RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
Here is a good article about UARS:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608900/
One takeaway: "UARS diagnosis is suspected in individuals with complaints of excessive daytime sleepiness or daytime tiredness, no OSAS and a polysomnographic study with respiratory parameters indicative of increased upper airway resistance, such as, flow limitation during sleep." But the whole thing is worth reading.
No one can guarantee that a bilevel machine will successfully address your symptoms, but using one is a very reasonable experiment to make. The experiment may fail, but it also stands a good chance of succeeding.
Your budget inevitably factors into your decision about whether to buy the machine on offer, but I'd say two years of use isn't a deal-breaker. Machines are expected to last at least 5 years. You might try to bargain, though, I suppose.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
(02-02-2022, 07:24 PM)Sleeprider Wrote: When optimized for pressure support the VPAP-S is a very good machine with all the features of the Vauto except automatic pressure adjustment. You still get all the trigger and cycle sensitivity, Ti Min/Ti Max and Easybreathe™. Great machine.
After nearly 7 years using an APAP, I bought a vauto from a seller on craigslist for $500, and it is astonishing how much difference it has made.
When I first started this adventure in 2014, and first looked at my data, I was puzzled by these "flow limits" and thought it was crazy. The reason that the machine reacts to FLs is that FLs are usually an early warning to an impending apnea. With me, however, they are not particularly. With me, using an autoset, if I am asleep I have significant flow limits, and if I'm not having flow limits, then I'm not asleep. Period.
The first night I hooked up to my vauto last summer I woke up and look at my data and was astounded. There were long stretches where I knew that I was asleep but there weren't any flow limits! I know the vauto can detect them, because I occasionally see a little burst of them, the machine ramps up the pressure, they go away, the pressure comes back down.
But, anyway, my point is that when I'm using the vauto (and I manage to keep myself out of positional apnea, which is a different story) the pressure support eliminates the flow limits, and the pressure stays pretty much at the minimum all night. So for me, the queen of flow limits, during most of most nights I would do just fine with a vauto-S. If the price is right, go for it!
02-05-2022, 02:43 PM
(This post was last modified: 02-05-2022, 02:45 PM by highwaystar86.)
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
(02-03-2022, 05:26 PM)Dormeo Wrote: Here is a good article about UARS:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608900/
One takeaway: "UARS diagnosis is suspected in individuals with complaints of excessive daytime sleepiness or daytime tiredness, no OSAS and a polysomnographic study with respiratory parameters indicative of increased upper airway resistance, such as, flow limitation during sleep." But the whole thing is worth reading.
No one can guarantee that a bilevel machine will successfully address your symptoms, but using one is a very reasonable experiment to make. The experiment may fail, but it also stands a good chance of succeeding.
Your budget inevitably factors into your decision about whether to buy the machine on offer, but I'd say two years of use isn't a deal-breaker. Machines are expected to last at least 5 years. You might try to bargain, though, I suppose.
Thank you for that article. Yes, budget does factor into this. To me there seems to be enough data that it would almost for sure improve my quality of sleep and how I feel.
Ever since I had the lung surgery in May 2020 it seems like things got progressively worse for me which lead to the OSA diagnosis. But on top of the fatigue I also developed anxiety like never before, started getting bad brain fog and right now I'm holding onto this hope that if I solve my sleep problem then almost all of these symptoms I'm experiencing will improve. The more I read about UARS it seems be that those are the symptoms that persist after apneas are controlled but flow limitations are still happening.
(02-03-2022, 05:50 PM)cathyf Wrote: After nearly 7 years using an APAP, I bought a vauto from a seller on craigslist for $500, and it is astonishing how much difference it has made.
When I first started this adventure in 2014, and first looked at my data, I was puzzled by these "flow limits" and thought it was crazy. The reason that the machine reacts to FLs is that FLs are usually an early warning to an impending apnea. With me, however, they are not particularly. With me, using an autoset, if I am asleep I have significant flow limits, and if I'm not having flow limits, then I'm not asleep. Period.
The first night I hooked up to my vauto last summer I woke up and look at my data and was astounded. There were long stretches where I knew that I was asleep but there weren't any flow limits! I know the vauto can detect them, because I occasionally see a little burst of them, the machine ramps up the pressure, they go away, the pressure comes back down.
But, anyway, my point is that when I'm using the vauto (and I manage to keep myself out of positional apnea, which is a different story) the pressure support eliminates the flow limits, and the pressure stays pretty much at the minimum all night. So for me, the queen of flow limits, during most of most nights I would do just fine with a vauto-S. If the price is right, go for it!
Thank you for sharing. I am going to ask the seller if they can drop the price and hopefully I'll be getting it tomorrow.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
(02-03-2022, 04:53 PM)Gideon Wrote: EVERY detailed, zoomed chart you have posted has shown us a very highly flow limited breathing that is indicating difficulty breathing and making you feel like **** most of the time. And you have the best of the best looking at it here and offering advice based on that data.
IMHO get a BiLevel. You need it!
Thank you. I really appreciate the opinions and everything that I've learned because of this forum. Money is obviously a factor for me but I think I'm going to pull the trigger, worst case I can sell it myself and make most or all of the money back BUT I truly believe that I have enough data that points to this being what will work for me.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
I am picking the unit up today!
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
5600 hours is not a concern as the machines seem to be fine beyond 20,000 hours. It does affect the price, but prices have been pretty insane this year. Looks like you are ready to go on your new bilevel, and we can look forward to seeing how it works out. It can take a while to adapt to bilevel pressure, but I think you will really like it. It should greatly improve the flow limitation you experience.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
(02-06-2022, 09:40 AM)Sleeprider Wrote: 5600 hours is not a concern as the machines seem to be fine beyond 20,000 hours. It does affect the price, but prices have been pretty insane this year. Looks like you are ready to go on your new bilevel, and we can look forward to seeing how it works out. It can take a while to adapt to bilevel pressure, but I think you will really like it. It should greatly improve the flow limitation you experience.
To me the money isn't even a worry if this works because that means I can get back to being myself and doing all the incoming generating activities I've been struggling to do for the past 5 months!
I did a little trial run at IPAP = 11 and EPAP = 5 just for a few mins laying down and the breathing patterns look A LOT more normal to me on OSCAR. Plus I didn't feel the usual strain/anxiety while exhaling against 8 with the CPAP.
I'm excited to try it out tonight and see how I feel/look on OSCAR in the morning!
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
You may need to purge the data you already imported in order to import the full session from tonight. Just use the menu in Oscar Data/Advanced/Purge Current Day. Your test will prevent additional data from being imported for February 6 unless you do this.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
I would increase PS slowly and see how things progress rather than jumping straight to a high value (6 cm is at the higher end of what we see people need). Lots of people notice 3 EPR to 4 PS as being a noticeable difference.
Imo I would use 6 cm EPAP (previously were using 7 cm) and 4 cm PS. Then depending on how things go can try 4.5 or 5 cm PS if you feel more is still needed.
02-06-2022, 06:32 PM
(This post was last modified: 02-06-2022, 06:34 PM by highwaystar86.)
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled
(02-06-2022, 04:01 PM)Sleeprider Wrote: You may need to purge the data you already imported in order to import the full session from tonight. Just use the menu in Oscar Data/Advanced/Purge Current Day. Your test will prevent additional data from being imported for February 6 unless you do this.
Thank you for letting me know
(02-06-2022, 05:33 PM)Geer1 Wrote: I would increase PS slowly and see how things progress rather than jumping straight to a high value (6 cm is at the higher end of what we see people need). Lots of people notice 3 EPR to 4 PS as being a noticeable difference.
Imo I would use 6 cm EPAP (previously were using 7 cm) and 4 cm PS. Then depending on how things go can try 4.5 or 5 cm PS if you feel more is still needed.
Interesting. Okay makes sense because I had my ramp feature starting at 9 on the CPAP and was able to relax and fall asleep breathing out against 6
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