grizwilson - Therapy Thread

[grizwilson]

   

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hoping sleeprider or someone knowledgeable will help Thanks

[staceyburke]

The numbers look good. Do you have questions or problems?

[grizwilson]

On the far left side is where I took a nap late in the afternoon, continue tired and leak issues considering trying Inspire..... Sleeprider suggested I start OSCAR and see if I can improve sleep.  Thanks

[SarcasticDave94]

It looks like mask leaks either disturb your sleep and/or are hindering the AutoSet from delivering good therapy. You're likely going to need to check mask cushion for wear and tear, correct size, and making sure strap tension isn't too tight which will cause pain and also distort the mask cushion making it hard to seal.

[Sleeprider]

Hey Griz, thanks for posting the chart.  In your posts in the Inspire thread, we were just guessing at your OSA and the continued tiredness you experience http://www.apneaboard.com/forums/Thread-...275?page=3  As others have noted, you have an exceptionally low 0.00 AHI, but let's discuss what is really screwy here and see if we can maybe figure out why your sleep sucks anyway.  Your Airsense 10 is set to 10-20 pressure with EPR at 3.  This does resolve all the AHI.  Leaks are high, but what really captures my attention is your really long inspiration time of 2.3 compared to your expiration time of 2.16.  For some reason, you're having to expend a lot of effort to get air in, which is typical of flow limitation or upper airway resistance syndrome (UARS), and yet your flow 95% flow limit is only 0.07.  I am going to bet we can look at a 3-4 minute closeup of this flow rate chart and see long flattened inspiration curves and fairly rapid sharp expiration.

Let's do some closeup views of the flow rate. You can use the Events tab to select a 3-4 minute view window at the bottom of the left pane, then switch back to Details and pan the flow-rate.  I'm interested in what you find there.  Try to avoid areas with large leaks to take any screenshots as that will further flatten the inspiration curve.  When we see a long inspiration time, it reminds me of trying to suck a thick milkshake through a thin straw.  It takes a lot of effort, and you don't get as much to swallow as you might hope.  Same with flow limitation.  You suck air through a restricted airway spending a lot of effort, and don't end up with the air or the sleep  you came for.  The worst flow limits are going to be near those peak pressure increases at 02L30, 04:00, 04:45, and 07:00.  The question for your ENT is what is causing this intermittent upper airway restriction? If nothing is visible, then a very common problem is simple chin-tucking as we discuss in this wiki section on Positional Apnea. http://www.apneaboard.com/wiki/index.php...onal_Apnea The good news is, if your apnea, or this flow limitation with CPAP, is attributable to positional issues, we can help you resolve that, and Inspire may be a very workable issue for you.

[grizwilson]

Sleeprider, Thanks, I will work on trying to figure out how to follow your instructions in the morning, having my evening fatigue unable to process information very well.  I may try using the collar tonight, be interesting to see if that makes a difference.  Thank you again.

[grizwilson]

    Here is my feeble attempt

[grizwilson]

            Ok, I will post my 12/31 and snapshot again, to be honest I had a few drinks on 12/31.  Then 1/1/22 no drinks, then 1/2/22 tried the soft collar. Seems my AHI got worse each night, but realize just one night each.... Thanks getting more confused???

[grizwilson]

Sleeprider ?"Let's do some closeup views of the flow rate. You can use the Events tab to select a 3-4 minute view window at the bottom of the left pane, then switch back to Details and pan the flow-rate. I'm interested in what you find there. Try to avoid areas with large leaks to take any screenshots as that will further flatten the inspiration curve."

not figuring out how to get pan the flow rate or close up of times you mention????

[Ratchick]

Click with the left mouse button, hold it down and drag to the left or right on the chart to highlight the section you want to look at. You can Zoom in and out by using left and right clicks, and you can pan by right-clicking and holding, then moving left or right. Also, if you click the events tab on the left side of the screen, at the bottom is a bar where you can select how many minutes you want to see, from 1 minute to 30 minutes. So use those controls to centre in on what you want to show, and then take a screenshot.