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Technically Treated - To my core Tired
#11
RE: Technically Treated - To my core Tired
I agree with turning ramp off and increasing EPR to 3. I would have min pressure set at 7 (I noticed it was different in your examples), this will give you the full effect of 3 EPR which will help flow limitations and should increase tidal volume.
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#12
RE: Technically Treated - To my core Tired
Thanks for your input Geer1

tonight i will turn off the ramp and then proceed to increase the EPR tomorrow.

I have my min pressure at 7 (changed from 6 in january) and ill see how things are next week to see if increasing this helps with the tidal volume.

cheers all - your help is very much appreciated!
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#13
RE: Technically Treated - To my core Tired
You might as well make both changes tonight. Ramp won't affect the results significantly, all it does is delay treatment which is why we recommend turning it off unless it is needed.
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#14
RE: Technically Treated - To my core Tired
Another mask choice is the hybrid, which offers nasal pillows with a mouth cover. Examples are the Amara View and Dreamwear Full Face. The possibility of movements causing the leaks would be consistent with what I see in terms of spikes of leak and lots of leak flow variation. Finding a way to more hours of sleep is an obvious need, and not always easy to achieve, but you really need to work towards more hours of good rest. The best therapy can't substitute for sleep time.
Sleeprider
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#15
RE: Technically Treated - To my core Tired
So last night with ramp off and EPR 3 basically sucked but as my AHI only raised to 1.07 i am definately needing to look elsewhere and am inclined to think that possibly restless leg/periodic limb movement is in play.

I tried to record myself but for some reason the night vision did not activate on the camera and all i have is a whole night of black recorded.........will try again this evening.

If you do look at the attached OSCAR data you will see a gap in the data where i was woken with left sided nasal pain, upper tooth pain and a mare of a migraine.  So possibly i now need to look at the humidity settings to see if i have it too high maybe?

and just a few more


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#16
RE: Technically Treated - To my core Tired
I'll start with the thought that your upper tooth pain, migraine, and even the left side nasal pain has little or nothing to do with CPAP or humidity settings. This could become a theme. Similarly, the misery of your sleep may not be related to CPAP therapy which was pretty good from the perspective of low leaks, better tidal volume, negligible flow limitations and very low pressure fluctuation.

I think your therapy looks great, and the priority is to make you more comfortable, but you need to seriously ask if you are scapegoating the therapy for unrelated issues that might have been present with or without the therapy.
Sleeprider
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____________________________________________
Download OSCAR Software
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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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#17
RE: Technically Treated - To my core Tired
Sleeprider - thanks for the input. I concur that my issues do not appear to be apnea related and my apnea is effectively treated. I am assuming that the residual CA and hyponeas are just as a result of positional changes or sleep stage transitions...........hopefully i can pick up some clues from overnight video recording.

If i may ask one final question - do you think i would benefit from narrowing down my pressure settings? looking at the statistics in OSCAR my maximum pressure over the last year was 15.
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#18
RE: Technically Treated - To my core Tired
You are effectively treated at 7.0 and could go fixed pressure to reduce all pressure disruptions (i.e. minimum and maximum pressure at 7.0 or CPAP mode). I would be completely okay with fixed pressure or any reduced range up to your current maximum pressure that you never see happen.
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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#19
RE: Technically Treated - To my core Tired
Again, thanks for the very helpful input.

I shall see how i go for a couple more nights with the changes made last night and then next week see about reducing my range.

cheers all for you input it is very much appreciated!
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#20
RE: Technically Treated - To my core Tired
It is hard to deal with one of "those" nights. A few weeks ago I woke up to a headache and ocular migraine that had me feeling really off. Hard to think straight when you can't see straight. A lot of therapy comes down to common sense and problem solving, both of which should be in your wheelhouse. I suspect you have a science background from your user name. If so, you share that in common with some of our most active members including myself. It takes time for the recovery to catch up with the efficacy of therapy, and sometimes we just have to start looking at external factors. Once you are sleeping as comfortably as possible and have beat-back the problems of leaks, events and the natural distraction of wearing a mask and blowing air into your nose; we sometimes have other problems that didn't come to the surface until we could actually breathe. The problem is that many other health and lifestyle issues have the same symptoms as sleep disordered breathing and adapting to CPAP. Solve this problem, assess, and move on to the next most likely issue, and eventually you may arrive at the root cause or at least diminish the contributing complications.
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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