[Treatment] Optimizing My Treatment

[Gideon]

Your numbers say that there is no need to change anything, How do you feel? What is bad about your therapy? There is no reason to change anything and no sense in chasing numbers.

[SuperSleeper]

IF I  WERE TO SUGGEST A PRESSURE. It would be min epap9, because that cleared the OA.

Okay, here's the problem ajack - you keep interjecting your "recommendations" into numerous threads BEFORE you even have had a chance to look at the most recent OSCAR charts.  In addition, you seem to thrive on what you perceive as "contrarian" information, when in fact, your information is, in many cases either completely illogical, misinformed or just plain wrong.

You were not demoted because you have contrarian views, but rather that you kept interjecting alarmist rhetoric into numerous threads warning brand new forum members that they DIE if they used an ASV.

If I have to remind you, I will.  My PM I sent to you back in 2018 stated:

Ajack,

I am forced to require you to stop being so alarmist with regard to the ASV dangers for new members that post on the forum.  In many cases, you have no clue to their entire medical history or how it was determined that they need an ASV, and yet you are consistently and repeatedly insinuating that folks are likely to die with ASV.  It seems as if you're obsessed with making sure every single ASV patient comes away from reading your posts with a great trembling fear of ever using ASV.  There's ABSOLUTELY NO REASON to do that with a brand new patient on this forum (causing them unnecessary worry and alarm), especially since (again), we don't have their entire medical history in front of us.

This is not simply a difference of opinion.  It's the manner in which you cause new member undue stress and many times unnecessary alarm and panic which disrupts the calm and reasonable discussion that should be the norm on this forum.

I'm pulling your Advisory Member status for the time being my friend.  It's nothing personal, but we can't have newbie members alarmed and scared to death because they keep reading your alarmist posts concerning ASV.

Specifically, your anti-ASV posts have been disruptive (by you inserting them into just about every ASV-related thread lately).

and my additional solution for you:

The solution:

If you believe that there's truly a clear and present danger for these folks to use ASV, go ahead and start a new thread on that topic, and we can all discuss it IN THAT THREAD.  But don't keep inserting the alarmist replies into each and every thread where ASV is mentioned on the forum please.  That, my friend, must stop, and stop now.

Again, this is nothing personal, as I understand you have strong opinions on this issue.  It's the disruptive nature of inserting that opinion into numerous threads in an alarmist manner that must end now.

Don't expect your illogical, misinformed, and incorrect advice to go unchallenged, especially when you have NO CLUE about someone's details and data, and yet ramble on-and-on about how they need to change this or that setting prior to them even sharing any OSCAR charts, and especially with someone who ALREADY HAS a relatively LOW AHI.  There is no "group-think" involved here, but rather as a forum, and as a community, we must guard against giving out bogus advice or advice that is not based upon facts.

Now, I suggest you get off this thread and allow the OP to interact with people who know what they are talking about.

[SuperSleeper]

I apologize to hearsay73 for having to read all this, but this particular member (ajack) needs what what was said here, since he's failed to respond to private rebukes.  In addition, new members need to realize that too many times ajack's advice is incorrect, or (at best) uninformed advice that is hastily given without first seeing all the data.

Now, lets allow this thread to stay on-topic.  Sorry for the diversion.  

[jaswilliams]

Hearsay 37 I would not be changing my settings at all I would be evaluating sleep quality issues rather than making any further changes to my machine.

[Crimson Nape]

hearsay73 - I noticed that you have the Periodic Breathing (PB) turned off in the Events graph.  Do you have the Hypopnea (H) turned off as well?   I'd like to see these activated just in case you are experiencing any of them.  You can turn them on by using the dropbox in the lower left side of the Daily screen.  You may turn off the VS2.

[hearsay73]

Thank you for all the replies! I really appreciate all your advice.

SuperSleeper: no problem at all! I appreciate that you are looking after the welfare of us newbies. 

Ajack: thank you for your advice just the same. I appreciate you taking the time to look at my results and giving advice.

Crimson Nape: Thank you for that! I was wondering what that dropbox was for and was toying around with it. Didn't notice that I was turning off some data. 

Jaswilliams and Bonjour,

Thank you for the advise on not changing anything.

To answer your question, I do feel great with my therapy. The sleep I've had in the 3 weeks since I started PAP therapy has been the best sleep I've had in years. I thought that waking up at night to pee every two hours was normal!    

My reason for asking if my settings can be optimized further is really based on the titration data from my sleep study which had a lower pressure which (it seemed to my untrained eyes) had even better results than what my current setting. 

I'm also concerned about therapy induced central apnea with the high pressure of 22. Is there a cause of concern? Or am I just being paranoid?   

Attached is my latest OSCAR data.

[Crimson Nape]

How do you feel?

[hearsay73]

Crimson Nape: I feel great. No daytime sleepiness anymore. I can even survive not having an afternoon nap which I did regularly before I had PAP therapy.

[Sleeprider]

Hearsay, your current settings are at EPAP min 16 with PS 2-4, and max IPAP is not really an issue here. What I see in your results is a persistent flow limitation which would be better treated with pressure support. The fact the EPAP is nearly unchanging, suggests you may tolerate a lower EPAP min pressure. My suggestion is to drop EPAP min to to 14 and PS min 3.0. There may be more room for dropping pressure, but let's start here and see how you feel. I'd rather see you comfortable than chasing numbers.

[hearsay73]

THanks for the advice Sleeprider! I'll try that tonight.