RE: 6 Days on my own, then DME (Olivander's Mask Shop)
This was a brief nap Saturday afternoon, using the Dreamstation Go and the "spare" (now primary) F30 and taking the new integrated battery for a spin. I used the 15mm hose from the DSP instead of the 12mm hose that came with the DSG. I'm not positive when I had actually dozed off during the first bit of junk, vs when I was just breathing erratically as I futzed with the mask. At 5:34pm, I was awake but consciously keeping my breathing very controlled, and bumped the auto range up to 13-15 (A-flex+ 1). then I dozed off. As far as I can tell, the three following pressure rises (at roughly 9 minute intervals) are just an oscillation in the Dreamstation algorithm. I don't see any other reason for it. Then, just after 6:02pm, my mother called with a question. Oh well, time to get up I guess. This is from Oscar v1.1.0-testing-4.
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
(09-09-2019, 03:22 PM)ragtopcircus Wrote: This was a brief nap Saturday afternoon, using the Dreamstation Go and the "spare" (now primary) F30 and taking the new integrated battery for a spin. I used the 15mm hose from the DSP instead of the 12mm hose that came with the DSG. I'm not positive when I had actually dozed off during the first bit of junk, vs when I was just breathing erratically as I futzed with the mask. At 5:34pm, I was awake but consciously keeping my breathing very controlled, and bumped the auto range up to 13-15 (A-flex+ 1). then I dozed off. As far as I can tell, the three following pressure rises (at roughly 9 minute intervals) are just an oscillation in the Dreamstation algorithm. I don't see any other reason for it. Then, just after 6:02pm, my mother called with a question. Oh well, time to get up I guess. This is from Oscar v1.1.0-testing-4.
These are test pressure probes. It's how the Dreamstation algorithm tests to see if a greater pressure is needed or not. You see plenty of those in a night. They are perfectly normal.
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
(09-09-2019, 03:06 PM)ragtopcircus Wrote: So, I was still struggling with the F30. I had two identical masks, both new, both adjusted exactly the same (measured repeatedly). I even shaved in the middle of the night, hoping to improve the seal and stop the "raspberries". Tweaking the straps or nudging the mask around didn't help. Each time I thought I had it fixed and tried to relax, I would start feeling a bubble move under the edge. After a few seconds, the farting (so to speak) would start. Finally, I dug the spare out of the box and tried it. Bingo, I slept fine for the hour or two left before my fiancee's alarm went off, and went back to sleep for a bit after she left. That afternoon, I sat down with both masks, trying to figure it out. One mask was not finicky at all; it just worked. The other was impossible to adjust. I carefully matched them again, still no dice. Then I noticed that one had sort of a wrinkle in the edge of the seal, right where the leak always started ... aha!
All screenshots are from Oscar v1.1.0-testing-4.
This is last night with the "good" F30 mask, 15mm tubing, Dreamstation Pro, pressure fixed at 13, C-Flex+ 1, no ramp, no cervical collar, but a "My Pillow" small travel pillow on top of a fairly flat feather pillow for side-sleeping. From 69.6 diagnosis to AHI 1.67, and my first night of essentially sleeping all night since, well, I really can't remember when (granting that I did go to bed late because we had company). If I'm interpreting it right, there was at most one "real" CA event, ignoring some sleep/wake junk.
3am - small cluster of OA events. I think this was when I rolled onto my back without moving the travel pillow. I'm going to try rotating it sideways so I roll off of it when on my back. I think I partially awakened and moved it at the end of the cluster.
3:57am - there's an OA, CA pair that look almost identical to me except for a slight difference in amplitude. Is one of these events misidentified by the Dreamstation? Which one?
5:58am - there's a CA event flagged, but could it be "junk" from being partially awakened? My daughter typically wakes up around 5:45, dresses, and leaves her room around 6:00.
6:50am - another CA event that might be more partially awake junk. That's about the time my daughter leaves for school. She's not quiet.
If you see a big increase in tidal volume before a CA event, it usually means it's an arousal and not a central apnea. You probably woke up, took a couple of deep breaths and waited a bit before breathing again. It can also happens in REM sleep as your breathing is a bit more irregular during this stage.
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
(09-09-2019, 03:53 PM)alexp Wrote: If you see a big increase in tidal volume before a CA event, it usually means it's an arousal and not a central apnea. You probably woke up, took a couple of deep breaths and waited a bit before breathing again. It can also happens in REM sleep as your breathing is a bit more irregular during this stage.
Great, so I may not have had ANY real CAs last night! There were none in my home sleep study either, but I had been seeing some pop up in the data while I was struggling with mask issues.
09-12-2019, 09:23 AM
(This post was last modified: 09-12-2019, 09:29 AM by ragtopcircus.)
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
So, I promised the RT I would stick with one mask, the fixed pressure machine, no collar, etc with no changes for one week, and I did (except I did have to use my WoodyKnows nasal dilator the last night). The best night was 0.67, and the average was a little under 2. The data still shows (I think) a clear positional issue, but otherwise the prescription pressure (13 fixed) is looking pretty good overall. I reduced the Flex progressively from 3 to 2 to 1 with good results, I think.
I told her that going forward, I would be using the collar, updating the Dreamstation Pro firmware, and using the Dreamstation Go Auto when travelling. That includes, to me, any night away from home, so probably a night or two every weekend at least. I think I'll keep the Auto at 13-15 and see how that goes, so the machine can respond to positional issues if needed. I don't think, for me, there's any benefit to allowing the inhalation pressure to go below 13 (or allowing the exhalation pressure to drop much lower).
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
And ... now I need to get used to sleeping with a collar again. Argh! Oh well ....
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
Sounds like you've got a good thing going!
I want to encourage you that you DO have choices when it comes to DMEs. If a particular DME doesn't like to dispense Auto CPAPs, then take your business elsewhere. I experienced that, and that's what I did! I handed back my rental and went elsewhere.
10-07-2019, 02:54 PM
(This post was last modified: 10-07-2019, 03:15 PM by ragtopcircus.)
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
It's been up and down with the Dreamstations, but the AHI numbers have been pretty good overall. Sleep has remained erratic (and generally insufficient though better than without xPAP). I went back up to Flex 3 because of frequent restriction in my nose that sometimes made it difficult to exhale enough to make room for the next breath. It hasn't been clear to me that Auto on the Dreamstation Go was really providing much benefit over fixed pressure on the Pro (for oft-mentioned reasons - it responds too slowly to the events, and returns too slowly to normal operation). I also wish Flex would reduce the pressure a little longer instead of just dipping briefly.
So, I bought a Resmed AS10 For Her. Due to some unpleasant associations with the sound of the AS10, no matter how faint, I found some sustained release melatonin to help me get used to it. The first full night that I managed to use it was still a little unsteady, but I'm not seeing much to complain about with the second (see below). Since I'm using EPR 3 (which goes around 1 cmH2O lower than Flex 3), I kept the min pressure at 13 like I've been using. I raised the max pressure from 15 to 16 for the same reason. I typically start getting centrals somewhere around 15, and get a lot if I spend much time around 16. Since the AS10 comes down faster, I took a chance on raising it a little, but that's why I'm not letting it go to 20.
I slept an hour through a leak that would have previously awakened me immediately. I did eventually wake enough to nudge the mask a little though. Next up: loosening the P30i even more. The "large" pillows are still a little too small for my cavernous nostrils, so they leak if the headgear pulls them too close to my upper lip.
Also, though the P30i manual specifies the "pillow" mask setting, the large size is not very restrictive. It felt like the AS10 was a little unstable, trying to overcompensate for mask resistance (probably more appropriate for a smaller size), and jumping nervously between IPAP and EPAP. "Nasal" seems to smooth it out, so that's what I'm using (for lack of Trigger and Cycle controls on this machine).
These are all from Saturday night. Other than addressing the leak, and continuing to stay off my back as much as I can, does anything need tweaking?
All night:
Deepest sleep:
OA1:
OA2:
CA1:
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
Is it reasonable to let the Airsense keep slowly cycling in the 13~14 range, or does it need to be bumped up a smidge? Assuming it keeps doing that after I get the leaks back under control ....
10-08-2019, 01:19 AM
(This post was last modified: 10-08-2019, 01:19 AM by jaswilliams.)
RE: 6 Days on my own, then DME (Olivander's Mask Shop)
(10-07-2019, 09:57 PM)ragtopcircus Wrote: Is it reasonable to let the Airsense keep slowly cycling in the 13~14 range, or does it need to be bumped up a smidge? Assuming it keeps doing that after I get the leaks back under control ....
With your numbers so low it's more about how you feel there is no need to focus on your pressure changes unless you believe them to be disruptive
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