hookedonstitch - Therapy

[Sleeprider]

You need to stay in Autoset mode for flow limitations to be recorded. Setting the machine in Autoset with the same minimum and maximum pressure allows the best yield of data.

[hookedonstitch]

[hookedonstitch]

Last night's stats at 7,0 Min and 7.0 Max APAP with EPR 3.  The pressure settings on OSCAR didn't update (again).  I feel like hell this morning, like a zombie.

[Sleeprider]

Your event rate is low, however flow limitation is persistent. The ideal solution remains a bilevel therapy with greater difference between IPAP and EPAP (pressure support). Your results and flow limitation are no different at 7.0/4.0 than they were at 9.0/6.0, and you did not tolerate a higher pressure of 10.0/7.0. With therapy producing acceptable AHI but unsatisfying sleep, presumably arising from high flow limitation and respiratory effort, we have pretty much exhausted the capability of the Autoset to improve your sleep. If an opportunity to move to a Vauto should arise, you should take advantage of it. If CathyF should stop by, she might be able to tell you first-hand what a difference it can make.

[OpalRose]

This may have little to do with your results, but I notice that you are using the "for her" mode. Have you tried setting it to "Auto" mode? (minimum 7 - maximum 7)

[hookedonstitch]

I'm so confused why did my Sleep Dr. say I am doing really good :  I think you might have mentioned to me in the past that loosing weight might help with the flow limitations or just giving it all some time.

If this persists (how long should I let it go?) then how on earth do I get my Sleep Dr. to listen to me when I say I am exhausted?  She brushed me off this time saying my iron was still too low and that was the reason (which it probably is playing a part in).

What do I need to say to her to get her to listen to me?  And if my AHI is low but flow limits are high am I even still getting any benefits from the machine?

[hookedonstitch]

I have tried the regular autoset and I find the pulses of air really annoying and wake me up even more than the pulses sent out in the autoset for her.

[factor]

What is preventing you from getting your iron corrected then?  Get that corrected then she cant say "oh its your iron".  Are you taking Vitamin C and or Iron supplements?  What did the Doctor say to do about it?

[hookedonstitch]

I've been trying to get my iron up, taking 2 supplements daily with vitamin c but my levels dropped.  I just had GI tests done that were both normal.  I'm being sent for a CT of my intestines to make sure that is not the reason why.  I eat lots of meat, veggies too.  Not sure what is going on, it's very frustrating.

Dr. is trying to get me referred to a Hematologist but my iron is 1 point above the lowest part of the normal range so they are refusing to see me.  Family dr. is trying to refer me himself for Iron infusions.

Ferritin is at 24 and sleep dr wants it over 75 for at least 6 months.

[cathyf]

Angela, your graphs look like mine! Flow limits like crazy -- which peg the machine at whatever you set the max pressure to -- but they are NOT harbingers of impending apneas/hypopneas. Just crazy flow limits in and of themselves.

I've been whining for awhile over on this thread: http://www.apneaboard.com/forums/Thread-...ow-limited

I bought a vauto on craigslist and have been using it for almost two weeks. I'm not sure what I can report for results -- but it's absolutely amazing what it does for the flow limits even at a pressure support of 4 (like EPR).

As for doctors, I'm pretty discouraged by the entire practice of sleep medicine. I'm not sure whether I really even have apnea, but I produce flow rate curves that are pretty unlike anything I see anywhere! All the clinic is interested in is that I used my machine and what they saw on the sleep study (which looks fairly bogus).

I've been at this for 7 years, and the one thing that I've learned is that sleep medicine consists of long periods of ignoring you entirely punctuated by scolding and threats when they catch you paying attention to your data.