why is my Respiratory rate high?

[koy23]

I'm trying not to open a new post as per previous guidelines so I'm going to add this to this older post:

I can't for the almost 3 years now get a successful therapy, you can see from my posts and these Screenshots from oscar taken through different days in 2022, i could see some expiratory resistance, maybe something closes in my throat causing the sharp inhale/exhale
i kept reading on this sub about palatal prolapse but i'm not sure it is what i have, I already had UPPP surgery, partial glossectomy, even genioglossus advancement and removed tonsils, and Uvula , so i 'm not sure it is soft tissue blocking exhalation. from desperation i tried to mimic different settings like higher EPAP and no PS or high PS with minimum EPAP ( as I read in the palatal prolapse posts ) and you can see all the flags/events where i acually slept good the first night with PS 7 altough all these flags but horrible next night.
I almost tried most of settings, steady low epap, steady high epap, 0 PS or PS between 1 and 4 they all lead to arousals and all have these spikes i'm not sure anymore what to do, and no i'm not wing dialing i have meticulously adjusted on variable at a a time though the years. 

I'm attaching a zip file of my Aircurve 10 SD card here : SD card 

and a sample of screenshots here: sample of SCs

even when i find some kind of relief from a setting it does not last, it's like my body change using the same settings for a month i would have different results.

at this time hopefully someone in the forum can take a look at the data and advise.

thanks again

[Brazen]

Koy - can you attach some sample OSCAR screenshots to a post here? It's the preferred method for the experts to review.

How are you measuring "successful therapy"?
Are you going off numbers/charts or how you feel?
Are you making notes to yourself with each setting change (ie how you slept/feel)?
Do you have a sleep disorder doctor?
Are you mask leaks controlled?

[koy23]

hi,

thanks for trying to help, i am attaching in the post sample of screenshots from different days ( see sample of SC) they are more than 4 which is max allowed to attach here, also there is a zipped google drive link to my whole SD card if you would like to download it and see it on your oscar software

thanks

[koy23]

not sure if anyone had looked at my latest post in this old thread or I should make a new thread?

[Sleeprider]

Koy, I looked at your Sample charts and what I see there is a frequent arousal as indicated by big flow spikes. This is unrelated to the settings on your Vauto, and I can't determine what causes this. Your settings are all over the place, and it's really difficult to associate a problem with settings, but lower PS below 4.0 seems to be much better than the ridiculous try at PS 8.0. Your event rate is generally low and the spikes arise out of no apparent respiratory source. Movement or sleep hygiene may contribute, but if I had an answer I'd have said something. No need to post a new thread. We're trying, but just can't correlate your issues with therapy.

[koy23]

thanks for trying, it has been so hard to find consistent settings with machine or masks etc..
But let me try to explain what happens if i don't have pressurized air, at sleep onset, my throat almost "closes" i could feel my airflow narrowing in this same second that i'm jerked awake again, it is a reaction of my body probably when something touch another thing triggering the fight or flight control.
as you could know from my previous posts i had UPPP, partial glossectomy and genioglossus advancement with hyoid bone suspension yet still there is this throat closing suddenly and sudden arousal.

Using the machine had allowed me to "fall asleep" as the pressurized air seems to prevent the "touching that happens" but the struggle is "staying" asleep. they only thing that is consistent are those sudden spikes which i'm going to translate as this "something" was almost going to touch the other"thing" but didn't as i get a stronger air inhale exhale.

I'm not sure if it happens in inhalation curve or exhalation curve, i could see flow limitations sometimes at the top of the curve, sometimes at the bottom of the curve, that is why i uploaded my SD card of all nights as i tried patiently to find something that works, so far nothing is consistent, i still have arousals at night ( abnormal arousals that i remember dreaming in each one) nasal pillow and keeping EPAP/IPAP around the 7.6/8 area with PS zero or less than one looks like one with the lowest flags.
My user flags are airflow reduction of 20% in 5 secs and in 4 secs, plus the normal OA/Hypopnea flags.

I am starting to consider an ASV, for the exhale breath control, but long route/expensive, insurance fight, etc.. and still not sure if it will resolve my issues.

[Sleeprider]

What are you doing for trigger and cycle sensitivity?

[koy23]

Tried different options depending on how I felt so now trigger is high cycle very high. 

I'm getting a doctor appointment soon, I just wanted to know if an ASV is something that might improve my condition or the vauto bilevel is what I need?

[Sleeprider]

I don't see anything suggesting the need for ASV. No centrals and very consistent tidal volume, minute vent and respiration rate.

[koy23]

Thanks for your feedback!