[CPAP] jdougc - Therapy Assistance

[jdougc]

My sleep is still fragmented, still difficult to roll over, may have to get another trigger point injection in my upper back. Very tired and ready for a nap.

I have gotten 3 nights with clusters of OA events or CAs early morning, not sure why. The OAs seem like positional Apnea though.
Been tired all week, not catching up on the good sleep. 
My throat is a little sore.
I am still side sleeping with a soft cervical collar, mouth tape and a SomNoSeal device. 
I have tried a spare cervical collar and had similar results.
Night before last night was fine though no cluster and AHI under 1.
Any thought would be appreciated.
   


   


   

[Pokey49]

JDoug. I can sure empathize with you. Despite my limited knowledge of interpreting these graphs it appears you had pretty unrestful nights despite low AHI. Obviously a low AHI is not the gold standard equating to waking up refreshed and you are on BiPap. I’ve had numerous nights of low Ahi and yet feel like warmed over dog poop the next morning.  Making me wonder if my fighting with my DME and Medicare to go on BIPAP is going to be worth the effort. They are telling me I don’t qualify for BIPAP because I failed to be compliant within 3 months with APAP and need another study. Sarcastic Dave Sent me the Medicare rules on switching to BIPAP. You almost need an NY attorney to interpret them but the way I’m reading them I can qualify. I’m seeing my PCP next week to see if he can help me out with qualifying. I figure BIPAP can’t be any worse. 
I wish I had good advice for you.  I wish you well nonetheless.

[jdougc]

Thanks Pokey,
I hoped things go well for your visit with your PCP next week.

These Oscar charts are anomalies for me, very perplexing. 

The Bilevel has improved my breathing patterns immensely, but the outside circumstances are the struggle for me.
I think if I get get to the point where rolling over isn't so difficult, my nights will become refreshing.

[ejbpesca]

I have seen the experts call out clusters of apneas as positional many times when events are due to obstruction but since CAs are not obstructive apneas that blows apart calling that cluster positional unless the machine cannot truly delineate between CAs and OAs,  and the CAs are actually OAs.  I zoom in on both and find quite similar on my graphs, but there may be details I do not recognize.

I see your pressure goes right to the max and stays there.  Have you tried using the median pressure as the min. pressure?   In other words, is your minimum pressure high enough to prevent events, and is your maximum pressure high enough to go after push-through events?

I look at the min/max pressures like dosages of medicine.  You have a maintenance dose, the min. and a level of higher dosage for outbreaks that push through the maintenance dose and dosing is done by a computer.  Your computer shows max dosing across the graph and symptoms continue.  Do you feel those pressure settings are correct?

[jdougc]

ejbpesca, thanks for looking at my issues.

Normally my AHI is under 1, which doesn't mean much for me, my sleep is fragmented.
I don't sleep well with larger pressure swings, but at the end of April, I did 5 nights at a max of 13 cm and got 3 nights of AHI of "0" but didn't sleep well.
I then lowered the max to near what sleeprider gave me, 11.6cm but stayed in the APAP mode instead of my original CPAP mode.
I can't remember if CPAP doesn't score Flow Limitations on the AirCurve or another setting. 

I still am not very clear headed.
I ignored my alarm to check my SD card, and it wasn't fully seated, so no data from last night. The machine said my AHI was 0.91.

I will try the 13cm again for a week and see how it goes.

[Pokey49]

JDoug as you know Oscar does not measure/record SPO2. I wonder if you are having some ODI 4% & 3% issues like I’m having. I got a low AHI last night (1.95) but had really poor sleep per my smart watch. And my Oscar flows were ragged. I checked my O2 a few  times with a regular Oximeter and my Sats were yinging and yanging between 98-93 and. They may have been going lower when I was asleep. I’m going to do an all night oximetry tonight and see what I can find out. I don’t know how ODI correlates with AHI if at all, but it seems to me one could have a 3 or 4 % drop in O2,but it won’t trigger an event on Oscar, but I might be wrong?? I just know something is amiss and I’m flipping over rocks. 
Just something to ponder.

[jdougc]

Pokey,
I think that there is a delay between apnea events and and O2 sat drops. Heart rate issues are more inline with the events though.

My fitness tracker doesn't measure O2 sats, but it does measure my heart rate. It splits up at midnight and presents a tiny graph.
May I ask what you wear to track your O2 sats and heart rate?

I may need to add something to my bday and dad day list, since they are close together. I get into trouble for not having a list.

I was originally looking at at devices that had a finger O2 reader.

[ejbpesca]

Health issues like a sore throat and injured back make my sleep fragmented.  All I hope for from my APAP machine is to keep AHI down.  Wearing the gear fragments my sleep and when I tried a collar, tape, mouth appliance, and chin strap it was more framented so I gave up on those items.  If I can get a 1 or less AHI,  I feel that's about as good as my machine will render my breathing during sleep.  I do not expect the machine to improve my sleep beyond preventing apneas.

[jdougc]

ejbpesca, I get it, our sleep can be so fragmented by issues that we have limited control over.

I need a  mouth guard, but didn't consider a mad device that might mess up my bridge work.
Also it can be frustrating that settings and a mask that once seemed life changing now do not provide decent sleep 

[Pokey49]

JDoug here is the oximeter I got off Amazon: It records your O2 all night. My FitBit watch just tells me my average O2 for the night and if there was high or low variation which is pretty much worthless. This little gadget records the actual SPO2 all night. I hope this link works. If not its called am EMAY continuous  oximeter on Amazon

https://www.amazon.com/Monitor-Overnight...154&sr=8-9