Felt an update should be forthcoming. It’s been awhile now.
‘Cervical Collar’ in the thread name has become a misnomer as, even though it helped, it is no longer used as it is annoying, hot and puts a kink in a bad vertebrae. Acute Sinus drainage and skeletal age-related problems mandate back sleeping, so back-sleeping is mandatory.
Still waiting on an appointment next week but thought maybe I would gain some insight with current data to take with me. On my VPAP I have changed the IPAP from 25 to 24, leaving the EPAP-13 and PS-4
I did find out from the cardiologist that LVEF (Ejection Fractions; eg: 40%-45%) is a calculated figure by the technician administering the echocardiogram. An EF is not a specific number such as 44.8% as it is a variable from beat to beat. One beat might be of a higher volume than the next, thus the final calculation falls somewhere between 40-45% in this example. If you already knew that, you are smarter than I was. But, that tidbit just reinforces the [09/01/15] SERVE-HF study (currently accepted LVrEF -'r' meaning ‘reduced’ or <45% for allowed use of ASV) exclusion on low LVEF.
Back to the point; Pondering what AJACK stated about ‘disregarding apnea events going into or out of sleep’, I re-read RobySue's Beginner's Guide to SleepyHead, particularly Wake breathing and "False" events and Sleep transition breathing and "False" events in detail.
Following that interpretation;
[IMAGE of GRAPHS]The December 5, chart had conveniently been laced with pauses due to repeated mask leaks from strap adjustments, which were finally corrected by 00:40 hours. This December 5, chart as a whole has an AHI-15.14. Having introduced the breaks in the graph it allowed me to shut down the events that I KNEW to be transitional sleep and comprised of what was termed SWJ (sleep-wake-junk). Actually, I see two more SWJ clusters in this chart that I can't click-out where there is an obvious 'going back to sleep' apnea activity. I have started shutting down the VPAP at around 04:00-ish when I would notoriously wake for a ‘p’ break, knowing the next 2-3 hours would be just laying in bed in a state of SWJ, thus avoiding false elevated AHI numbers. That same December 5, chart with the SWJ removed was AHI-9.46. Not too shabby for me and I am confident the lower stats are more accurate.
There is also a chart for December 6, where I just ‘zonked out’ last night. There is a slew of KNOWN SWJ on the going-to-sleep stage up front, but it can’t be clicked-off ‘cause I did not have a break in therapy in this instance. AHI-13.96. A quick perusal of this chart with the lead-in apnea mentally blanked out is very encouraging to me. There was NOT a single (nocturia) 'p'-break in the 7:15 period... THAT is alone a major accomplishment!
I will update with what come from the appointment next week in regards to any change in machine, like perhaps an ST-A?
Thanks in advance Z
