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Still Feel Tired After all This Time
#21
RE: Still Feel Tired After all This Time
Hi Old Steve,

Ho you think you slept last night, any wake ups? How are you feeling?

Your Nov 4, Is interesting. Even though the pressure was lower then other days your flow limitations were not higher, first half of the night. Last half of the night, you may have fallen to a much deeper sleep, in your back or combination of both.

My suggestions,

- put the EPR back to 3, to hopefully reduce the centrals.

- put minimum pressure to 10 cm, which in reality, the minimum EPAP would be 7 on OSCAR. With this I am hoping that there will be less pressure increase because by needing less of an increase to airways open.

Some people can sleep on there back with CPAP, like me. Others may not be able to do it. What is the cut off point I have no idea.

I am not a doctor or scientist, I have no idea if there would be short/long term damage from to much pressure trying to keep airway open for back sleeping.
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#22
RE: Still Feel Tired After all This Time
I tried that setting for two or three days a few weeks back.  The results were not better.




   
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#23
RE: Still Feel Tired After all This Time
Old Steve,

Then keep those numbers for few days and see how it goes. Stay off your back. Remember to look at the RERA they do go into the AHI calculation. Keep an eye on centrals.
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#24
RE: Still Feel Tired After all This Time
After 22 years, with the help of OSCAR and the folks on this site I have finally had a decent nights sleep!  All I needed was a soft cervical collar, mouth guard, Breathe Right nasal strips and the most important change...sleep on my side rather than my back.   Now, looking at last nights OSCAR chart, is there anything that needs to be tweaked?




   
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#25
RE: Still Feel Tired After all This Time
Old Steve,

I am glad you got a decent night sleep. Yah.

How are you feeling.? How long into the day do you feel tired, that you think is leep related?

Every one has a different definition of a decent night sleep, and it changes. I am sure your body is going to be demanding more sleep.

I would increase minimum pressure by 1 cm to see if that would reduce the Flow limitations. I would look at the flow limitations and see if they are disturbing your sleep, or do you wake up first. If you look at the flow rate, do you some spikes sticking out. Are those disturbing your sleep.

Looking at the clear airway events. expand to see if you were awake when you had them.

Other then that leave it for a couple of days to see how it goes, unless to day was a fluke.

What did you do to stay on your side all night?
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#26
RE: Still Feel Tired After all This Time
Totally brillant! Well done.

Supine sleeping can get really ugly. 

The only think I would suggest is in the graphs to help you in your monitoring.

Reduce the size of the events box to make a little more space

Then change the order to:-

1. Events
2. Flow Rate
3. Pressure 
4. Flow limitation
5. Leak Rate

Of course things can go wrong, but with Oscar you can usually identify and correct the eventual problems, now without clusters gumming the works.

I had similar problems, but used a DIY positional apnea belt.
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#27
RE: Still Feel Tired After all This Time
KS and Expat

I feel quite a bit better right now, I usually get tired around 3PM,  I'll let you know what happens today... 

I have a problem getting much more sleep as I have a prostate problem.  I am usually up early to pee, then usually about an hour later, I have to pee again.

As to the CA events the first one last 75 seconds, the second one for 30 seconds start to finish.  I appear to be sleeping just prior and right after both CA events.

Most of he flow rate spikes appear to be arousals...

To stay on my side all night I used extra pillows to keep me in place, I was surprised it worked.  I have ordered a sleep apnea pillow and plan to make some sort of apnea belt to keep me off my back.

I will also re-arrange my OSCAR chart. 

I will increase pressure 1cm

Thanks guys, I appreciate all your help.

Old Steve
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#28
RE: Still Feel Tired After all This Time
Here is my second night sleeping on my left side and raising the pressure 1cm...I feel about the same as yesterday.



   
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#29
RE: Still Feel Tired After all This Time
Wow, a nice clean set of graphs. Don't think you could do any better than this. Only 2 centrals, which is not much, but cant see the duration, (click on the left hand arrow.)

Concerning pressures, I guess you have a max of 20 (before EPR), a minimum of 8.4 (previous night 7.4+1) again before EPR, I guess.

Seems a good move to me.  Your pressure graph is interesting, as you are maxing at only just over 11,  so a  20 limit is not really needed, but it can be left as doing no harm. Maybe in a few months you could do a bit of housekeeping and reduce to say 15, leaving a safety buffer of 4.  Early days and now you have the tools to do the job.

I have I believe a compelling auguement that down the line you will not need a collar. I will explain:-

The "gold standard" for resolving clusters/positional apnea in this forum seems to be the soft surgical collar, and the proof seems to be that many members have had good results. I can understand this remedy being effective for "chin tuck" when the head drops down towards towards your chest.

But when you are sleeping on your back, especially  during REM sleep when muscle tone is lost, I think it is unlikely that for some people thehead will actually drop forward towards your chest. I think it is more likely to drop backwards under the force of gravity, (unless you have a thick pillow that inclines your head forward) 

This is my interpretation of the researches carried out.

But during these REM sleep periods and this consequent loss of muscle tone, your tongue and soft palate can fall back and block the airways. 

So not sure a soft surgical collar would be effective in this case.

(See the two YouTube videos of "Dr. Vik Verr"and "CPAP Reviews" channels, there are plenty of others but didn note them down. Subnects like masks, taping, adjustments to CPAPS et....)
 
I think it is useful to research now and again sleep apnea issues on this medium, as complementary to the forum. 

If in the future you can dispense with the collar, one less thing to worry about, and especially you tried a collar previously and it did not help, although you have a new one now?

Anyhow,  a pretty impressive result
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#30
RE: Still Feel Tired After all This Time
Expat31,


I agree with you about the collar and sleeping on my back. Now that things are under control it seems obvious that the majority of my problem has been due to sleeping on my back. 

The CA's were around 11 and 13 seconds duration.

It appears to me that now after 22 years with OSCAR, you and KeepSmiling's help I may finally get some decent sleep, for that I am so grateful.

I will check out the videos.


Thanks

Old Steve
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