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Replaced my ASV, not happy, need help
#41
RE: Replaced my ASV, not happy, need help
Wow, you're not kidding -- I just read the article on Colin Sullivan. The man probably deserves a medical Nobel (they have those, right?) Thanks for the history lesson.
Wishing all a good night!
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#42
RE: Replaced my ASV, not happy, need help
Happy Saturday! Here is my progress report:
I couldn't tolerate the higher pressures -- EPAP at 5.6 plus PS minimum 4.4 meant a base pressure of 10, which caused puffy mouth and discomfort right off. So I dropped the PS back to 4 pretty quick. That got rid of puffy mouth but still ramped up aerophagia, which has been getting worse and is being unpleasant Sad . I took the EPAP down to 5.4 pretty early on, then later dropped it to 5.2--which actually led to better numbers than I've seen in a while, 2.06 overall but much lower in the latter part of the night with the lower EPAP--I think I actually may have been awake for that second group of hypopneas:
   

A close-up of the one cluster of hypopneas confirms the leaks are in lockstep with pressure spikes -- and again the leaks were way less in the last part of the night:
   

So I really think I do better staying with the lower pressures, at least for now, especially as the AHI seems to be going down or at least leveling off.  I don't want to raise the EPAP any more for the time being, at least till I can adjust to current levels. Maybe also take the max PS down to 9 to try and fend off big spikes?

I'm feeling encouraged overall. I'd love to get the AHI back under 1, but I can live with a little higher if it means no air in my belly and few leaks. . .
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#43
RE: Replaced my ASV, not happy, need help
It isn't looking bad by the numbers. Leaks and most events look under control. If you'd like to try PS Max 9, see what happens to your results and how it feels. If you don't like it for whatever reason, return it to whatever is set now. Unless there's anything major in the discomfort aspect, why not try this at least 2 nights after you decide on the PS Max. See what you get and post up an image with comments. And certainly post sooner if something falls off the tracks.

On settings when I go to adjust, I jot down what's current so I know what to return to if needed.
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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#44
RE: Replaced my ASV, not happy, need help
Sounds like a plan. I keep resolving to use the Notes section in Oscar to track such things, but have done a dismal job of it so far. So will try to do better.
Thanks!
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#45
RE: Replaced my ASV, not happy, need help
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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#46
RE: Replaced my ASV, not happy, need help
(11-02-2019, 11:45 AM)bemused Wrote: I'm feeling encouraged overall.

And this is the best part of all!

Sounds like you are developing a pretty good understanding of where you are on the pressure dynamics and a sense of what to do next and not,  or at least not yet.   

Look forward to seeing the next report. 



WillSleep

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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#47
RE: Replaced my ASV, not happy, need help
So. I think I may have diagnosed the problem (fingers crossed). Last night I woke up at 12:30 and couldn't feel any air coming through the mask -- because my nose was completely dry and blocked. I've always struggled with nasal dryness but it's been worse lately, even though I've ramped up the humidity on the machine as high as it will go. Somehow this time it occurred to me to actually check the tubing, at both ends, and it was bone dry, zero moisture anywhere. I didn't want to deal with it so just went without the rest of the night. This morning I took a good look at the whole setup for the humidifier, which I confess I hadn't paid much attention to before. And it finally hit me that the strategy I was using in the summer and fall to avoid rainout was biting me now that the weather is cold. We keep our nighttime temp around 62 degrees, and I had the climate line temp set to 81- basically drying up any moisture coming from the tank. Duh. So I lowered the tube temp to 65 and spent some time with it on -- lo and behold, nice moist air.

I am thinking that this could be the reason I've been having so much trouble--and also why my nose has been sore.  I get dry air blowing up my nose until it blocks up, then I start fighting with the machine for air, and the whole vicious cycle begins. 

That's the hypothesis. Make sense to y'all? I will test it tonight and post results tomorrow. I expect I will need to do some tweaking to get the right temperature/humidity balance, any tips on that would be appreciated.

Wish me luck. . .

PS. This is off-topic, but I'm not clear on the protocol for links to articles. This article on ProPublica lays out the whole sorry story of how insurers are taking gross advantage of XPAP users, not to mention the whole Big Brother aspect -- should I post it as a thread, or is that kosher?
https://www.propublica.org/article/you-s...stigations
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#48
RE: Replaced my ASV, not happy, need help
(11-04-2019, 01:08 PM)bemused Wrote: And it finally hit me that the strategy I was using in the summer and fall to avoid rainout was biting me now that the weather is cold. We keep our nighttime temp around 62 degrees, and I had the climate line temp set to 81- basically drying up any moisture coming from the tank. Duh. So I lowered the tube temp to 65 and spent some time with it on -- lo and behold, nice moist air.

I am thinking that this could be the reason I've been having so much trouble--and also why my nose has been sore.  I get dry air blowing up my nose until it blocks up, then I start fighting with the machine for air, and the whole vicious cycle begins. 

That's the hypothesis. Make sense to y'all? I will test it tonight and post results tomorrow. I expect I will need to do some tweaking to get the right temperature/humidity balance, any tips on that would be appreciated.

Wish me luck. . .

PS. This is off-topic, but I'm not clear on the protocol for links to articles. This article on ProPublica lays out the whole sorry story of how insurers are taking gross advantage of XPAP users, not to mention the whole Big Brother aspect -- should I post it as a thread, or is that kosher?
https://www.propublica.org/article/you-s...stigations

Yes your hypothesis could have some legs.  Seems like the right thing to tweak next.  I don't have any additional tips on the humidifier tuning yet.  

I think posting that article/blog post is fine.
  • Is Apnea related
  • Is not a site owned by a DME
  • Is not a link to page that includes direct marketing or a "Buy Now" type link
  • Not to Social Media
        
Good article as well. 

Here are a few links on posting policies 
http://www.apneaboard.com/wiki/index.php...be_avoided
http://www.apneaboard.com/wiki/index.php..._agreement

And Rule #5 at  http://www.apneaboard.com/forums/Thread-...oard-Rules


WillSleep

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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#49
RE: Replaced my ASV, not happy, need help
If it makes you feel better, then it's good. My strategy is to increase tube temperature and humidity in the winter. The tube temperature prevents condensation on a cold surface, and the humidity setting controls the evaporation rate of water. It sounds like you are using manual settings rather than automatic climate control, and that is what I do as well. At this point, I would keep tube temperature higher, and increase the humidity to 4 or 5 with manual climate control.
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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#50
RE: Replaced my ASV, not happy, need help
If what you found fixes it, congrats. My humidity is on Manual control and both humidity and heated hose stay within the upper half for my personal preferences. Seasonal changes and my current pulmonary status dictate edits for me if or when they'd be needed.
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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