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Where can one find a respiralogist?
#11
RE: Where can one find a respiralogist?
A quick follow-up question. Are you using EPR? What settings? Can you post a chart that shows the summary statistics and settings in the left column? We may be able to make some suggestions to improve your results with the Airsense 10.
Sleeprider
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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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#12
RE: Where can one find a respiralogist?
Amazing information sleeprider. I feel like you saved my life. In this one post I've gotten more useful information than any doctor has given me the past 5 years. Well for everything I posted so far, I was not using EPR at all. Pressure was around from 15.6-16.2 to 20.0. I did use EPR 3 last night with pressure 17-20. I'm at work though now, will post further pictures when I get home. I'm not sure I slept any better on the EPR, maybe, hard to say because I seem to be in a cycle of sleep horribly for several days and have one day where every few where I just crash and sleep a little better. Last night was a little better. Interested to see the charts.

Also I am correct then that this is the worst one:
[Image: zPXdot5.png]
Because the high and lows are actually under 20? Even though it looks more rounded. The rates are too low, even in the exhale. Am I correct that for exhaling I would want a greater negative flow rate right? Closer to 0 would indicate difficulty exhaling?
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#13
RE: Where can one find a respiralogist?
EPR is similar to pressure support in bilevel, limited to 3-cm of pressure difference between IPAP and EPAP. If you implement EPR 3, full time then when your CPAP reaches 20 cm, your exhale pressure will be only 17 cm. As you begin inhaling the pressure increases and provides support to your inspiratory effort. Even though 3-cm is not much, it is something you should feel and see some differences.

I don't compare my analysis of your CPAP data to the medical expertise of your doctor. I am aware of how these pressure changes and some subtle adjustments can improve your comfort and results. Unlike your doctor, I'm simply willing to lay out the details, and leave it up to you to do some research on the side to understand why things work the way they do. I think many doctors don't offer more technical explanations because very few patients can, or will use that information. People that come to this forum have a genuine interest, and are willing to make a substantial effort to learn and understand this. We have a Wiki, and you can research terms you don't understand. It's really up to you to challenge your doctor's assumptions and engage him in technical discussions, otherwise, you will end up processed and prescribed the same as everyone else. This discussion gives you some important concepts that you are learning more about in order to engage in a meaningful discussion on flow limitation and what that means to your health and sense of rest. If I can give you that, then my job here is done, and most doctors will talk with you as an equal with that background. If not, then a change might be in order to find one that respects you and whose goals match your own.
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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#14
RE: Where can one find a respiralogist?
Here some data you requested, for last night with EPR 3 on, pressure 16.8-20, some 2 minute segments:
[Image: B6SYqeR.png]
[Image: 1oFuPhh.png]
[Image: 7c5VQxU.png]
Seem to still have pretty sever inspiratory flow limitations. You said 60-80 is normal for inspiration, what about expiration? 

Here is summary data you requested for the last couple days. 9/6 had EPR3 on, every other day had EPR off:
[Image: ET6wFe5.png]
[Image: 3c4mHbD.png]
[Image: M77hJyo.png]
[Image: XbngYyL.png]
[Image: kEOR5Dy.png]

You can see my overwhelming majority of events if the custom 50% limitation for at least 5 seconds. Can't imagine how in the dark I would be without it! What can you tell me? EPR yay or nay? Higher pressure still?
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#15
RE: Where can one find a respiralogist?
My statement of 60 to 80 was too high. With your tidal volume, it's going to be 40 to 50. The inspiratory form is rounding out a bit here and your 95% pressure is lower! Your AHI was less than 1/3 of what you have posted so far. I don't think it's an anomaly, and I think this Autoset is going to work out for you with EPR.

Let's try a range of 15-20 with EPR 3. Be sure to minimize the monthly calendar on charts by clicking on the triangle in the date line, and we don't need the pie chart. Turn that off in the menu at File/preferences/appearance and uncheck show event pie chart.
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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#16
RE: Where can one find a respiralogist?
I'll try that tonight, so I should aim for a range of inspir 40-50 FR, even while asleep, and what about for expir? What's good? Could you mind posting an ideal sample from your own data?
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#17
RE: Where can one find a respiralogist?
Let's not worry about the numbers. What I'm looking for is a normal inspiratory curve. We will know it when we see it, and there is nothing you can do while sleeping to change it. Just go with the flow man! I think you're going to be more comfortable and that's not bad. The whole goal here is to make this good enough that you can heal and feel sleep was worthwhile.
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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#18
RE: Where can one find a respiralogist?
"I have 2 custom flags, Flag 1 which is 20% restriction for at least 5 seconds, and Flag 2, which is 50% flow restriction for at least 5 seconds."

That's really cool. How did you set that up in Sleepyhead if you don't mind me asking?

GuppyDRV 
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#19
RE: Where can one find a respiralogist?
Just under File --> Preferences --> CPAP Tab.
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