afib and sleep apnea

[poppypete]

re: (from Software Forum) "the AFib issue needing resolution in the first instance...and that's scheduled for sometime in June."

Having the TOE 31 May...   ...great news!!!


That to follow the answer to LVEF% on Monday next, 28 May, with the TEE procedure.

Took a punt last night after previous night's unsatisfactory effort with CPAP, and slept alone with the oximeter...but not a good look either: see attachment.

Too late now to be stressing over this issue of syncing this oximeter data within the SleepyHead or ResScan software, but I'd like to come back to trying to resolve it after next week's treatments.

Cheers...poppypete  

[Sleeprider]

I'd say CPAP is definitely better for you SpO2 than going without. Good luck on the upcoming evaluations. I certainly wish you good heart health and a good outcome.

[poppypete]

I'd say CPAP is definitely better for you SpO2 than going without.  Good luck on the upcoming evaluations.  I certainly wish you good heart health and a good outcome.

Sleeprider...

re: "better for you SpO2 than going without"

Last night's results prove that to me conclusively now... by referencing both sets of data. Similarly, when napping even, I'd be wise to be supplementing on own body efforts too!!!

Last night:
5hr 23min first session: 4.27AHI.

Excellent result for me at this point, with SpO2 levels good while on the machine...however:

I rose for a toilet break, feeling well rested, so had a cup of camomile...and 35min later put mask back on.

No sleep came, so I called it quits 40min later.

Towards the end of that 40min is revealing, as I lay awake with mask and machine doing their thing...
...maintaining my SpO2 level (refer MedView attachment)...
...4 OSAs in quick succession precede a CA (refer SleepyHead attachments)...
...which activates my (unconscious to conscious) thinking to call it quits for the night...
...not before registering 7.89AHI for that 'awake' period.

I'll be explaining all of this to my cardiologist on Monday, and hopefully I'll be able to follow through on your suggestion to source (thanks for the thought), a 2nd hand ASV from Kentucky!!! [I've often wondered what used/no longer needed machines were recycled...could be both sold and bought, as folk change with their needs/type of machine changing...as mine are likely to do soon.)]

 re: "Good luck on the upcoming evaluations."

I'm looking forward immensely to these outcomes...and changes that will surely follow.  

Cheers...poppypete  

[poppypete]

Sleeprider...

re: "...when napping even, I'd be wise to be supplementing on own body efforts too!!!"

Have a look at this attachment, which I'd suggests confirms the above view...

...but do you see the same as what I see?

[Pressure increases at 13.37 as flatlining of respiration begins, and prevents any apneas @ around rate of 12...proving that yes, even while napping I should wear.]

Cheers...poppypete   

[Sleeprider]

You have been sending me emails requesting suggestions on therapy. Here's the deal...I will respond to you on Apnea Board forums on therapy questions where others can benefit or contribute their thoughts. Please post your ASV experience here, rather than contacting me privately.

[poppypete]

You have been sending me emails requesting suggestions on therapy.  Here's the deal...I will respond to you on Apnea Board forums on therapy questions where others can benefit or contribute their thoughts.  Please post your ASV experience here, rather than contacting me privately.

My apology...and the deal is gratefully accepted.

A mixed bag of results on my first night on ASV to chew over.

I woke after 1hr 49min on these settings (which I thought I'd changed to EPAP 4-8 and PS 0-12) for this first session result:
 [img]blob:http://www.apneaboard.com/14a872de-10e2-4643-a83d-203520dfda21[/img]

The second session was of only 53min duration, while the third went for 1hr 16min (graphs attached).

Obviously, I need further advice please.

Thanks...poppypete 

[poppypete]

Sleeprider...

re: "You need to change settings to EPAP min 4.0 EPAP max 5.0 PS min 1.0 PS max 12.0. ..all events happened at higher EPAP and you may not tolerate a minimum PS of 3.0"

I had a 20min rest just now with these suggested settings, and so the graphs attached should show that I got the changes right this time.

The comfort was greater than during yesterday's nap and last night's efforts, so I'll report further results after tonight.

Thanks again...poppypete  

[Sleeprider]

Pete, that's great. Since I was responding on an iPhone, let me fill in some details. In reviewing your early results, it was apparent that as EPAP pressure rose, your events became worse. There were also examples of fairly low pressure that descended into obvious CSR and periodic breathing. In your case I'm fairly certain that using the "recommended" minimum PS of 3 was actually triggering your central events. What we want to to do is let the machine do its work when needed, but not to create a trigger.

My recommendation was to set the machine in ASVauto with a very limited EPAP range of 4.0 to 5.0, and to reduce PS from a minimum of 3.0 to zero, and have a PS max of 12.0 to resolve CSA, hypopnea and periodic breathing. On a preliminary basis this strategy looks to be working well. Your latest graph shows that your breathing has evened out nicely with the machine responding to events, rather than creating them.

For some reason on this short session, your tidal volume is very high, and we want to keep an eye on that. I think your normal is closer to 600.

I enjoy working with you, but have tried to avoid helping members privately. First, I don't consider myself a therapy professional and prefer that any input I give is public and can be reviewed and corrected, disagreed with or agreed with by others on the forum. Secondly, others who are watching your progress don't get to see what is going to be a huge success.

[poppypete]

Tom...

In the same spirit of your comment within the last sentence (about sharing the journey), I have copied and pasted from that private email (before posting last night's good result..."good" in the sense I can see (and feel) we're heading towards "the great success" you also write encouraging me to expect:


On the oximetry data, of note:

1. An hour of stable oxygen flow, and heart rate appearing to my eyes, as less volatile in range than as seen on previous charts (what a good sign!!!).
   
2. Unfortunate that I can’t sync this oximeter info into these charts at present, but I’m willing to go the extra step and purchase another if I could successfully do that. There’s no doubt in my mind, that these two ‘issues’ affect each other, and as one stabilises, it will help improve the other…so I must remain patient and continue to persevere for at least another couple of months of heart rhythm ‘non-correction’ (the news from the cardiologist last Wednesday, suggests I won’t get a cardioversion until possibly 8-10 weeks now).
   

[My so-anticipated cardioversion has been delayed due to fears of a clot existing (could an old scar from something past), so a treatment of Warfarin is required to increase my safety margin when finally hit with the paddles.]

• These two 'asleep' sessions are significant to me for the total absence of CAs and OSAs.
  
• [b]I think these sessions have the clues, if you can successfully interpret them for me please…[/b]
  

I'll be back in a little while...

Cheers...poppypete 

[poppypete]

Sleeprider...

Yesterday/night's data consists of a rest of 20min, 2 evening 'asleep' sessions, and a final rest attempting to go back into slumber.

A cup of camomile on rising then, downloading data, and analysing personally before responding here.

The first attached graph shows the whole 4 sessions using mask/machine...
...the second is showing the two 'rests' in isolation from the 'asleep' sessions...
...the result shown on the third graph.

Limited to 3 graphs per post, I'll next post show you (and others), the two meaningful (to my eyes), 'asleep sessions'...for your comments and assistance with adjusting settings again, for tonight's effort.

Cheers...poppypete