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Therapy numbers, lack of them, weight loss, etc
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Galactus Offline

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Post: #131
RE: Therapy numbers, lack of them, weight loss, etc
(11-02-2014 09:07 PM)retired_guy Wrote:  It clearly shows two things:

1. On October 31st you turned into a pumpkin.

2. Not going to bed until around 3:00 am is a goofy thing to do.

On the bright side no one tried to carve me.

And acknowledging I'm goofy is as much a revelation as you're being retired Eat-popcorn

Besides I'm getting my 6-8 hours so who cares when? lol

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11-02-2014 09:26 PM
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vsheline Offline

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Post: #132
RE: Therapy numbers, lack of them, weight loss, etc
(11-02-2014 08:51 PM)Galactus Wrote:  At 3.5 it started to be a bit annoying, then I adjusted, at 4 it started to annoying again, and I have almost completely adjusted. It is still a tiny bit annoying, but no more so than say Retired_Guy poking me asking me if I'm awake yet.

Now the real question, based on the results of the data below does it seem like I am gaining anything at 4 that I didn't get at 2?

Hi Galactus,

How have you been feeling? A high PS does for us some of the work of breathing, and some people feel better with higher PS. In particular, higher PS also helps reduce the likelihood of Flow Limitation caused Respiration Effort Related Arousal (RERA) events.

Judging by the data you posted, I suggest reducing PS to 3.5 or 3.0.

These are still coarse tuning experiments, just one week at each setting. Eventually (when fine tuning in future), better to have data for several weeks before further changes.

Compared to the numbers for other values of PS, the numbers for PS of 3.5 look best, I think. The 7-day average AHI was 0.67, and only 2 out of 7 nights had AHI of 1.00 or worse.

For PS = 2.0, 2.5 or 3.0 the percentage of nights with AHI above 1.00 was higher (3 or more nights per week), and the 7-day average AHI was higher (above 1.00 for PS = 2.0, 2.5, or 3.0).

For PS = 4.0, the percentage of nights with AHI above 1.00 actually looked best (just 1 out of 9 nights) and the 9-day average AHI (just 0.72) was only slightly higher than the 7-day average for PS of 3.5, but the one bad night (Oct 31) had especially high AHI = 2.25, with much of it concentrated in the last 15 minutes. (Was Leak was okay during that last 15 minute period, and do you remember whether you were still asleep?) But in any case, after several days you still find it at least a little annoying, so I suggest it would be good to lower PS.

After a while at the lower PS setting, at some point you might want to try lowering the Min EPAP setting by 1, to see whether obstructive events remain acceptably low, and whether you feel better or worse with lower EPAP.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 11-02-2014 11:51 PM by vsheline.)
11-02-2014 11:42 PM
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Galactus Offline

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Post: #133
RE: Therapy numbers, lack of them, weight loss, etc
Hi Vaughn,

Overall most days I am feeling ok.

Thanks so much for the input. Yes, you can pretty much attribute any of my las "10-20 minutes" as my being awake. I have a bad habit of just laying there with the machine on while I'm still in bed, even after being awake. Most days I try and take it off as soon as I am awake so as not to mess up the results but on that morning I was considering going back to sleep, and apparently I considered too long.

I have noted a few nights my pressure ramping up to 19 and 20. And have noted the flat line of 13 most of the time as well. The 4 had been annoying at the start, but I have been adapting. I also now have 9 days at 4. I had been watching the events go down slowly as PS was raised, and raising by .5 was easier on me.

I'm considering staying at 4 for the rest of the month just to see what the data looks like, even if it is annoying now and again, I am feeling ok, and some days even better than ok. I think if we drop out that 2.25 bad night the rest looks like the best averages yet.

Thanks so much for all your help. It's been great having someone to help who knows the information so well.

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11-03-2014 12:24 AM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Post: #134
RE: Therapy numbers, lack of them, weight loss, etc
(11-03-2014 12:24 AM)Galactus Wrote:  Hi Vaughn,
I'm considering staying at 4 for the rest of the month just to see what the data looks like, even if it is annoying now and again, I am feeling ok, and some days even better than ok. I think if we drop out that 2.25 bad night the rest looks like the best averages yet.

A longer trial at PS=4 sounds good.

Keep an eye out for the effects of changes in sleep position. If feasible, you may want to take notes immediately upon getting up, noting how rested you feel and any changes in sleep position.

Sounds like you are making good progress!

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 11-03-2014 01:07 AM by vsheline.)
11-03-2014 01:02 AM
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Galactus Offline

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Post: #135
RE: Therapy numbers, lack of them, weight loss, etc
Hi Vaughn, (I'm back for more lol)

Ok, so here's where I am at, I just posted the combined stats as it was too much day by day, and I didn't want to scare you away.

Please note on most of the AHI's that are 1+ it happens in the morning while I am laying in bed deciding whether or not to get out of bed or go back to sleep. Those events are while I am awake for the most part.

I also switched over to a heated climate line and the alternate humidity about 2 weeks ago.

Last night I made my first new change which was to lower EPAP to 12.

So what do you think? Any advice? Or am I really pretty much there? I get the impression I am never going to get to 0 no matter what I do, and I'm feeling like .2 to 1 is about as good as it gets for (though I'm not sure I need anything better).

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12-20-2014 12:28 AM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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Post: #136
RE: Therapy numbers, lack of them, weight loss, etc
(12-20-2014 12:28 AM)Galactus Wrote:  Please note on most of the AHI's that are 1+ it happens in the morning while I am laying in bed deciding whether or not to get out of bed or go back to sleep. Those events are while I am awake for the most part.

I also switched over to a heated climate line and the alternate humidity about 2 weeks ago.

Last night I made my first new change which was to lower EPAP to 12.

So what do you think? Any advice? Or am I really pretty much there? I get the impression I am never going to get to 0 no matter what I do, and I'm feeling like .2 to 1 is about as good as it gets for (though I'm not sure I need anything better).

Hi Galactus,

You didn't mention how you are feeling, which is pretty important to keep track of.

Looks to me like reducing the Min EPAP to 12 is worth trying for a week or more. The first night saw an increase in Obstructive Apneas, but that isn't significant yet.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
12-20-2014 03:54 AM
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Galactus Offline

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Post: #137
RE: Therapy numbers, lack of them, weight loss, etc
Hi Vaughn,

I'm in a pretty stressful business, at a particularly stressful time of the year. I'm in a "mood", but I really think I feel better. I'm not up 3x+ a night to find the bathroom, I'm not falling asleep at the dinner table, I'm not falling asleep in the car as a passenger, or at the movies, or watching TV, or reading a book. So overall my mood I believe is just business as usual. The apnea symptoms I think are pretty much gone. The groggy always tired feeling is all but a thing of the past. The back pain here and there I attribute to work, not apnea. So I guess I'd say on a 1-10 I'm feeling about an 8 overall as it relates to apnea.

In regards to the reduction, I did that after I posted this data and had yet to download, that last day was just another one of my morning laying there deciding to get out of bed or not that put me up.

I have to say the 12 did feel a little better to me all of a sudden. So at 12/20 PS 2/7 that caps me at 19? I guess I should raise 2/8 to 2/9 unless 8 is max, I actually don't remember at the moment and really just thought about that. Though as you can see the 13 is flat, I mean it is almost never over so lowering to 12 certainly seems sensible.

As always I'm open to opinions. Thanks again!

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Everyone knows something, together we could know everything.
12-20-2014 06:44 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Post: #138
RE: Therapy numbers, lack of them, weight loss, etc
(12-20-2014 06:44 PM)Galactus Wrote:  The apnea symptoms I think are pretty much gone. The groggy always tired feeling is all but a thing of the past. The back pain here and there I attribute to work, not apnea. So I guess I'd say on a 1-10 I'm feeling about an 8 overall as it relates to apnea.

In regards to the reduction, I did that after I posted this data and had yet to download, that last day was just another one of my morning laying there deciding to get out of bed or not that put me up.

I have to say the 12 did feel a little better to me all of a sudden. So at 12/20 PS 2/7 that caps me at 19? I guess I should raise 2/8 to 2/9 unless 8 is max, I actually don't remember at the moment and really just thought about that. Though as you can see the 13 is flat, I mean it is almost never over so lowering to 12 certainly seems sensible.

Hi Galactus,

I think it should be okay to raise PS Max to 8, since the machine will increase PS only as much it's treatment algorithm indicates you need.

But you could also simply keep PS unchanged at 2 to 7.

If it were me, I'd probably increase PS Max to 8, mostly to see if PS ever goes that high when EPAP Min is set to 12. That is, unless I was experiencing anything troublesome which could be caused or made worse by the pressure getting too high, such as troublesome leaking or needing to keep the mask straps uncomfortably tight, or a painful amount of air-swallowing, or lung or eye or ear pain, or increased inner eye pressure making glaucoma worse, or hearing loss or dizziness or tinnitus.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-21-2014 03:12 PM by vsheline.)
12-21-2014 06:04 AM
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PaytonA Offline
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Post: #139
RE: Therapy numbers, lack of them, weight loss, etc
I think that Galactus must be closely related to Retired_Guy. Can't keep from futzing.
12-21-2014 01:43 PM
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