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waveforms review
#1
waveforms review
I haven't posted in a couple of yrs. My waveforms show all kinds of issues.[attachment=12224]
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#2
RE: waveforms review
Welcome back,

Look at the Organization link in my signature. 2 key and important charts are missing, Flow rate and pressure.

Your Obstructive Apnea is clustered, this implies a positional apnea caused by your chin tucking, if this is typical you should use a soft loose fitting cervical collar (Releaf is popular), or an anti-snoring collar (Dr Dalota is popular) to hold the chin up.  Yes it really works.  It should dramatically lower your obstructive Apnea.

You have enough Flow Limitations and RERAs that I would address them with Flex set at 2 but it looks like you are already there, are you?  RERAs are defined as a series of flow limitations ending with arousal.  These will then be addressed with increased pressure.  

Periodic breathing, and Centrals.  I have to ask about your heart and lung health, Any COPD, CHF, Pain meds (Opioids especially) because they can impact these.  
Tell me about your centrals, have you always had them?  Are you just restarting therapy or have you been using your machine for many months.

Pressure and pressure changes are a big deal here because higher pressures and pressure changes tend to make Central apneas worse.  NEED to know your pressures, I expect to be lowering them.  Obviously, this may increase your Obstructive Apnea.

Post a couple 5 min close ups of the Periodic breathing so we can evaluate that.
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#3
RE: waveforms review
the Flow Rate & Pressure charts were covered when I took the screen print. Here it is again with these 2 charts uncovered.  Thanks for the suggestion of using a cervical collar to hold my chin up - I've ordered the Releaf.

Flex was set to OFF, other choices were C-Flex & C-Flex+. The 2nd Flex setting was already set @ 2. I reset the first Flex setting to C-Flex+, & left the 2nd Flex set were it was @ 2. the mode setting is APAP

I don't ever take opiods . I do take Cannabidiol caps (3:1 THC/CBD) to get to & stay asleep each night.  No COPD. I use a Dr Neil saline solution bottle to wash sinuses each afternoon. I live (& sleep) @ 1220 meters - in the Sierra mtns. Never had a diagnosis of CHF.

I'll have to research Centrals - i'm unfamiliar with the term.

I use the APAP every night since August 2016. Device has 5070 hrs clocked.

Pressures are 10 & 17.
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#4
RE: waveforms review
[attachment=12234] 
Here is a recent day's PB.
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#5
RE: waveforms review
A screen shot of the whole night please, with these same charts on them.

Your Periodic breathing is not CSR which is a good thing.

I do not know how your Cannabidiol caps (3:1 THC/CBD) reacts with your sleep apnea.  Do you happen to have charts from before you used this?

Central Apnea is apnea without attempting to breathe.  Your body just does not send a signal to initiate a breath.  There is no obstruction.  Some medical conditions can cause it as can some drugs, even fully legitimately prescribed opioids.  Sometimes no reason can be found.   
Central Apnea, Clear Airway, Complex Apnea, Mixed Apnea, and Treatment-Emergent Apnea are all forms of Apnea that have at least an involvement with your nervous (central) system.

If you have data from way back it would be useful, looking for Central Apneas to see if you have a history or if this is a new thing.

If have recently restarted CPAP therapy that would be one cause of the Centrals.
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#6
RE: waveforms review
[attachment=12243][attachment=12244]

Here is the chart for May 26 & one for July 19, 2017

I have not stopped using the CPAP, or the APAP at any time since August 2016. So, no restart has occurred. I don't believe I was using CBD in July 2017.

I have older CPAP files, but I get an error msg trying to open them.  I had archived them when I switched to the Philips Dreamstation APAP.
  drror msg is "unknown archive format or archive corrupt (damaged)".
  
these file have a 10 digit sequential numeric filename with the extension 0001, 002, or 005.

I'll try skipping the Canabidiol for a few nights & report back.
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#7
RE: waveforms review
No sign of centrals in the old file,  skipping the Canabidiol for a few nights & report back is a good plan. Look in your records and see if you can determine when it started and as such maybe ID a cause.  I have nothing either for or against Canabidiol though I would prefer not to use it.  Do you know how long it takes to clear out of your system?

If you intended to show the full day you only showed a 15 minute segment of it.
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#8
RE: waveforms review
If you have been on cpap for 2 years and it isn't positional, those CA aren't going to go away. It's time to go to the doctor and do a study for the machine that will treat them, the ASV. I would ask for a resmed asv.
I would try a $10 foam cervical collar first, even with ASV, it won't fix positional apnea.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#9
RE: waveforms review
Bonjour, the 2017 chart lists 26 centrals, it seems, if I’m reading it right. The flags may have been turned off.
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#10
RE: waveforms review
(05-27-2019, 08:18 PM)bonjour Wrote: No sign of centrals in the old file,  

If you intended to show the full day you only showed a 15 minute segment of it.

Centrals are in the old file it seems though that the event flag is turned off on that chart but you can see 26 reported in the left hand pane ? This could. Be altitude related. If so changing machine settings is not going to help and an ASV will be required
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