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increasing supplemental nocturnal oxygen from 2L to 3L
#1
Has anyone experienced an RX ncrease, and if so, was it any help in your apnea treatment?
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#2
Yes. It's helpful if you need it. Anything below 92% oxygen saturation is detrimental to your health, especially when it's sustained over five minutes. Below this point begins a steep descent on the dissociation curve between SaO2 and PaO2.

Has your sleep doctor tried raising you EPAP setting to help with oxygenation?
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#3
Actually decreased it a bit, and I won't know about oxygen until he reads the oximeter results, probably not before Monday, but I'm very curious what his decision will be. That's one of the real problems in apnea study -- how long it takes on the journey from patient to dme to doc and back. Thanks Matt00296.
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#4
(04-30-2015, 07:24 PM)nativedancer Wrote: Actually decreased it a bit, and I won't know about oxygen until he reads the oximeter results, probably not before Monday, but I'm very curious what his decision will be. That's one of the real problems in apnea study -- how long it takes on the journey from patient to dme to doc and back. Thanks Matt00296.

For future use, you can get a wrist pulse oximeter that records over night if you'd like to monitor your oxygen saturation on a more frequent basis. One that is often recommended is the CONTEC CMS50I, it's a bit over $100 -- I won't link to a specific retail site it here just in case that is against the rules. It comes with a USB data cable and you can import the data into SleepyHead software.

I definitely understand, my sleep doctor actually ordered my biPAP and aside from the IPAP/EPAP pressures he didn't even customize the settings for my specific needs (restrictive lung disease/hypoventilation). I went ahead and read the specific specific clinical titration guides and learns as much as I could and changed things myself (not condoning this!). It is what it is. I have a follow up with him in a few weeks and if he doesn't like the results then I am sure he will tweak the settings with his expertise.
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#5
thanks, Mat00926. I had the overnight oximeter test a couple nights ago, waiting for results now. didn't dump it on sleepyhead, didn't realize I could; wish I hadn't been so ignorant, but live and learn, and I've learned more here than anywhere. but have to wait now till Monday I guess. I really do suspect it is a saturation problem, however. Leaks have been zero for a week now. Did you find you needed to increase oxygen?
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#6
Good news, I hope: doc received the belated results of the 4/29 oximeter study today, and wants me to increase oxygen to 4L at night. I've been so anxious about the overnight readings, and i'm really hoping for an improvement now. AHI was 21 this morning, and it's been hovering in that area for the past 2 weeks. I had anticipated an oxygen increase, but the doc raised it more than I expected. There will also be a follow-up overnight study to see if further adjustments will be required. I've been very pleased with this doc; he is quick and thorough and concerned. Wish I could say as much about the dme.
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#7
First night at 4L: AHI 37.8, most it has ever been. Nothing we do seems to help. I am so disappointed. LEAKS 21, no great problem there, I've seen a lot worse. But AI was 24.2 and MV 7.7. I'll continue with the new regimen, but I've got a sore cheek that makes fitting the mask difficult and a constant annoyance. Slept 8 hrs, only up once, and rested well, but this is normal for me since I started the therapy. If only I could get some good numbers. I do understand that the new oxygen level may take some time to effect a change, and I guess I'm just an impatient old codger, but I had better numbers back in January, when AHI was around 8. Ah well. We'll see.

I wonder, has anyone tried a small bandaid as a cheek cushion? Would it break the seal? It's really uncomfortable now.
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#8
dr changed pressure to 18/8. beats me what he has on his mind. ahi lowered only slightly afterwards. to 34.5. i'm just taking up space here. i'll hold off on further entries until there is something substantial to report. i'm aware that i tend to run off at the mouth, and i do apologize.
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#9
(05-06-2015, 06:35 AM)nativedancer Wrote: First night at 4L: AHI 37.8, most it has ever been. Nothing we do seems to help. I am so disappointed. LEAKS 21, no great problem there, I've seen a lot worse. But AI was 24.2 and MV 7.7. I'll continue with the new regimen, but I've got a sore cheek that makes fitting the mask difficult and a constant annoyance. Slept 8 hrs, only up once, and rested well, but this is normal for me since I started the therapy. If only I could get some good numbers. I do understand that the new oxygen level may take some time to effect a change, and I guess I'm just an impatient old codger, but I had better numbers back in January, when AHI was around 8. Ah well. We'll see.

I wonder, has anyone tried a small bandaid as a cheek cushion? Would it break the seal? It's really uncomfortable now.

Hi old codger, In my opinion the rate of O2 flow as set on your concentrator's flow meter doesn't reflect exactly how much enrichment you receive. I say this because the greater part of the oxygen injected into the therapy air is washed away through the exhaust ports of your mask. Thus as pressure is increased, therapy air flow is increased which effectively lessens the amount of O2 enrichment. Therefore it's more about how you feel each day. Good advice, often offered on this board, is the purchase of an oximeter so you can monitor your SPO2 and relate these readings to the way you are feeling.

Never used anything under a mask, but there are cloth liners available I'm sure would help with your sore cheek.
All the best,
[Image: signature.png]Keep on breathin'
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#10
(05-06-2015, 06:35 AM)nativedancer Wrote: First night at 4L: AHI 37.8, most it has ever been. Nothing we do seems to help. I am so disappointed. LEAKS 21, no great problem there, I've seen a lot worse. But AI was 24.2 and MV 7.7. I'll continue with the new regimen, but I've got a sore cheek that makes fitting the mask difficult and a constant annoyance. ...
I wonder, has anyone tried a small bandaid as a cheek cushion? Would it break the seal? It's really uncomfortable now.

Hi nativedancer,

I suggest you try the bandaid, to see if it helps.

I use mask liners, which are cloth cut into doughnut shape, so the cloth is between the mask and our face.

Does not completely eliminate leaks, but the leaks become softer and less bothersome, with no mask burping/trumpeting, so I can wear the mask a little looser.

By the way, what is the breakdown between CA (central apnea) and OA (obstructive apnea)?

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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