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#51
RE: Uploading User data
I think to maintain your comfort, staying with these settings is better than going back to no EPR, however if CA events remain elevated, you may eventually want to consult with your doctor. I think the next step for you may be bilevel however the central events are only treated with ASV. If a bilevel is ever needed, the Resmed VPAP S and Vauto both offer trigger sensitivity settings we have seen effectively reduce CA events. I'm glad you're feeling better with the EPR or pressure support, but we would like to see the CA events reduced eventually, and that is either a reduction of EPR or use of an appropriate therapy device or EERS.
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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#52
RE: Uploading User data
Keep a pile of "bad" nights with the higher CAI. These represent a failure of efficacy. Present these to your doctor saying I do definitely have better nights but these are too much too often. . . or something like that.
This is building a case for either ASV with or without your doctor, or possibly EERS without your doctor
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#53
RE: Uploading User data
(06-30-2020, 08:06 AM)Sleeprider Wrote: I think to maintain your comfort, staying with these settings is better than going back to no EPR, however if CA events remain elevated, you may eventually want to consult with your doctor.  I think the next step for you may be bilevel however the central events are only treated with ASV.  If a bilevel is ever needed, the Resmed VPAP S and Vauto both offer trigger sensitivity settings we have seen effectively reduce CA events.  I'm glad you're feeling better with the EPR or pressure support, but we would like to see the CA events reduced eventually, and that is either a reduction of EPR or use of an appropriate therapy device or EERS.

Thanks Sleeprider, for now it's nice being able to fall asleep quickly, but I'm aware that my CAs are likely to increase. My CAI actually went down last night but I'm aware that they're unpredictable!

I'm gathering all this info with my screens to bring to my appointment next month,
Cheers
Being told by a Doctor that you don't have Sleep Apnea is a symptom of having Sleep Apnea
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#54
RE: Uploading User data
(06-30-2020, 05:55 PM)bonjour Wrote: Keep a pile of "bad" nights with the higher CAI.  These represent a failure of efficacy.  Present these to your doctor saying I do definitely have better nights but these are too much too often. . .   or something like that.  
This is building a case for either ASV with or without your doctor, or possibly EERS without your doctor

I'm having this consultation with a private CPAP (I assume this means other treatment methods as well) specialist in Poland next month, so I'll definitely do that. He was recommended by a family friend (a Laryngologist who specialises in OSA related to ENT problems, and diagnosed my Sleep Apnea) so I've got some faith in him. With him being private I think he'll be more likely to hear me out, but if not then I'm more than willing to go with the advice I'm receiving here since it's had such a proven positive impact on my sleep.

Attached is last night's screen, which looks better than the previous night (unpredictable again!) and I do feel better for it. 
Cheers


Attached Files Thumbnail(s)
   
Being told by a Doctor that you don't have Sleep Apnea is a symptom of having Sleep Apnea
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#55
RE: Uploading User data
Hi everyone,
here is my latest. I had some breathing issues last night as my nose was partially blocked (I have occasional sinus/allergy issues that can affect my breathing through my nose, which I'm still trying to get to the bottom of). I slept a bit longer than normal and my head felt a bit cloudy when I woke up - is this related to flow limitation because of it being more difficult to breathe? I tried comparing Flow Limitation between charts, but I don't know the 'acceptable' ranges!

I'm pretty tired today and have noticed a gradual decline in energy throughout the week (I felt alright when I posted yesterday, but crashed hard later in the day). I know it can take awhile to adapt to new settings but it seems like that may be wishful thinking based on the info you've given me.
Cheers


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Being told by a Doctor that you don't have Sleep Apnea is a symptom of having Sleep Apnea
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#56
RE: Uploading User data
Hi everyone, attached is my latest screen.
Looking pretty good although I did have 3x drinks with a lateish dinner so this may have affected my results somewhat.
Cheers


Attached Files Thumbnail(s)
   
Being told by a Doctor that you don't have Sleep Apnea is a symptom of having Sleep Apnea
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#57
RE: Uploading User data
You certainly have found a better therapy lately and this is pretty impressive compared to earlier problems, drinks or not. I can't believe I once thought we might have to resort to ASV or EERS when I see the current results.
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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#58
RE: Uploading User data
I just wish I could count on those nights every night! As you can see below, my CAs have swung the other way.

Since I won't be seeing a Dr till later this month is there anything more I can do in the meantime (asides from collecting a folder of 'bad' nights)? Will further lowering my pressure or EPR settings likely help in any way? I've attached my Overview and Stats screens if there's anything of note there. 

My sleep is certainly more comfortable now (I barely notice the mask and it doesn't leak nearly as much) so there's definitely some progress in my treatment. I'm still preparing myself to be pushing for a different PAP with this Dr though.

Cheers


Attached Files Thumbnail(s)
           
Being told by a Doctor that you don't have Sleep Apnea is a symptom of having Sleep Apnea
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#59
RE: Uploading User data
I'll guess the headache was the driver, that you tossed more than we realized resulted in some breath holding being incorrectly interperted as centrals. To be clear, you have centrals now and you had them then and you need to keep an eye on them.

Note and remember your current settings, they are a safe place for you to be.

Potential changes. We don't want headaches. Only 1 change at a time and small changes

If you had a VAuto I would suggest lowering PS 0.2 at a time. EPR lowering would be to 2, a value you had issues with before. This I wouldn't change EPR.

I might experiment with increasing min pressure slowly, 0.4, 0.6 at a time (you can't do 0.5) to address some very minor obstructive issues.
.
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#60
RE: Uploading User data
(07-04-2020, 07:35 AM)bonjour Wrote: I'll guess the headache was the driver, that you tossed more than we realized resulted in some breath holding being incorrectly interperted as centrals.  To be clear, you have centrals now and you had them then and you need to keep an eye on them.

Note and remember your current settings, they are a safe place for you to be.

Potential changes.  We don't want headaches.  Only 1 change at a time and small changes

If you had a VAuto I would suggest lowering PS 0.2 at a time.  EPR lowering would be to 2, a value you had issues with before. This I wouldn't change EPR.

I might experiment with increasing min pressure slowly, 0.4, 0.6 at a time (you can't do 0.5) to address some very minor obstructive issues.
.


I'll try just a small (probably <1) pressure change for now, as the EPR makes it more comfortable to breathe, therefore I might be able to tolerate a lower pressure as I'm going to sleep.

I've seen a 2nd Hand VAuto for a good price online - d'you think it would be a worthwhile investment? 
Cheers
Being told by a Doctor that you don't have Sleep Apnea is a symptom of having Sleep Apnea
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