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[Treatment] Optimizing My Treatment
#21
RE: Making sense of my Sleep Study Results
(08-02-2019, 06:03 PM)hearsay73 Wrote: My reason for asking if my settings can be optimized further is really based on the titration data from my sleep study which had a lower pressure which (it seemed to my untrained eyes) had even better results than what my current setting. 

I'm also concerned about therapy induced central apnea with the high pressure of 22. Is there a cause of concern? Or am I just being paranoid?  Laugh-a-lot  

Paranoia.  Not a concern.  That said on just about every chart I look at I first look at the AHI, the overall guide, then the CA index, then everything else.  That is because CA just needs extra TLC, and a bit more caution.  Always look, but don't worry.  If it gets over 3, ask, just to sure it is seen.  I'm not saying that is bad, just that it need a bit of study.

If you do not have a CA issue, and CA makes a BIG jump, it just needs to be looked at, nothing more.
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#22
RE: Making sense of my Sleep Study Results
Bonjour: Thank you for that reassurance. I will surely keep that in mind.  Shy
hearsay73
Hosehead padawan 
Repaying my sleep debt, 1 night at a time...
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#23
RE: Making sense of my Sleep Study Results
(08-02-2019, 08:24 PM)Sleeprider Wrote: Hearsay, your current settings are at EPAP min 16 with PS 2-4, and max IPAP is not really an issue here.   What I see in your results is a persistent flow limitation which would be better treated with pressure support.  The fact the EPAP is nearly unchanging, suggests you may tolerate a lower EPAP min pressure.  My suggestion is to drop EPAP min to to 14 and PS min 3.0.  There may be more room for dropping pressure, but let's start here and see how you feel.  I'd rather see you comfortable than chasing numbers.

Sleeprider:

Woah! Changing my EPAP to 14 and PS min to 3 resulted in my lowest AHI (0.45) ever!

As far as how I feel, I didn't feel any change as to how I felt prior to the change. I still awoke feeling rested.

About my flow limitations, I don't know how to read the data there yet though. Did that improve?


Attached Files Thumbnail(s)
   
hearsay73
Hosehead padawan 
Repaying my sleep debt, 1 night at a time...
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#24
RE: Making sense of my Sleep Study Results and Optimizing my Settings
Hello!

Attached are my OSCAR data ever since I lowered my EPAP to 14 and PS Min to 3 following Sleeprider's advice. 

My current settings are:

EPAP: 14
IPAP: 22
PS Min: 3
PS Max: 4

No change in how I feel with my settings. I feel pretty good and still feel that I've had a good night's sleep. No daytime sleepiness. Coffee

How does my data look? Did the change in settings improve my Flow Limitation?

Thanks!


Attached Files Thumbnail(s)
               
hearsay73
Hosehead padawan 
Repaying my sleep debt, 1 night at a time...
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#25
RE: Making sense of my Sleep Study Results
There are very few obstructive events. Let's continue reducing minimum pressure until there is an increase in the OA and/or H events. Drop 1-cm per night until you see the machine is busy changing pressure, or a higher event rate. You have some flow limitation, but to address that, we would need bilevel or the Resmed machines which offer EPR which is a true bilevel at 3-cm pressure support. Since reducing pressure from 16 cm minimum, your event rate has improved and your tidal volume is unchanged. Your respiration rate is nearly the same, and somewhat high. We would need to see a close-up of the flow rate (2-minute segment) to evaluate the actual respiration rate and to see if there are irregularities in the respiration wave. If you post a 2-minute segment of a flow rate, we can take a look and let you know. That said, I don't know of any settings on your CPAP that can alter the respiration rate.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#26
RE: Making sense of my Sleep Study Results
(08-10-2019, 10:12 PM)Sleeprider Wrote: There are very few obstructive events.  Let's continue reducing minimum pressure until there is an increase in the OA and/or H events.  Drop 1-cm per night until you see the machine is busy changing pressure, or a higher event rate.  You have some flow limitation, but to address that, we would need bilevel or the Resmed machines which offer EPR which is a true bilevel at 3-cm pressure support.  Since reducing pressure from 16 cm minimum, your event rate has improved and your tidal volume is unchanged.  Your respiration rate is nearly the same, and somewhat high.  We would need to see a close-up of the flow rate (2-minute segment) to evaluate the actual respiration rate and to see if there are irregularities in the respiration wave.  If you post a 2-minute segment of a flow rate, we can take a look and let you know.  That said, I don't know of any settings on your CPAP that can alter the respiration rate.
Thanks for the reply Sleeprider!

Attached is a 2 min zoom of my flow rate from my latest data.

I also already have a bilevel machine (Dreamstation Auto Bipap), at least that's what I've been led to believe!


Attached Files Thumbnail(s)
   
hearsay73
Hosehead padawan 
Repaying my sleep debt, 1 night at a time...
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#27
RE: Optimizing My Treatment
Respiration appears normal and is nearly 30 BPM. I really don't have an explanation, but it seems normal for you.
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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#28
RE: Optimizing My Treatment
Thank you for the reply Sleeprider!

I'll do as you advised and lower my EPAP 1cm per night until my events increase. 

Do I understand it correctly that as I lower my EPAP 1cm,
1. I leave my IPAP setting at 22?
2. and my PS Min and PS Max, at 3-4?
hearsay73
Hosehead padawan 
Repaying my sleep debt, 1 night at a time...
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