Pokey49 - Therapy Thread

[ejbpesca]

Looks as though you have therapy going extremely well.

[Pokey49]

Yeh I think the mystery of what are my best settings is pretty well dialed in or near so. Certainly the BIPAP is more pleasant than the APAP was. I don't know how people tolerate straight CPAP. 
I "think" Im waking up feeling air starved still at times, and thats why I pull the mask in the night, but Im not sure its the PAP therapy causing it.

[ejbpesca]

I am going to guess it is the sensation of the mask to face that causes the starved for air feeling.  This is very common and for some prevents them from using PAP.  It took me months to stop pulling my jet pilot mask off in the night, wake or asleep.

I had to do a silly thing to accept a regular FF mask.  I would fall asleep pretending I was on a high-altitude flight and MUST have the mask on to breathe.  I would drift off with a mind scene of being part of a flight crew flying for two days with in flight refueling and it was my turn to sleep with my mask on of course and with the thought that if that mask came off I would asphyxiate.  I did that mind trick night after night for quite a while and it worked to get my mind/body to accept the mask.

[Pokey49]

Well it would seem it would be pretty hard to beat todays AHI score. See below. Obviously I've got my VAuto dialed in with all the great help here. Thank you all so much.    But as I have learned here a good AHI does not necessarily equate to waking up feeling rested. Yesterday I had pretty good "score" and felt better than usual. This morning when I woke up about 5:00, I felt just ok, took the mask off and then fell back to sleep for another hour to awaken literally hurting all over my body with a headache. I checked my pulse ox, it was 98%. My heart rate was in the upper 50s, in normal rhythm. I have not a clue what is happening when I dont have the mask on. I suspect the medication I am tapering off of doing something weird???  I guess the moral of the story, keep my mask on until I'm ready to get up, but thts hard to do some times. Anyway thanks gents for your help. Hopefully things will continue to improve

[ejbpesca]

0.00 AHI, wow.  I'll never see such. 

The withdrawal journey I took 5 years ago after 20 years of taking SSRIs daily was truly something that made me very sick for a few months. The brain gets so accustomed to those drugs that once cessation begins it causes illness symptoms that are very difficult to understand and endure.

Congratulations on your as-good-as-it-gets therapy success.  From what I've read, AHI 0.00 is better than normal nonpathological apneas.

[Pokey49]

Well my AHI of 0.00 yesterday didnt last long, though I dont expect zero on a daily basis. I don't get what makes the difference from one day to the other. Same mask, same settings, same bedtime routine, went right to sleep. Those 2 early breaks in therapy I have no explanation for. I didnt get up or pull the mask (I dont think) at those times. Had leaks out the kazoo, CAs came back. Im starting to come to the conclusion maybe its better to not look at OSCAR daily and just go with how you feel day to day now that I have optimized my settings best I can......some days are diamonds, some days are stones!!!!

[ejbpesca]

From my many years with PAP therapy, I have found there is only one constant and that is change.  Once good therapy levels are found many like to give it a week or so then look over OSCARs to see how the figures are going.  Your machine will give you daily AHI and as long as you feel okay and it says reasonably under 5.00 AHI...fine.  The machine's ability to record exactly what happens during sleep is not perfect and each sleep session goes differently for the person.

[jdougc]

Pokey, it seems that you and I are alike in that we do calm breathing exercises to help fall asleep.
I use a 10 minute ramp and may got to 15 minutes tonight.
My  ramp pressure is my minimum pressure, not some extremely low pressure. So I get some minimal therapy pressure.
These ResMed machines don't score events during ramp and won't increase therapy pressure either, so it is a more gentle experience , at least for me.
Try a ramp of 10 minutes at your minimum ipap pressure of 10 cm.
Monitor your O2 sats though and if there are any issues, then turn ramp back off.

I hate getting flagged during my wake sleep junk breathing and I hate the pressure increases even more.

[Pokey49]

I dont know what to make of these daily OSCAR report variations. I have had two extremes within 2 nights of each other. Below is OSCAR for 6/9 and 6/11. A really good night w/ AHI of 0  and a really crummy night w/ AHI of 6+ with a big cluster of CAs. I woke up last night a couple times feeling air starved. Why I have no idea?? PAP works great one night, lousy another. Im frustrated.

[ejbpesca]

Are we seeing the infamous SWJ waves causing high AHI?  They sure can wreck an AHI.