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Titration Study Results
#91
RE: Titration Study Results
(04-30-2021, 11:14 AM)Geer1 Wrote: None of those apnea are real. When they are preceded by a large breath (then irregular odd breathing) that is an arousal and you are now awake and the apnea is SWJ (sleep wake junk), you holding your breath while changing position or an apnea when transitioning back to sleep. Regardless none are issue and all are good example of why some level of "apnea" are normal. If you had a PSG none of these would have been scored as apnea because you were not asleep at the time.

There are no signs of significant flow limitation in any of those zoomed in shots. Look for stuff where your breaths are flow limited by about half their normal size and then followed by big deep arousal breathing. That is when you know is an issue.

Thanks for putting my mind to rest and the tips of what to look out for.
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#92
RE: Titration Study Results
So I thought I was doing better and then last night happened.  

I am happy to report that I am now very comfortable sleeping with the Airfit P10 mask and hardly notice it is on at night, so that is a win!  I put the settings on my ResMed back to the Dr. prescribed autoset for her 5.0-8.0.  I have a follow up scheduled in July and I'm kind of on a mission to prove that this setting is not working.

I slept for over 9 hours last night and a few nights this past week but today I feel like a total zombie so I was not surprised to see my AHI a bit higher than it has been.  I only woke up once but do remember tossing a bit but not as much as normal.  I had some really vivid dreams later in the early morning hours, some good but mostly nightmares, which I haven't had for awhile now but had vivid dreams often before the OA diagnosis.

I'm wondering if all these events are real.  I think some might be and others not but I'm still finding it hard to understand all of this.  I know my AHI is still very low but if this is what "treated" feels like then it sucks!  If this is still a flow limit issue then I would like to know how to approach my DR about it so that she will listen and help.

My Resmed data is corrupted (again) so my pressure settings and time are off.  I slept from about Midnight to 9am.  I will have to try resetting the data for a fix.


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#93
RE: Titration Study Results
These are some of the CA's


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#94
RE: Titration Study Results
I was concerned about this multiple event.


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#95
RE: Titration Study Results
The Apnea event numbers don't look all that bad, but the higher flow limits don't look so good. For the FL, pressures need to go up. It appears you already have EPR on. If your isn't on 3 yet it may help to set it there.

Now the test: how do you feel after therapy?
Dave

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#96
RE: Titration Study Results
(05-08-2021, 02:36 PM)SarcasticDave94 Wrote: The Apnea event numbers don't look all that bad, but the higher flow limits don't look so good. For the FL, pressures need to go up. It appears you already have EPR on. If your isn't on 3 yet it may help to set it there.

Now the test: how do you feel after therapy?

Today I have been utterly exhausted and haven't stopped yawning all day.  I guess I will have to chase the flow limits after all!  I have changed my settings to 6.0-9.0 with EPR 3 and will see if that helps.  I will keep adjusting upwards until I get a good number or I can't tolerate the pressure.
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#97
RE: Titration Study Results
Weird that your settings are gone again.

If you are going to be adjusting settings you might as well let the pressure buck and see what happens. You don't have to increase min pressure to do this, the machine will do it on its own. For example fixed at 8 cm isn't really any different then 5-8 cm for you because 5-8 just maxes and sits at 8 cm anyways.

I don't get the comment in your original post that you do better on APAP then CPAP (who said that your doctor or sleep tech doing titration?). To my knowledge you have never really used the advantages of APAP. The titration study appears to have been at a fixed pressure and since using APAP your pressures are so low they just max and act as CPAP.

I would increase max pressure to 12 and then let the machine do its thing and see what happens. Either it will help or it will max at the new setting. Regardless you will get an idea if APAP actually helps you. If 12 still maxes then I would try 15. If 15 is still maxing then that is a good indication higher pressure isn't helping flow limitations.
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#98
RE: Titration Study Results
(05-08-2021, 08:44 PM)Geer1 Wrote: Weird that your settings are gone again.

If you are going to be adjusting settings you might as well let the pressure buck and see what happens. You don't have to increase min pressure to do this, the machine will do it on its own. For example fixed at 8 cm isn't really any different then 5-8 cm for you because 5-8 just maxes and sits at 8 cm anyways.

I don't get the comment in your original post that you do better on APAP then CPAP (who said that your doctor or sleep tech doing titration?). To my knowledge you have never really used the advantages of APAP. The titration study appears to have been at a fixed pressure and since using APAP your pressures are so low they just max and act as CPAP.

I would increase max pressure to 12 and then let the machine do its thing and see what happens. Either it will help or it will max at the new setting. Regardless you will get an idea if APAP actually helps you. If 12 still maxes then I would try 15. If 15 is still maxing then that is a good indication higher pressure isn't helping flow limitations.
My Sleep Dr. claimed I do better on APAP but I feel like I sleep better on CPAP.  I was originally prescribed 6.0-12.0 APAP but found I was being startled awake often throughout the night and whenever I checked the machine the pressure was always above 10.0 so I was lowered down to 7.0 CPAP and that stopped me being startled awake at night.  At both settings above I have always been tired.

Last night I was woken up 3 times grinding my teeth (hard) and the pressure was at 9.0 each time.  I gave up and turned it off.  I've tried sitting with higher pressures during the day to get used to it but as soon as I am sleeping it still wakes me up.  And 9.0 is not even a high pressure!

What am I doing wrong?  This is so frustrating.
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#99
RE: Titration Study Results
I assume that claim by sleep Dr. was based on AHI reported by machine? There is more to apnea then AHI.

Do you have data from the nights you used 6-12 settings? If so post it, I just need to see some data to see if if higher pressures appear to have any effect on flow limitation.

My gut feel is that you don't improve at higher pressure (might even get worse) hence why lower pressure seems more comfortable to you. If that is the case you are better at a lower pressure and using APAP at a lower pressure is useless because it pretty much maxes anyways so might as well use CPAP and avoid any pressure swings. If higher pressure does help then we just need to figure out how to make it more comfortable. Using CPAP mode might help if it is the pressure changes that are main issue that bother you rather than higher pressure, in which case the right ramp setting might also be helpful to make it easier to fall asleep if you find it difficult at a higher pressure.

As you can see there are options but we need data to drive the decisions.
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RE: Titration Study Results
(05-09-2021, 11:04 AM)Geer1 Wrote: I assume that claim by sleep Dr. was based on AHI reported by machine? There is more to apnea then AHI.

Do you have data from the nights you used 6-12 settings? If so post it, I just need to see some data to see if if higher pressures appear to have any effect on flow limitation.  

My gut feel is that you don't improve at higher pressure (might even get worse) hence why lower pressure seems more comfortable to you. If that is the case you are better at a lower pressure and using APAP at a lower pressure is useless because it pretty much maxes anyways so might as well use CPAP and avoid any pressure swings. If higher pressure does help then we just need to figure out how to make it more comfortable. Using CPAP mode might help if it is the pressure changes that are main issue that bother you rather than higher pressure, in which case the right ramp setting might also be helpful to make it easier to fall asleep if you find it difficult at a higher pressure.

As you can see there are options but we need data to drive the decisions.

Sadly I didn't save any of the data from when I first started :Sad   I'm going to try to sleep for the next week with my settings back to 6.0-12.0 and see what happens.  I will post back when I have some data.  Thanks for the help!
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