticed that occasionally my Minute Vent would very gradually drop so low that I would awake gasping for breath, and ASV machines just let that happen, since their ventilation target is based on the most recent 3 or 4 minutes, which works great for sudden central apneas or hypopneas but doesn’t treat breathing reductions which are very gradual. The ResMed ST-A works great for me. 

Also, when it was time for a new machine 18 months ago I was approaching the need for open heart surgery to replace my Aortic valve and was concerned that if I needed strong narcotic pain meds during recovery that having the iVAPS mode would be the most safe therapy available for preventing trouble from meds which may depress one’s ability to breathe. (As it turned out the operation went extremely well and no strong pain meds were needed.)

Regarding removing your mask, I suggest trying whatever you can to improve comfort. For example, try different settings for Trigger sensitivity (High makes IPAP start earlier, Low delays start of IPAP). 

Also, leaks bothered me terribly, especially around the eyes, until I started using a mask liner, which is a doughnut shaped circle of cloth which goes between the mask and the face. I use RemZZs brand. I think they probably make one for nearly every mask type and size. Mask liners completely eliminate mask burping/trumpeting and leaks around my eyes.  Or what leaking does occur is very soft and is not bothersome. I wear two liners at a time because thicker is better, and I change to a new pair of liners every 2 weeks or so.  (I am careful *not* to follow manufacture’s instructions to stretch the liners, because then I can’t reuse many times.). Also, I wear a napkin folded over several times to cushion where the headpiece of my full face mask touches my forehead. And I am careful to not over tighten the straps and cause soreness or headache.
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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