Chin Tucking as cause of apnea

[ejbpesca]

I finally got the files to OSCAR Mac via the iOS version of the ViHealth App.

No file search of any type will find the O2Ring binary files on my Mac if they were downloaded by using the O2 Insight Pro app. 

The ViHealth app for iOS has three file-type options for downloading to a Macintosh and one is Binary.  Using AirDrop (a Bluetooth function) will send the file to the Mac where it is easily found by OSCAR > Data > Finder then one click will insert it into an OSCAR report.

So, those with an iPhone or iPad can easily get a Wellue, Viatom, or Lookee O2Ring binary data to the OSCAR Mac version.

Whew...I'm worn out after trying those long lines of code found in ApneaBoard Wiki and from O2Ring support that led to "Directory or file does not exist."

I think I am beginning to understand the need for higher Min. pressure due to positional and UARS apnea. I may be on my way to much better therapy thanks to your suggestions.  I see an improvement in SPo2 and other data by using a higher Min. pressure setting.  I never would have known to try it without your help.






  

[JamesD0079]

I never sleep without a cervical collar after  reading advice on the board. Has made a massive difference for me as I mainly have UARS and chin tucking was further preventing airflow. In combo with cpap and a few other tweaks I sleep reasonably well now all things considered

[UnicornRider]

My heart is gladdened to hear the good news. Now we can move on to your therapy sessions. It will be interesting to see how the information from the Pulse/Oximeter moderates the approach to therapy vs. AHI vs. watching for undetected events UARS. I know my whole attitude towards AHI changed substantially. I started paying attention to external influences to my sleep quality, cervical collar, pillow, bed time teas, late dinners, they all affect the quality of sleep.

Give us some update after you review a couple of nights worth of OSCAR Reports.

[ejbpesca]

UnicornRider wrote:

Give us some update after you review a couple of nights worth of OSCAR Reports.

Two consecutive nights of OSCAR reports have produced these results:  

No collar, no tape
Times in CPAP therapy ≈ 4 and 8 hours

O2:  Avg. 96% and 97% both with a range of 92-98%
OAs:  3 and 1 events  WOW! Only 1 event on night two, a 7:51 hour session!
CAs:  2 and 4 events
Hs: 1 and 3 events
LL 6 and 11 events
Flow Limitations: @95% = .15 and .12  (I do not know if those figures are good or not.)


Pressure Min. set to 13.60.  Pressure runs 13.60 to 15.00 when no events occur.  EPAP 10.00 to 11.00

Waking with a surprisingly high level of alertness as opposed to the usual feeling as if I'm trying to recover from a coma.
  
Having trouble keeping my full face F20 mask from leaking.  I move in sleep causing the mask to large leak.  I wake, reposition the mask and my body, and repeat this up to four times a night.
I know a tight mask can be a leaky mask, but I have to keep it tight to prevent leaks which is irritating.  If I loosen it, the pressure breaks the seal.

Questions: 
Is the goal of the flow limitations graph to be flat? (no peaks)  
Should I bump up the Min. pressure more? 
Can high min. pressure exacerbate acid reflux? (I am struggling with severe acid reflux that also can disturb sleep.)

The O2Ring files are fraught with errors.  I am in contact with support@LookeeTech.com  They are responsive, appreciative, and just maybe working to fix the bugs in the O2 Ring data transfers, files, and report apps.  It appears Lookee may be the US based support for Wellue, Viatom, O2 Insight Pro, and ViaHealth.

Thank you for your attention to my CPAP therapy.  Maybe I can get by without a BPAP.

[UnicornRider]

Great to hear the good news. Sad to hear about the GERD. I do not know of any reference I could quote to you as for *PAP curing acid reflux.. But from personal experience I can say it might be coincidence but Tongue exercises and a Sonmol Breathing Exercise Device, I think I was better able to control my upper airway so did not swallow as much air. That provided relief from several symptoms. Hot Flash & a New Years resolution I am going to learn to play the Didgeridoo, it is supposed to help, even if it doesn't you still look cool!

    If you have persistent acid reflux, lean on your Doctor. After the pharmaceuticals do not provide relief, the medical team needs to do a thorough review to ensure they left nothing unchecked. They had better have photographic proof they checked everything or I would tell them where they could....

[ejbpesca]

Thank you for your reply.

Last night's OSCAR + SpO2 had a nice AHI score of 1.31, but the majority of the 7.5 hours of sleep was fraught with poor breathing shown in the Flow Rate and Flow Limitations graphs. Large Leaks impaired therapy for an hour.  I agree with the guy from SleepHQ that AHI scores do not reflect how well therapy is going.  

I took an animated look at the Spo2, FL, and FR graphs.  On Mac (maybe PC too) keyboard arrows make this possible.  Up/down arrows adjust what portion of the graph is viewed down to one minute.  Left/right arrows move that minute across the graph like viewing a video in fast forward.  Only a small portion of the breaths movie showed round top waveforms.  O2 drops correlated with upticks in FL and jagged FR waveforms.

This may explain why I woke today unalert, with a headache, and lack of energy.  I wonder if I should adjust the min. pressure a bit higher in the hope of getting FL down, and some nice round waveforms on FR.

O2Ring file start time lined up with OSCAR just right today!  First time for that. 

GERD has plagued me a half a century.  I have been scoped and passed on a more thorough scoping.  I must change some bad habits if I am to get relief.

Circular breathing through a digeridoo is interesting.  I am surprised at what appears to be a real deal digeridoo costs so little on Amazon. Free labor from termites may be a factor.  Years back at a dive in Pensacola, FL I saw a blues/rock band featuring a singer who also played an 8 ft. digeridoo instead of the ubiquitous harmonica.  This exotic shift from the norm probably had a large wow factor for audience members with medical THC prescriptions.  I blow on a recorder once in a while.  My main instrument is guitar, going back to '60s garage band days.

Thank you for the advice.  

[UnicornRider]

"I took an animated look at the Spo2, FL, and FR graphs.  On Mac (maybe PC too) keyboard arrows make this possible.  Up/down arrows adjust what portion of the graph is viewed down to one minute.  Left/right arrows move that minute across the graph like viewing a video in fast forward.  Only a small portion of the breaths movie showed round top waveforms.  O2 drops correlated with upticks in FL and jagged FR waveforms."

 Now that you have information from the Pulse/Oximeter/Motion Ring entered into OSCAR and you have demonstrated the ability to zoom in to a granular level and animate the display so you can view the Flow Rate in comparison to recorded OSCAR Events, did you Pin the FLow Rate so the other graphs could scroll up underneath the Flow Rate for comparison in the raw form before Zooming in for the granular view? Many times your O2 Ring motion graph will show a correlation to events that will identify when you should have had that cervical collar on, or used a lower pillow, or just indicate a yawn and roll over.

  I had another 0.00 AHI today, OSCAR showed a few O2 drops and a whole bunch of Pulse Change events. The O2 Insight Report looked really good too, O2 Score 10.0, 73% of the time >= 95% SpO2, the remainder >= 92% SpO2, no drops, no alarms.

    Yet when I go granular on OSCAR graphs, I can see just about every breath disruption is associated with a Pulse Change Event recorded in OSCAR it makes me wonder how much my "Fight or Flight" system is being activated. If I had an EEG would it record the disturbances as an indication of arousals'?  

      When I neglect a sleep aid such as SCC, CPAP pillow, BedTime tea, it becomes visible on the charts. So I now have an additional tool to evaluate my own contribution to my sleep performance, as well as the performance of my selection of a *PAP machine and it's Timing & Tuning.

I do not know if I have suggested CPAPfriend or Dr. Steven Parks YT videos. Here are a couple I recommend about the value of AHI scores for some of us who have concerns beyond the AHI score <5.  

     CPAPfriend:  https://www.youtube.com/watch?v=xl8iU-b0BRw

    Doctor Steven Parks:  https://www.youtube.com/watch?v=OYlkFZhnhfs

As for the Didgeridoo, I know the Sonmol Breathing Exercise Device increased my breathing score as recorded on their gauge that came with the device, and I did notice my AHI scores started to come down as I practiced with the Sonmol. So I had heard of the Didgeridoo and researched it too. There are several YT videos out there.

     https://www.youtube.com/watch?v=ZJ82RrXUkQc

I doubt that it would replace the BiPAP that I utilize, but it may help improve my Quality of restorative sleep that I do get.

 If I have not already suggested CPAPfriend videos for OSCAR Report use, view them also. actually he only has a few videos out, they are all informative.

  Dr. Steven Parks has a lot of good videos and books but he is a salesman so he does push a lot of his stuff.

   I am really glad to hear about the animated Flow Rate Zoom use you have discovered. It is a very useful tool.

   CPAPfriend does a good job explaining several other features of OSCAR the would take me forever to explain here, do seek those out.

[ejbpesca]

Congratulations on a 0.00 sleep report.  I have had only one 0.00 from a 4-hour report over 15 years of CPAP therapy.  My OSCAR reports usually show my therapy is not effective. At least I am feeling some better now with the Min. pressure raised. All these years I had the impression a high Min. was not needed due to the machine reacting to apneas as needed.  It appears that UARS is not detected by the CPAP machine sensors. 

Thank you for the video links.  They were very informative and well understood. (10/4)

UnicornRider wrote:

did you Pin the FLow Rate so the other graphs could scroll up underneath the Flow Rate for comparison in the raw form before Zooming in for the granular view?

My response: 

I have not pinned any graphs.  I moved Spo2 up as seen on this OSCAR report.  It remains in position without pinning for future imports of O2Ring data. Is the function of pinning to keep a graph in a position on the OSCAR report?  I will have to review what the pinning function does.


The OSCAR report below may be an example of an apnea cluster event caused by chin tucking due to a back sleeping position which I did move to last night.  I cannot find a way to prevent this.  I do it while asleep to relieve pain from lying on my side for a period of time.  Some nights the pain wakes me so I consciously move to my other side and/or back.  I will give the collar another go to try to prevent chin tucking.

Taping kept my jaw closed last night but it does not prevent mouth breathing.  My lips find a way to open even with strong tape.  This explains the dry mouth with taping.  If I press the tape to my lips it will seal them shut to prevent mouth breathing.  A few days of this causes lips to be irritated, chapped and inflamed due to tape removal.  I keep trying but taping and collaring are not working out well for me.

It should be noted along with my age, weight, meds etc., that I get no aerobic exercise nor any other deep breathing activity.  I do not exercise due to permanent injuries.

Sorry, I left the calendar open on this report. What do the days in red signify?

   

[UnicornRider]

To Pin:  On your Flow Rate graph double click the title "Flow Rate" That should throw a CGI push pin into the graph and "Pin" that graph at the top of the display, You can then scroll the rest of the graphs up they will disappear behind the "Pinned" graph.You can then "Pin" another graph it will stay below the first graph pinned.  So you can compare graphs in raw form or zoom in to an event or area of interest and scroll the graphs up to see related information. So instead of rearranging the graphs you can just pin them temporarily.

  To "UnPin" just double click the graph title again.

Calendar Colors:  Black = no data populating the date.
                          Blue  = Data populating the date.
                          Blue Bolded = At the bottom of your "Notes" tab in the left hand side bar, you have entered "Weight" in the assigned box or "Feelings" in the sliding scale  0 to 10 (poor to Awesome) Your Weight will be entered to a graph on the "Overview" Page, Weight will also be utilized to calculate BMI with the height you entered in your OSCAR profile, BMI will be graphed on the "Overview" page also. The last three graphs on my Overview page are Weight, BMI and Feelings. 
                           Red = Data Imported ( your Ring O2 Data) ( on your "Overview Page" the colors of the bars will change in the "Usage" and "Sessions Times" bar graphs.)


   Your OSCAR Report does look like a positional apnea, probably chin tuck. Do you have alarms set on your Ring O2? Would they wake you up.

  On your "O2 Insight Pro" report how much time does it show for " <90% Time"?  There is a time factor for O2 drops the your medical staff would need to qualify you for supplemental O2. 

For now we need to focus on getting the best therapy and comfort for you. At the same time building documentation for possibly a different machine. You sound as if you are ready to try increasing your pressure. Start slow 0.2 (cmH2O) then give it several days to check for improvement, watching out for increased CA events. You will need to revisit the Mask fit wiki again,   Mask Primer    Be Sure to review "How to achieve the perfect mask fit - GUARANTEED! by Jeffy1958" but the rest of the article contains valuable information also.

   I realize it can be challenging to exercise but perhaps you can find a set of tongue weights and you can do tongue exercises.

            https://sleeptreatmentoh.com/tongue-exer...eep-apnea/

  Post a copy of your o2 Insight Pro report for this date, be sure to use the Notes and Bookmark tab to document this event,

[ejbpesca]

Thank you, I understand pinning now.  

Your OSCAR Report does look like a positional apnea, probably chin tuck. Do you have alarms set on your Ring O2? Would they wake you up.

I have the O2ring set to produce max vibration at 88% O2.  If it has vibrated, it does not wake me.

  On your "O2 Insight Pro" report how much time does it show for " <90% Time"?  There is a time factor for O2 drops the your medical staff would need to qualify you for supplemental O2. 

<90% Time = 0s on O2 Insight Pro report.

Post a copy of your o2 Insight Pro report for this date, be sure to use the Notes and Bookmark tab to document this event,

What information should I be entering into Notes and Bookmark on OSCAR for documentation?

Last night was a restless sleep with vivid crazy dreams.  Recalling dreams lets me know I will have a bad day.  Again, I suspect rolling to back and chin tucking occurred.  Apneas correlated with snoring, leak rate, and the highest flow limit peaks.    My total time in apnea has been way up the past two restless nights so after improving I am falling back.  I discontinued tape, I will apply it tonight.  At least tape can keep my jaw up.  I can see how chin down and jaw down could restrict airflow.

Thank you for your time and consideration.


  O2 Insight Pro 1 12 24.pdf (Size: 206.1 KB / Downloads: 2)