Paula's - Therapy Thread

[paulag1955]

Let me add...I'm taking it on faith that lower numbers = better health, whether I can feel the difference or not.

[FaceInTheCrowd]

I stopped therapy for several years and have just re-started as an act of faith that my health will benefit from not stopping breathing 40-ish times an hour.

If you have 40 an hour it’s a scientific fact your long term health will suffer. Treating it will benefit you.

I had 43 an hour in my test. No symptoms.

Ya gotta treat it.

[paulag1955]

Yes, agreed. I failed last time because I couldn't sleep with the machine. I was utterly exhausted and my sleep doctor's response was that I should ask my GP for sleeping pills. I wonder how many other people give up on treatment because their sleep doctors are...not good. Anyway, I'm not sure what the difference is now, but I'm sleeping pretty well with the same settings as before.

[FaceInTheCrowd]

It’s terrible to think of all the people who can’t do it because they don’t get proper medical help. The help doesn’t necessarily flow but the money always does.

I’m glad you are doing well now.

[paulag1955]

Last night's data. I'm wondering why I see these jumps and whether or not a jump in AHI of 1.5-ish is significant. Sometimes I get jumps that are even bigger, 2 or even 3 points. I'm comparing the charts from yesterday and today and I can't see any reason as to why the increase. Or maybe it is, indeed, random and I just have to live with it. I'm including yesterday's chart again for easy comparison.  

Yesterday
   

Today
   

[gainerfull]

Paula,

Some things that I've learned along my own sleep apnea journey:

1. Our bodies are interesting and variable, especially between nights of sleep depending on a number of factors so expecting identical results may not be realistic
2. Sleep quality is REMARKABLY improved, the earlier you go to bed. I noticed in both charts you're going to bed after midnight and I recommend hitting the bed no later than 9-10p if you can manage it.

A key for me has been establishing a bed time routine where I go to bed and wake up as close to the same time every day. Has worked wonders!

If I were you I'd slowly increase your static pressure from 8.0cmH20 to 8.2cmH20 tonight, then 8.4cmH20 the following night etc until most of your sleep disordered breathing is well controlled night to night. Your success criteria is maintaining a consistent sleep start time before 11p, no obstructive events (light blue) and check in with yourself to see how you feel.

[paulag1955]

Thanks for your response. I'll try raising the minimum pressure tonight and see what happens. Honestly, I have so few OA events that I hadn't even considered that I should bother trying to eliminate them.

I'll take keeping a set sleep schedule under advisement. I can pull it out of the hat at a later time if all else fails.

[paulag1955]

Any thoughts about what happened around 3:00 am? I didn't take my mask off.

   

[paulag1955]

So a while back I turned off EPR and switched to a fixed pressure that was lower than the max I had set on autoset and something kind of counterintuitive happened so I thought I would share the data with y'all.

So as you can see, my CAs went down. That's not the weird part. The weird part is that my OA events also went down. Hypopneas are up but even still, AHI is down. Then flow limits, which were already borderline too high, are also up.

So here is my question. Do I stick with the fixed pressure and the lower AHI, or do I try adding back EPR, maybe set and 1, and see what happens? If I have to choose between Lower AHI/Higher Flow Limits or Higher AHI/Lower Flow Limits, which way do I go? I can't go by how I feel because I feel the same no matter what the numbers say. I'm just trying to figure out how to balance it out for improved health. I'd contact my sleep doctor, but he was a jerk and anyway, my insurance wants me to jump through all the sleep study hoops before they'll cover that expense. So it's not really an option right now.



   

[gainerfull]

Will you share the OSCAR view for the the night(s) in question after the change? The Resmed machines are pretty terrible at scoring events so I'd be curious to see some of the events zoomed in on to see whether or not they are just position changes or other sleep / wake junk the machine is marking as hypopneas.