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[Treatment] Review [how am I doing?]
#11
RE: Review [how am I doing?]
Overall your numbers are great you have a few large leaks that looks to me like mouth breathing but don’t seem to be affecting your treatment.


The next real question is how are you feeling as I see no immediate need to change anything
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#12
RE: Review [how am I doing?]
First and foremost, your numbers are awesome. We will not improve on them.  Based on this there is nothing to improve.

On CA events, all I see is normal fluctuation which means absolutely no issue there and I do not anticipate one developing.

you said, "I do not really feel as rested as I would like and am interested in improvement."  I will try to address this.  This means look at other things that may be impacting you that do not impact your numbers.  No guarantees

Three things show up in your charts.  
1. Mouth Breathing, suggestion set the Y-axis for Leakrate to Max 50 (more than double the large leak threshold) min zero and added the dotted line "Leak Rate Upper Threshold"  Won't change a thing but should make it clearer.  Work on the mouth-breathing as this can be disruptive.  

2. RERAs, I only see 2 of them but by definition, a RERA is a series of Flow Limitations that ends with arousal. Arousals are bad as they disrupt your sleep.

3. Flow Limitations,  The Flow Limit chart rarely tells the full story, for the full story you need to examine a 2-minute view of the entire Flow Rate chart for flow limitations.   Flow Limits are one of the things that drives pressure up.  Look at 2130 and see a Flow Limit them look up and see a pressure rise, up in the events chart see the RERA.  If we can manage your Flow Limitations we should be able to eliminate your RERAs and smooth out your Flow Limitations.  What is a Flow Limitation? OK an Apnea is represented by a reduction of 80-100% of your Flow Rate (we don't measure DeSats so we go based on Flow alone)  Hypopneas are determined by a flow of 50-80%, Flow Limitations are between 0 and 50%.  So severe Flow Limitations, which are not counted in AHI,  can be disruptive also.

We will make some setting adjustments that you can expect to be adjusted further in the future.  Items 2 and 3 are best treated with "Pressure Support" or PS.  PS is the difference between exhale and inhale pressure and is added to exhale pressure.  For you we will us EPR to achieve the same effect.  This means we will adjust your min pressure because EPR is subtracted from Inhale pressure and is limited to 3 cmw.  When that is exhausted we go to pressure increases.  We may end up at a fixed pressure and EPR.  Time will tell.

Changes

Min Pressure = 11
EPR = 3

In the future it is likely that we will raise your min pressure and possibly your maximum.

It is important that you advise us of any changes that you feel or perceive.  The numbers are not going to tell us if we are making progress or have reached our goals.  Please be specific.
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#13
RE: Review [how am I doing?]
Changed EPR from 2 to 3 and here is the outcome and stats[attachment=13761]:
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#14
RE: Review [how am I doing?]
Thanks To all. My quality of sleep worsened as I definitely feel less refreshed today.
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#15
RE: Review [how am I doing?]
Try it 1 more night, let's make sure this is not a one off night. If it's still a problem set EPR=2 and Min Pressure = 10 for one night, then try EPR=1 (this should raise Flow Limits) and see how you feel.
Your flow Limits seem to be up and your Snores seem high. The typical solution for this is to raise Pressure support.

Your chart is hard to read. Please drop Mask Pressure and respiration rate and increase the size of the other 6 charts to fit the page.

Thanks

Fred
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#16
RE: Review [how am I doing?]
Thank you Fred. 


I missed your recommendation last night and did not make the min pressure change you suggested. I will change the min pressure to 11 tonight and leave the EPR on 3 and repeat. 


Regarding the charts, I read the guidance and tried, but need a little more help. Could you please provide more details specifically on how I should change my charts so they are best for you?
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#17
RE: Review [how am I doing?]
EPR 3 and Min pressure 10 would lessen the effective applied EPAP pressure (It is EPAP pressure that manages Obstructive Apnea), that could explain the increases.

Click on any graph title and click on "restore to 100% Zoom" (good place to start.
Grab a horizontal edge/line of a graph and drag to change size.  Snores and Flow Limits are spikes and are readable at a smaller size than size, Leakrate is another one that can be shrunk. and set the Y axis Max at 50, twice the Large Leak limit.
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#18
RE: Review [how am I doing?]
Ok hopefully I got the chart ordering and sizing right this time. Is this correct?
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#19
RE: Review [how am I doing?]
Read this
http://www.apneaboard.com/wiki/index.php...ganization

Add your Snore chart because you are showing snore
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#20
RE: Review [how am I doing?]
Ok, I re-read and am muddling through this. Is this what it should like?
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