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Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
#51
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
Sleepyhead and OSCAR both read the PAP generated data on the SD card and create the graphs.
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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#52
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-15-2022, 11:49 PM)SarcasticDave94 Wrote: Sleepyhead and OSCAR both read the PAP generated data on the SD card and create the graphs.

No, I'm asking about the Machine Settings on the left side of the page.
I should be able to see (on today's and tomorrow's charts) the change
to EPR of 3.

See attached clipped SleepyHead example.
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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#53
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
I'm thinking the settings change show on there a day after they're edited. Example, changes now should be seen after use tomorrow. That's what I recall about my usage on Sleepyhead anyway.
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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#54
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-16-2022, 12:39 AM)SarcasticDave94 Wrote: I'm thinking the settings change show on there a day after they're edited. Example, changes now should be seen after use tomorrow. That's what I recall about my usage on Sleepyhead anyway.

That's exactly what happened, Dave.

On using a collar, last night's results were without one.
Too much caffeine and a cat sleeping on me may have
contributed. Have to repair the mask.
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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#55
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
Just want to confirm what you are currently/recently using for equipment.

N30 mask is correct?
Collar most nights?
Chin strap or mouth tape?
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#56
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-16-2022, 04:35 PM)Geer1 Wrote: Just want to confirm what you are currently/recently using for equipment.

N30 mask is correct?
Collar most nights?
Chin strap or mouth tape?

Yes, N30. Collar when it gets fixed. 
Cut off too much Velcro.
No chin strap or tape.
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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#57
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
Those close up views you shared show what is either expiratory mouth breathing (where you inhale through nose/cpap but then exhale through mouth) or palatal prolapse which is when your soft palate blocks nasal passage during exhale.

The reason I was curious about what equipment you are using is to know if expiratory mouth breathing was possible and because I was surprised to see your leak rate is pretty much zero. I believe this makes expiratory mouth breathing less likely.

My guess is that at times you suffer from palatal prolapse during exhalation and that your soft palate and nasopharynx region is probably a significant source of your obstruction/restriction.

Unfortunately palatal prolapse is tough to treat and it usually isn't very responsive to PAP setting changes. In your most recent data the higher EPR appeared to help so I recommend continuing to use 3 EPR to see if treatment seems adequate. 

If these settings don't seem adequate then I only know one member that has successfully treated palatal prolapse and it was using a 6 inch Alaxo Stent (tube placed in nasal passage to hold airway open). You can see his info here. 

http://www.apneaboard.com/forums/Thread-...l-Prolapse?

The other option I know a few members have considered for palatal prolapse is UPPP surgery but unfortunately I don't believe any of them have had the surgery done (or if they did they did not come back and share results). If considering this you would want to find a good experienced doctor/surgeon (probably ENT that specializes in apnea) to investigate your airway and see if you are a good fit for UPPP. UPPP is controversial because it doesn't help a lot of people with apnea (which makes sense because most apnea occurs lower in airway), often still requires CPAP or other treatment after surgery (to treat apnea in lower airway) and sometimes it can have negative side effects (I think the surgery has improved and this is less likely now). That said it makes sense that people with obvious palatal prolapse would have a higher chance of success of benefiting from the surgery, unfortunately we haven't seen cases to support the theory yet though.
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#58
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
Hi geer1,

Thanks for your detailed descriptions of possible solutions.
Surgery is a non-starter. The stent sounds very promising.

SleepyCPAP's therapy journey is extraordinary and his
results are dramatic. If the stent can do the job

without an xPAP it would be marvelous.

His conditions are remarkably similar to mine: a wedge
pillow (mine for LPRD, a cousin to GERD), a cervical collar,
and a blood thinner, if memory serves.

A low AHI with the repaired collar didn't pan out.
Thumbnails below, one each with and without flags.
With flags, the graphs are very cluttered.

My doctors are affiliated with a prestigious area hospital.
I'll see if any of the ENTs know about the stent for OSA.

Best,

Harv
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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#59
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
(01-17-2022, 02:15 PM)midwestguy Wrote: SleepyCPAP's therapy journey is extraordinary and his
results are dramatic. If the stent can do the job without an xPAP it would be marvelous.

<snip>
My doctors are affiliated with a prestigious area hospital.
I'll see if any of the ENTs know about the stent for OSA.
Harv,
I found my primary care doctor and sleep doctor had not heard of the AlaxoStent. They didn’t want to sign off on the stent without having known about it, nor knowing any patient who used it. I got a referral to an ENT… but it was taking forever to get an appointment with an ENT in my region so while waiting I asked AlaxoUSA to refer me to one of their ENT’s, for a virtual consultation. After a couple weeks that process was complete, and that ENT signed off on my order. Finally the local ENT had an opening and scoped my throat when I was sitting upright and awake, and my soft palate looked fine, but the doctor thought I might benefit from an oral appliance to advance my lower jaw. The AlaxoStent order was already on its way to me, so I tried that first, and it happened to be exactly the right treatment.  I don’t think I need the jaw advanced, I just think it is something the doctors are more used to seeing.

So you may need to be the first person they know to go with the stent.

-SleepyCPAP
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#60
RE: Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare?
Hi, Sleepy CPAP,

Thanks for your reply.

Your experiences may save me some effort. 
When you had the virtual consultation, what
did you have to provide? Was it via screen or
just phone?

Best,

Harv
Thanks to everyone who helps us get a better night's sleep.

Anything I post here or elsewhere on these forums is my opinion, not medical advice. Medical advice comes from a doctor.
An Advisory Member is a member of the Advisory Committee which helps shape Apnea Board's rules & policies.
Such membership does not imply medical expertise or qualifications for advising sleep apnea patients about their treatment.

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