Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Roller coster AHI...
#11
RE: Roller coster AHI...
That's encouraging results, and I think your conclusion to avoid more than one pillow is consistent with good cervical alignment.  We usually see improvement as you adapt to a collar.  I was looking forward to seeing your review because we have fewer choices for those of us with more neck circumference.  I hope you will consider adding a review to the Review forum once you have a few more nights of experience.  The difference in leaks and flow limits is impressive.  The chart format you used before would be much more helpful than the summary, but you seem to have come a long way.

[Image: attachment.php?aid=23446]
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.
Post Reply Post Reply






Donate to Apnea Board  
#12
RE: Roller coster AHI...
(06-05-2020, 07:20 AM)Sleeprider Wrote: That's encouraging results, and I think your conclusion to avoid more than one pillow is consistent with good cervical alignment.  We usually see improvement as you adapt to a collar.  I was looking forward to seeing your review because we have fewer choices for those of us with more neck circumference.  I hope you will consider adding a review to the Review forum once you have a few more nights of experience.  The difference in leaks and flow limits is impressive.  The chart format you used before would be much more helpful than the summary, but you seem to have come a long way.

Your advise of using the SCC earlier in this thread much appreciated and it seems like, it'll work out for me. I've never done a review, especially related to CPAP machine; with that said, give me couple of weeks to review the two of them I have.

This is the first day's chart with Coreflex:

   

And from last night:

   

Yesterday, there had been way too much activities for my age. I've spent 5-6 hours on the water fishing, had to clean all of the fish, had my grandkids over for a  barbecue, I was the "chef". Playing tag, hide and seek, etc., with kids five and eight isn't easy. They could not stop for a minute. I was dead tired by the time bedtime rolled around. Despite being so tired and AHI > 5, I woke up well rested and even in the afternoon, I feel just fine.

The day before, with the AHI < 1, I did not feel as good as today. Go figure... maybe I should have slept more than four hours...
"Life is dream, awakening is death..."
- Chinese proverb
Post Reply Post Reply
#13
RE: Roller coster AHI...
Using just one pillow didn't move the AHI to the right direction, quite the opposite:

   

The leakage rate didn't change much, it's still good.

On the other hand the number of events for CA, CSR and OA were high. I did wake up last night once or twice coughing.

Could the coughing be the reason for the number of events increasing? Conventional wisdom says, the answer is yes...

Looking at the overview, FFM vs. NM, shows interesting results:

   

In general...

With the full face mask the Apnea related value deviations weren't that large, while the high leakage rate pretty much stayed constant with a few exceptions. The latter one had been the primary reason for switching to nasal mask.

With the nasal mask, the results were opposite; the Apnea related value deviations were large, while the high leakage rate pretty much were cut in half.

Using the soft cervical collar (SCC) with the nasal mask, the Apnea related value deviations were still large, even with minimizing the leakage rate further down.

Seemingly, returning to the full face mask with the soft cervical collar could result in minimal leaks and lower and more even AHI related values. Provided, that the "meatball" does not change much on the other end of the heated hose...

Is there any adjustment on the AS10, that would help reducing the variations for the AHI related values?
"Life is dream, awakening is death..."
- Chinese proverb
Post Reply Post Reply
#14
RE: Roller coster AHI...
The leaks make identification of the events less certain, but the increasing CA events is a surprise. Your flow limit is very low, and the clusters of OA are not clusters of CA. I think we mght want to zoom in on the flow rate chart and look closer at your breathing pattern. Although your leak rate is generally low on the chart, I think you are exhaling from your mouth and inhaling orally quite a bit. A closer 2-minte view of the flow rate may show a rounded inspiration and a spike of expiration or absent expiration.
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.
Post Reply Post Reply






Donate to Apnea Board  
#15
RE: Roller coster AHI...
The two minutes intervals, randomly picked based on the issues from last night, below:

       

As a novice at OSCAR, I am not certain, what should I look for?

My best day from couple of nights ego, about same time frame for the two minutes, shows pretty much the same chart:

   

One difference I've noticed is, that respiratory rate didn't drop below 8.x, while the ones from last night did. In some cases, the ones from last night dropped as far as less than one for a short time period. Short or not, that cannot be good...

The leakage rate is pretty much a non issue, based on these three days, correct?

Thanks for your help...
"Life is dream, awakening is death..."
- Chinese proverb
Post Reply Post Reply
#16
RE: Roller coster AHI...
Your leaking is sorted nothing to worry about there, you big issue now is CA’s
Post Reply Post Reply
#17
RE: Roller coster AHI...
I'm not sure leaks are so sorted here.  We have an old figure that shows a few wave-forms and what they mean.  Yours looks just like the next-to-last which is expiratory mouth breathing with inspiratory flow from the mask.  This is actually pretty common in most nasal mask users from time to time, but I see it occurring all the time in your graphs.  This explains the absence of an expiration flow, and the spiky appearance of the lower part of your flow rate chart.  The central event you showed in your chart appears to be real, with diminishing inspiratory flow to the apnea and a gradual recovery.  You may need to change to a full face interface or use something like taping to stop exhaling from your mouth.  The severity of the CA is such that it might be worth having a titration test that evaluates those events. If they are determined to be central apnea, then ASV is the appropriate therapy.  I think we need to get the expiratory mouth breathing out of the picture before we draw conclusions.

[Image: Flow_limitation_images_zpsdb148d1f.jpg]
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.
Post Reply Post Reply






Donate to Apnea Board  
#18
RE: Roller coster AHI...
(06-07-2020, 01:07 AM)jaswilliams Wrote: Your leaking is sorted nothing to worry about there, you big issue now is CA’s

Thanks Jas...

The "CA" means Central Sleep Apnea, correct? The one that, according to bonjour, quote:


Quote:Central Apnea, it is consistently inconsistent.

Last night did prove that:

         

Is there any adjustment that I can make on the AS10, reduce the minimum pressure, EPR, etc., that would help?

As posted earlier, with the FFM without SCC, the AHI  range was 2.62 to 10.58, average 5.38. That's not as wild of a ride, than with the nasal mask.

With the nasal mask without SCC, the AHI range was 1.92 to 22.79, average 7.97.

With the nasal mask and SCC, the AHI range was 0.26 to 21.60, average 7.30.

I'll give the nasal mask with SCC another week or so, before going back to the FFM, this time with SCC that I have not tried yet..
"Life is dream, awakening is death..."
- Chinese proverb
Post Reply Post Reply
#19
RE: Roller coster AHI...
@Sleeprider... sorry, didn't see your post...

I'll go back to the full face mask tonight with the soft cervical collar. The letter one should keep the leaks in check and we'll see how other values the change.

Thanks...
"Life is dream, awakening is death..."
- Chinese proverb
Post Reply Post Reply
#20
RE: Roller coster AHI...
Switching over to FFM with SCC did not start out as well as I hoped for. OSCAR's initial start up pretty much summarizes the result:

   

The AHI of 4.26 is pretty much in line with the usual AHI values for the FFM; the time over leak redline increased from 0 to 27.15%:

   

While 27.15% is a lot, it's actually on the low end what I usually have with the FFM; 30 - 60% was not unusual before I switched to the nasal mask. I contribute the "lower value" to using SCC.

For some reason, I really don't like the FFM, but will give it couple of nights to see, if it'll improve.

Physically/mentally I feel fine, other than mildly being upset that the FFM/SCC didn't perform better...
"Life is dream, awakening is death..."
- Chinese proverb
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Why do AHI and Centrals show a roller coaster result ckingzzzs 8 1,686 07-18-2016, 06:52 PM
Last Post: ckingzzzs


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.