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[Treatment] Treating UARS with CPAP and bilevel
RE: UARS and APAP
Hi, slowriter
_ not sure how your feel, but..
_ don't much on oxigen issues; it may happens I would have to known more beyong trivial....

_ it looks your experiencing a great deal of flow constrictions (likely Unflagged RERA)....constrictions also in REM. Then, eventually, you would benefit from some more EPAPmin. Not easy say more without TV.

_liked very much correlation between Pulse and RR! it helps a lot people like me that don't use pulse.

_ have you used zoplicone this night? or other?

all the best
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RE: UARS and APAP
Yes, I was planning to raise EPAP min a bit, after reading another post where sleeprider points out that's a way to raise oxygenation. Also because I've been getting a few OA events recently.

I did not use eszopiclone last night, but did the night before for the comparison (so there's the one difference).

The quantity of sleep last night was good (8 hours), but you can see from the sleep stage data that the quality was only OK. The Dreem has been reporting fairly low REM and Deep % numbers for past few nights; not sure why that would be, or what, if anything, I can do about that.
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RE: UARS and APAP
I will add, just for the record, last month or so I've been transitioning back to a ketogenic diet. That transition definitely screws up sleep quality for me, which is the part of the reason I haven't posted much. But I think I'm almost through that, so sleep is beginning to stabilize again.
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RE: UARS and APAP
(11-15-2019, 08:22 AM)slowriter Wrote: Yes, I was planning to raise EPAP min a bit, after reading another post where sleeprider points out that's a way to raise oxygenation. Also because I've been getting a few OA events recently.

I did not use eszopiclone last night, but did the night before for the comparison (so there's the one difference).

The quantity of sleep last night was good (8 hours), but you can see from the sleep stage data that the quality was only OK. The Dreem has been reporting fairly low REM and Deep % numbers for past few nights; not sure why that would be, or what, if anything, I can do about that.

...well, lately, since last month, I have experienced more REM (times and duration), nothing simillar since I started, some 7 months ago. No doubt, I would credit this to less arousal/awakenings, on account what I think is ultimate fine-tuned EPAPmin and PS, persistent Valerian 1060mg, Melatonin 3mg. Last four days or so, I had suspected part of some remaining arousals/awakenings were due to chin tuck (believe it!), and I am on the collar, which appears are improving things, including REM duration.
_PLMS has improved last month, not sure exactly why: likely lower arousal/awakenings themselves (as theory), valerian, melatonin, and a row of suplemenst (all kind of B, Mg, K, Iron)
_ to summarize: target is less arousal/awakenings. This is deleterious, incuding preventing from enter REM.

all the best.
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RE: UARS and APAP
...month ago, asked my doctor zplicone, used just 1 night. Awful thing!...When needed, Clonazepam is better, even as low as 0.3mg (sometimes not at bed time, but in the early morning, during my once wakeup....duration is short).
gl
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RE: UARS and APAP
(11-15-2019, 09:45 AM)mper6794 Wrote: ...month ago, asked my doctor zplicone, used just 1 night. Awful thing!...When needed, Clonazepam is better, even as low as 0.3mg (sometimes not at bed time, but in the early morning, during my once wakeup....duration is short).
gl

When I take it (only a 2-3 times/week), I find in general it leads to less wake ups, and a bit longer sleep duration. But I don't necessarily always feel great the next day. Not consistently bad; just that I haven't determined whether it helps enough.
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RE: UARS and APAP
I don't see a problem with the SpO2 levels posted so far. They are solidly above 92 and appear to have a median near 95%. In mechanical ventilation, a higher PEEP is associated with better O2 exchange. This is as you noted, an increase in EPAP min.

There has been a recent trend on these forums to obsess over nuances in these Sleepyhead charts and here we see SpO2 and sleep stage being tracked. The suggestion that flow limitation may be an issue seems pretty far-fetched given the 0.00 in the 95% range and extremely low values in he maximum. As someone that has evaluated many charts, I would have no higher expectations for results from anyone, including myself. My best advise is to get out of the weeds with the charts and evaluate results solely on how you feel. If you change pressure, do it for a week without looking and ask yourself, is this better or not? There is far too much dependence on the data here, and I think it is way overboard.
Sleeprider
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RE: UARS and APAP
Sleeprider, many thanks for this post. It answers some questions that have been occurring to me as I've been following this thread and several others.
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RE: UARS and APAP
(11-15-2019, 11:03 AM)Sleeprider Wrote: I don't see a problem with the SpO2 levels posted so far.  They are solidly above 92 and appear to have a median near 95%.  In mechanical ventilation, a higher PEEP is associated with better O2 exchange. This is as you noted, an increase in EPAP min.  

There has been a recent trend on these forums to obsess over nuances in these Sleepyhead charts and here we see SpO2 and sleep stage being tracked. The suggestion that flow limitation may be an issue seems pretty far-fetched given the 0.00 in the 95% range and extremely low values in he maximum.  As someone that has evaluated many charts, I would have no higher expectations for results from anyone, including myself.  My best advise is to get out of the weeds with the charts and evaluate results solely on how you feel.  If you change pressure, do it for a week without looking and ask yourself, is this better or not?  There is far too much dependence on the data here, and I think it is way overboard.

Seconded!!!  Lolabove
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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RE: UARS and APAP
I appreciate the sentiment sleeprider, and will follow the advice.
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