Custom 68 Therapy Help Thread

[jdougc]

What would an engineer do without numbers and a plan of action, with 2 or 3 backup contingencies plans?

[custom68]

More true than most would understand.

[custom68]

Ok, it is update time.  I have settled into these lower numbers which makes me happy.  I have only had a couple of good consistent days but I will take that as progress.  I will note the junk around 3 I was probably awake.  for some reason I was wide awake and thought I had a full night of sleep.  I ended up getting a quick sip of water and did fall back to sleep and had an even better last few hours.
Last night I dropped the pressure .2 to 7.6, I feel it helped some.  I will stay at this for a few days.  I have watched most on here go up in pressure so I had been following that same advice.  For me and the CAs I was experiencing it was not working.  The CPAP constant pressure seems so far to be a better fit.
If you want to see anything zoomed in specific let me know.
Thanks,
Dave

[custom68]

out of curiosity I am including two events that are close enough I can capture on one screen.  I cant see much difference.  What do you look at to distinguish between the CA and OA events besides the marker?

[jdougc]

The OA event was marked as the machine sent a pulse and the pulse was reflected back.
Not so with the similar looking CA event. The pulse was not reflected back

[custom68]

I seem to have settled into the use of this PAP machine.  I don't know if all my issues of high CA events before was just getting use to this or if the lower 7.6 CPAP pressure is close to where I need to be.  I do feel more rested for sure.  It may need a bit more tweaking but I do know to go slow with any changes.
If you see anything glaring or thoughts they are welcome.
Thanks for riding along this adventure with me.
Dave

[custom68]

I tried changing the pressure down .2 realizing that is pretty minor however it did cause my CA to go up some?  Not sure on that but maybe I just had a worse couple of nights.  Back at the 7.6 I have stable numbers again.  I am not sure I need to worry about the few events I am having but my sleep seems better from the charts and how I feel.  
How come I have a flow spike during the events shown below?  Is that normal?
Thanks
Dave

[jdougc]

Glad to hear that your sleep seems better .
I think most of that zoomed in chart should be one long flow limitations, but ResMed does a terrible job of flagging flow limitations. So many flattened breath tops and small and irregular shaped breaths.

Can you raise the EPR to 3 for a few nights? EPR is used to treat these flow limitations. 
But if these flow limitations are not bother your sleep, then never mind!
You may need to increase the pressure to 8.0cm if you feel suffocated/uncomfortable.

Remember this is a journey and the landscape changes, so what was perfect for a few weeks might need tweaked

[custom68]

Thanks jdougc, yes I can raise the limit to 3 for a try. I thought for the most part the flow limits seemed pretty low overall. Just caught that spot when zooming in. I had actually thought maybe EPR needed to go down to help the CA events based on other posts I have read. I don't know that they are bothering me but I assume or believe I have lived with the moderate APNEA for a long time and didn't realize it so it will take some time for me to get this sorted.
My next shot was to slowly raise the pressure like you are suggesting to see if that would make a difference. I don't feel that it is uncomfortable and I am just happy to see things stabilize some. I was worried when I was having clusters of CA so this is much better.

[jdougc]

If you have time, zoom in around the clusters if you could even call them that and see if there is a  larger breath before. Scroll a earlier and see if there were flattened breaths or smaller breaths. Sometimes the larger breaths reduce the CO2 and the brain says to skip a  breath to get back in balance.