Bipap Titration advice needed.

[amafra]

Great, I'm going to set Vauto to Epap 8, PS 3, Max IPAP 11.
I was thinking there is something wrong with 10/6 recommended on titration, I tried to prove that using the asv graph, that did not prevent apnea at lower pressures.
The polysomnography guy said he got rid of all apneas at that pressure, not sure if I even got to rem, I will see when results come in.

Thanks for the explanation on how pressure is calculated, I need extra time to breathe many times. I don't breathe fully through my nose. When I push the upper sides of my nose upwards to the outer sides, the airways open and a lot of more air gets in. I asked my doctor about it and she said it happens to everybody. If I have rhinitis, which I do often, I need extra time to breathe because the airway is narrowed and air restricted.
The doctor used a camera to check airways to the throat, she said passage is a bit narrower than usual, with small septum deviance, but nothing that could explain my apnea. She asked for a facial tomography that I will attend.
Thanks for your patience and help.

[amafra]

Quick question, is the leak lowering the pressure and allowing apnea to happen?
I did not sleep more than 4 hours last night, possibly less so I tried an hour sleep now, I got 21 minutes.

[Sleeprider]

This session is all of 21 minutes long. Were you asleep? Leaks in the first graph did not affect therapy. There are three OA events just as ramp ends, each pause in breathing is followed by high-volume recovery breathing. I'm going to speculate that only 8-minutes into a session, and with your sleep latency, this has nothing to do with sleep disordered breathing and is you adjusting and messing around.

[amafra]

Just to check if is fine. It as 11/8 as you suggested.
Thank you

[amafra]

Buddies, 
Last night by mistake, not intentional at all (no stubbornness), I forgot machine on S mode that I had set to 10/6 (planned to test in future), instead of 11/8 that I planned. Just figured out. 
The results are probably not very useful because it is short and does not record flow limitation. I will post anyways just in case.

Yesterday I had very few sleep hours because of the sleep test, around 4. Took coffee and Vyvanse at 4am ( I don't recall even taking it due to sleep deprivation), I just know I did due to feeling the medicine effect, I went straight to the gym, had a very intense leg workout trying to get as tired as possible for last night. I burned all glycogen stores enough to get into ketosis (1.1 mmol/L) in the same day.  Nutritional ketosis not ketoacidosis for those who are familiar.  I took zolpidem and clonazepam to sleep and still cannot pass two hour with cpap. Just to make it clear, I don't like to need medicine and I don't believe medicine is helpful with very few exceptions. Most things have better alternatives than medicine. The only medicine I usually take is vyvanse for ADHD. Not everyday, just days I managed to wake up at 5-7AM. I'm not retired and It is messing up a lot with my life as you probably released already. How to keep mask on longer?


Most of the time I sleep after taking the mask off,  I woke up at 6am. I'm managing to wake up early then preview days because I just don't try to put a mask on many times, or I'm so tired that I don't even know I had no mask. 

Is deem 2 monitor sleep helpful? I see data can be exported to OSCAR. I can manage to get my hands on it.
Appreciate all the support and help.



Last night screenshot and SD Card.

[Sleeprider]

Things look great from 1:50 until the end of session. Why did you arouse and stop therapy?

[amafra]

Things look great from 1:50 until the end of session. Why did you arouse and stop therapy?

I don't really know this time. I don't recall, maybe because of these medications. 
I'm making your help harder because I can't have one full night with the mask. I've been trying for more than months, before I joined the apnea board. First I was on a cpap that I borrowed and my F20, then on the current one with Mirage Quattro. I know I breathe from the mouth as well, especially with a congested nose. If not , I would buy a nasal mask.
When I wake up, the first thing I do is look at the display. I figured out I used the wrong mode and settings. I set S to 10/6 Vauto to 11/8, probably drowsy I left on the incorrect mode. S is limited. 
In the past I recall waking up on high pressure or face pain caused by a tight mask. 

I May need an IR camera.

TKS


Screen report.

[SarcasticDave94]

Had the possibility that this is lung disease or pulmonary malfunction of any sort instead of Apnea based problems? Have you gotten a pulmonary function test and/or arterial blood gas test? Are the breathing issues and fatigue present in the daytime? Just my take but it seems PAP therapy makes you worse rather than better.

What makes me ask? Your comment on blue skin coloring some time in your past.

[amafra]

Had the possibility that this is lung disease or pulmonary malfunction of any sort instead of Apnea based problems? Have you gotten a pulmonary function test and/or arterial blood gas test? Are the breathing issues and fatigue present in the daytime? Just my take but it seems PAP therapy makes you worse rather than better.

What makes me ask? Your comment on blue skin coloring some time in your past.

Hi Dave, 

I never went to a test like you said. My father told me sometimes that he believed may have some problem, but not too impactful. He says he would see me with bluish skin tone when kid swimming or other high aerobic exercise. I am tired every day, every minute. I always had problems waking up in the morning, after teenage years and graduation, I was always tired, always needed coffee. I do have strong ADHD, tiredness, poor sleep, foggy mind all are associated with ADHD, the problem is apnea and poor sleep symptoms overlap, I know very loud snore happen since 22, when I when to US for first time and kids sleeping on the close room thought a monster liked in the house. My ex-girlfriend and wife usually sleep first and like dead rock, so did not complain too much. In 2019 I went on a 20 days trip to the US with my father, he slept in the same room and from there he kept asking me to do a sleep test and he said my sleep was terrible and scary. I kept disregarding it until my last two girlfriends couldn't sleep at all on my side. Feeling tired all the time and wanting to be able to go to hotels without being awake the whole night in an effort to not wake her up, I decided to attend a sleep study. After that, everything started getting worse, now I wake up fully with mask leaks, face pain on a tight mask plus the apneas while on mask. I can;t concentrate even with 70mg of vyvanse. If someone here already has experience, will know it is a bit of a punch in energy. I may have a little issue. My grandmother is 94, she has a 30% ejection fraction and heart failure. She oxygenates 97%, I usually have 92, 94. I got 97% just after box breathing exercise.
If I could sleep at least one night with the cpap, it would be great. 
I think two weeks ago I had 50 minutes of great sleep in the morning with cpap that I don't recall when I had something like that. I did not give up yet because I hope I can achieve  that great feeling again. 
After cpap, it seems that I can breathe open, before it was like when I have aspa allergy and I need the pump.
You have no idea how important all the support members here are providing. Doctors most of the time simply forget to really try to take care of the patient. Insurance forces them to prevent exams as hard as they can. I figured out I had Hashimoto Thyroiditis by myself for example, and I was on my lab exams for at least since 1999. I went to the doctor and they say T3, Reverse T3 are not exams that need to be done. Just to give you an idea of the health system. Around minimum salary monthly insurance. I went very overboard here. Sorry.
I never did a pulmonary test.

[Sleeprider]

Using VPAP-S mode rather than Vauto is not very important. The only difference is getting flow limit data, and that's not a deal breaker.

"When I wake up, the first thing I do is look at the display." This is a problem. You need to hide your machine in a drawer or tape a cover on the display, anything to keep you from being distracted from your job of sleeping at night. I wake up at night, and lay quietly and try to keep my mind from running, and when that works, I fall back to sleep. You pop up, remove the mask, look at the screen and you're done. Sleep hygiene may be the most important task you have. It is far more important than settings, data or any other distraction to your sleep. You need to think of strategies to remove or hide distractions and just focus on sleeping at night and waking up in the morning. Don't even look at your data in the morning, you can check it later. It is the least important thing you will do all day and certainly at night. You are turning your sleep into a compulsive, anxiety problem, and you need to be in a different mind-set about sleep.