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Titration Study Results
#71
RE: Titration Study Results
(04-27-2021, 08:52 AM)Gideon Wrote: All of your charts show awesome numbers, and as you noted your flow limits are high, great you are aware!!!

What to do?  That depends, that depends on you!  How do you feel so how do you feel?

The goal at this stage is to focus on your comfort and your nights sleep.  We have nearly reached the limit of what we can do about the flow limits with your machine.  We can try increasing the pressure BUT, and this is a BIG BUT, changes need to either improve or maintain your comfort, numbers, including your flow limits should NOT be chased.

Any change you make please evaluate and post, if you wish to, which settings feel better, and yes, this is very subjective.  Comfort overrides your numbers going up.
I am still tired but I'm going to give it more time to adjust to the therapy while slowly moving my maximum pressure up to see if I can bring the flow limitations down.

I will let you all know how it goes.  I have a follow up with my Dr. in July.
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#72
RE: Titration Study Results
(04-27-2021, 10:43 AM)SarcasticDave94 Wrote: On the waking with mouth open and PAP is on your Max pressure is pretty much expected. An open air circuit is what you've got in these circumstances and the PAP goes as high as is allowed by your settings.

Did this happen because that pressure is too high for me or because I'm just not used to it?  My teeth were also chattering!
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#73
RE: Titration Study Results
Typically your opening of the mouth is mechanically either the jaw dropped and broke the mouth seal or your natural tongue seal was breached.

Not being used to PAP can be very likely the culprit, so you may need to get used to the PAP by sitting comfortably with PAP and mask on while reading, watching TV, listening to the radio.

Too high of a pressure for you, this pressure set is on the low end of available PAP pressures. While it's likely you're not used to it, the pressure itself is not likely to cause an open mouth.

I'm inclined to believe you're not used to it, and it is a big deal to get used to the PAP airflow, the mask, and all that.
Dave

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#74
RE: Titration Study Results
(04-27-2021, 11:17 AM)SarcasticDave94 Wrote: Typically your opening of the mouth is mechanically either the jaw dropped and broke the mouth seal or your natural tongue seal was breached.

Not being used to PAP can be very likely the culprit, so you may need to get used to the PAP by sitting comfortably with PAP and mask on while reading, watching TV, listening to the radio.

Too high of a pressure for you, this pressure set is on the low end of available PAP pressures. While it's likely you're not used to it, the pressure itself is not likely to cause an open mouth.

I'm inclined to believe you're not used to it, and it is a big deal to get used to the PAP airflow, the mask, and all that.

This is what I was thinking, I'm just not used to it.  Will try to wear the mask more often during the day with the higher pressure to see if it will help my flow limitations when I'm asleep.  

Thanks for your input! Thanks
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#75
RE: Titration Study Results
At any of these lower pressure settings the machine is going to pin itself against max pressure because of your flow limitations. You are best to find a pressure that feels comfortable to you and then switch to CPAP mode so there are fewer pressure fluctuations. Use the machine like that for a while to allow your body to adjust and get used to PAP. Then you can try increasing pressure.

Based on what you have posted so far there isn't a clear relationship with improving flow limitations at increased pressures and if increased pressure is going to help you will probably have to go noticeably higher (like 15 cm) which is probably better to slowly work yourself into (and if it doesn't help then come back to a lower pressure again).
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#76
RE: Titration Study Results
While your RLS/PLM being worse when you forgot the Gabapentin it's still good to know that the Gaba is actually doing something and helping.

It would be good to see a 2 minute zoom around one of the periods with high flow limitations and/or CA events. Also increase the Y-Axis scale on the Flow Rate graph (e.g. set Scaling Mode to Auto-Fit  or Override to a more suitable scale).

You may want to change your OSCAR profile name so you don't have to keep masking the screenshots using the process described here: https://www.apneaboard.com/wiki/index.ph...ofile_Name
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#77
RE: Titration Study Results
(04-27-2021, 12:37 PM)Geer1 Wrote: At any of these lower pressure settings the machine is going to pin itself against max pressure because of your flow limitations. You are best to find a pressure that feels comfortable to you and then switch to CPAP mode so there are fewer pressure fluctuations. Use the machine like that for a while to allow your body to adjust and get used to PAP. Then you can try increasing pressure.

Based on what you have posted so far there isn't a clear relationship with improving flow limitations at increased pressures and if increased pressure is going to help you will probably have to go noticeably higher (like 15 cm) which is probably better to slowly work yourself into (and if it doesn't help then come back to a lower pressure again).

I've started at a cpap pressure of 8.0 with EPR 3 last night and will slowly increase the pressure until I see the flow limitation decrease or I can no longer tolerate the pressure.  I agree that I seem to sleep better with a constant pressure and not the fluctuations of apap.
Thanks
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#78
RE: Titration Study Results
(04-27-2021, 05:20 PM)kappa Wrote: While your RLS/PLM being worse when you forgot the Gabapentin it's still good to know that the Gaba is actually doing something and helping.

It would be good to see a 2 minute zoom around one of the periods with high flow limitations and/or CA events. Also increase the Y-Axis scale on the Flow Rate graph (e.g. set Scaling Mode to Auto-Fit  or Override to a more suitable scale).

You may want to change your OSCAR profile name so you don't have to keep masking the screenshots using the process described here: https://www.apneaboard.com/wiki/index.ph...ofile_Name

Not sure if I did this the right way with the closeup view.  The pressure was between 7.8-8.2 last night.  When I got up I increased the pressure.  I had a much more comfortable sleep.


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#79
RE: Titration Study Results
Try to figure out why "Mode and Pressure Settings Missing". You could try creating a new profile and reuploading CPAP data to it. If that doesn't work I would uninstall and install latest version of OSCAR. Only other thing I can think of is reformatting SD card but you will lose old data doing that.

I don't know what causes this as I haven't seen it before, it does make it a bit tricky to interpret your settings.
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#80
RE: Titration Study Results
there's an option in oscar to purge a day, then re-download from the sd card and another option to rebuild data. these might solve the missing settings problem. avoid downloading from the card more than once a day.
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