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Started BiPaP treatment, makes things worse. Struggling with the settings.
#51
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
Members have gotten over 50% reduction in events by merely being aware of positional apnea, so there is some benefit that comes from taking steps with your pillows and avoiding the chin-tuck position. With PS limited to 2.0 cm, there is not enough pressure to cause a breath during a central event, so there will be a few of those or hypopnea if the breath is not sufficient to maintain flow. The current strategy is to avoid centrals rather than treat them, but I'm sure a few will happen. Once we eliminate positional obstruction as a cause, we can decide which way to take this.
Sleeprider
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#52
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
Interesting night with my collar!

I woke up feeling a bit hungry but ready to start the day, and definitely couldn't go back to sleep. After trying for a little while, I checked and it was 2:15. I think I woke at 2ish.

I was VERY awake, more than my best days. Even more than if I've got a rush of adrenaline, some coffee, an ADHD stimulant medication, etc. The most awake I've ever been. I couldn't sleep until 5.15.

My partner woke at a similar time to me, and the hunger thing might be a blood sugar issue as we both had a sugary drink not long before bed. Regardless, I'm going to assume it's unrelated to the apnea/equipment. Just bad luck on the first collar day.

So I've attached the data. BUT 2am-5am can be fully discounted. I've attached zoomed pictures for the periods before/after being awake. 

Before I woke up, 0 flow limitations! I did loosen it a bit when awake, and decided not to use a pillow, and it seems to have been a bad call. Overall I'm still having events, but the inbetween is much more stable!

Going to do what I can to get proper sleep hygiene tonight and if I can get the full night in without waking up, I'll make an update.

I do have a question: Is it going to be bad for me to sleep with a pillow and the collar, in terms of posture etc? My neck didn't ever feel strained and it's not aching today or anything.


Attached Files Thumbnail(s)
           
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#53
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
I'd think that adding a thin pillow should be fine. It's sounding like therapy is improved and AHI is considered medically treated as it's under 5. That doesn't mean there's no room for improvement. Comments of those in the forum tend to be best results is when AHI is about 3 consistently. Remember that a 0 AHI isn't the goal, but as low as is comfortable would be reasonable should be attainable.
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: Started BiPaP treatment, makes things worse. Struggling with the settings.
Let's see what we get with PS min and max at 2.5.
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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#55
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
I'll try that tonight - I had to change the maximum pressure from 11 to 11.5 to add 0.5 to the PS min - I assume that's okay?
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#56
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
I forgot we had you on fixed pressure. You're getting smarter than me. Smile
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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#57
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
Ha! Far from it. Smile

Last night was good! Slept through the night, AHI of 0.96 (only been this low once), and data looks great.

Things of note:

1) 6 Flow limits, and I could tell when I woke up that it wasn't going to be 0-3 (where I feel best).

2) Leak rate a bit higher early on, not sure if I had a mask leak?

3) Still some odd flow rates without events.

4) Almost no centrals!

Overall, collar + PS 2.5 seems like it was a strong move.

Attached advanced view, zoomed on the "worst bit" (not bad!) and a random no-event-odd-flow-rate period.


Attached Files Thumbnail(s)
       
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#58
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
Forgot to add a picture with the leak rate, sorry!


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#59
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
I'm glad we added some PS to the picture. Feel free to continue titrating PS if and when you feel it's needed. I've learned that the Philips AutoSV can work as a simple BiPAP Auto. Not the settings we usually make, but it seems to be working for you.
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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#60
RE: Started BiPaP treatment, makes things worse. Struggling with the settings.
Thanks SleepRider. So slightly higher PS to see if events are reduced further, and if CA increases, dial it back?

Also, now I've actually gotten through the day a bit, I'm really tired and I did sleep really poorly. The only thing I can think of is either I'm reallllly sensitive to the flow limitations, and/or my mask leak that had a big impact. My partner told me that they could tell my mask was leaking a little bit earlier in the night. I'll try to develop a trend before tweaking settings again!
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