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Angela P Therapy
#1
Angela P Therapy
I had a 6 month update meeting with my Sleep Dr. yesterday (phone consultation) and after asking me some questions about how I am doing she looked at my sleep data and recommended a bump in my pressure because she noticed I am always maxing out.  I am now on APAP 6.0-9.0 with EPR 3.  I am still using the Airfit P10 Nasal mask which I find very comfortable.

I did explain to the Dr. that the vivid dreams/nightmares I was having before I knew I had sleep apnea are coming back.  Is this normal or something I should be worried about.  

Also I woke up with a cracking headache this morning and was just wondering if it was related to last nights events or something else.


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#2
RE: Angela P Therapy
Hello, is there anyone that can help explain this?
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#3
RE: Angela P Therapy
Your numbers look great but your min is at 6cm. For me (Ann’s most adults) 6 is to low to get enough oxygen. My absolute min is 9 to get enough air to not feel air starved. 

The symptoms you have go along with lack of oxygen.  I would raise the min to at least 8 or 9 and see if that helps. 

Also the only way for people to help much is to see data. Download OSCAR - it is totally free. Please post your OSCAR charts.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Angela P Therapy
At 6-9 EPR 3 your pressure remains at the maximum pressure of 9.0 most of the night, being driven by flow limitation. Your ideal solution would actually be a bilevel machine that provides more pressure support, or pressure that supports your inspiratory effort so that it does not hit that wall of resistance near the peak. All of your inspiration waves in Oscar have flat or irregular peaks that comes from some form of airway resistance. A higher maximum pressure of 10 may help to keep your airway more open and reduce the amount of flow limitation you experience.

If you were using a Vauto, I would continue to keep your EPAP at 6.0, but would increase IPAP to 10.0 with PS 4.0. With your autoset, we are limited to 3-cm of pressure support (difference between IPAP and EPAP), so the next step in pressure of 10 will result in EPAP 7.0 and IPAP 10.0. The objective will be to increase pressure as recommended by your doctor, then compare the 95% flow limitation to see if it has been reduced.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Angela P Therapy
First, my observation is based on your most recent screenshot and I haven't read the thread's history.

Using an EPR of 3 in an attempt to reduce flow limitations, is not reducing them to a low enough level.  This is causing your CPAP to increase its pressure in an attempt to overcome these restrictions.  Based on your flow limit value, your CPAP will probably always go to the highest set pressure. At the same time, the EPR's pressure difference is also inducing CAs.  This is akin to a double-edged sword, which do you want to reduce the FLs or the CAs?  It would appear that you have hit the best medium.

Unfortunately, an event is reported as a binary value.  Either you have one or you don't.  In reality, it is a little more gray.  Yes, you have an event, but how long did it last?  If the few CAs that you are experiencing are of minimal time, then that's the best trade off with flow limitations that you can make.   However, as the CA's event duration increases, so should your concerns and a decision to decrease your pressure would be in order to help reduce the CAs. The CAs could be pressure induced and may subside as your body becomes acclimated to the pressure.

I realize that I have provided a bunch of definite maybes, but based on your last results, I would look more to how you feel.
Crimson Nape
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Angela P Therapy
I appreciate all of the input so far.  Last night was awful, I kept waking up blowing air out of my mouth, the pressure sat at 9.0 for the whole night.  I don't know how to describe it but I feel like I am choking on air and I have to release some.

Should I break down and try a full face mask?


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#7
RE: Angela P Therapy
Set your pressure range to 7 to 7 then show your OSCAR report

You are not having issues with events other than flow Limits and this is the lowest pressure you can get the max benefit from the EPR which helps flow Limits. We can adjust from there.
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#8
RE: Angela P Therapy
Set Min and Max to 7.0 ?  CPAP or APAP?
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#9
RE: Angela P Therapy
Only the Auto(APAP) mode will have a min and max. However, with both set to 7 cm, it doesn't matter if it is CPAP or Auto mode, your call.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Angela P Therapy
Thanks for clarifying, I will set both to 7.0 min and max tonight and post the OSCAR result tomorrow.
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