DanEm [Therapy Thread]

[DanEm]

Gideon


I don't know if this will prove useful for my understanding but since you mentioned flow rate, I referred to the Respiratory Rate in my charts. (See included screenshot.)

Except for the Mid one, they are pretty hectic.

Do you see a problem there?

[Gideon]

That is why I avoid extremes except in special circumstances. Those look fine from that view. The min readings say that you are dead, obviously that is not thye case, Ignore extremes.

[DanEm]

Going over my data, I realized that my best performance was between 22-Dec-21 and 09-Jan-22.  (See Settings_Jan_30_22.png)

I am wondering if I should revert to those?

Do my last results (Daily_View_Jan_29_22.png) show positional apnea?

Last discussion on that was that the collar I was using did not seem to do the job.
Asked without success for suggestions to replace the collar by a better one.

Not certain what I should do now

[Sleeprider]

Flow limits are high and clustered OA say, get a better collar. There are a number of reviews in the reviews forum.

[DanEm]

If you have similar sleeps for one night or one week or one month with AHI always around the same value my guess is that you have regular consistent sleeps.

In such a case, if you get tested by a doctor (one night sleep at a sleep clinic) the results will show the AHI that the doctor will base is treatment on if you need one.

If, like me, your sleeps are not regular i.e. different AHI for different sessions, days or weeks, then a one-time test does not seem reliable to describe your overall condition. You might need treatment or not.

Is there a (medical) standard which define for how long you should measure your AHI and then use the average value or the calculated overall AHI (total events of all sessions divided by total time for all sessions) to describe your apnea severity?

Or is there a general practice among patients taking such consideration into account?

[Gideon]

Look for a taller collar, your big problem is positional, that and your flow limits are out of control.
Step 1. Resolve the positional aspect of your apnea.

Step 2. After positional apnea is resolved (or mostly so), Re-evaluate, especially looking at your flow Limits 95% Stat, if still high consider a BiLevel such as the VAuto for the higher pressure support to help manage the remaining hypopneas, Flow Limits, and RERAs.

[Gideon]

On AHI, the medical community looks at the events per hour, on a titration study it is for the brief period you were at a set of settings, usually just pressure and no EPR/PS unless it is a BiLevel Titration. Otherwise, it is just your overnight AHI, again in Events per hour.

[DanEm]

Gideon
Step 1. Resolve the positional aspect of your apnea.

I will try the collar again.
I was thinking maybe a rigid collar if I can be comfortable with it. Something to explore.
That for my positional apnea.

Gideon
Step 2. Re-evaluate, especially looking at your flow Limits 95% Stat

What would be the values for flow Limits 95% that would be something like min, average, max or is it poor, ordinary or optimal.
Is there a range to consider or a value above which you are most likely dead or will soon be? 

[Sleeprider]

We shoot for 95% flow limitations less than 0.1 and consider that satisfactory. Flow limits don't seem to be scored consistently among different individuals, and sometimes 0.05 is not tolerated well, but for others it is bliss. So the point by Gideon is correct that when it is good enough you'll know by how you rfeel. I would think at this point, it's not so good. I think with correction of the positional obstruction you may get closer to the goal of less than 0.1 FL, but I would not be surprised if long-term you are better served by a bilevel like the Aircurve 10 Vauto. This wiki article discusses flow limitation and why bilevel PAP therapy is better, but we really need to address the airway obstruction from chin-tucking first http://www.apneaboard.com/wiki/index.php..._and_BiPAP

[DanEm]

Sleeprider
We shoot for 95% flow limitations less than 0.1 and consider that satisfactory.

 
Oh boy, I am way over that. See screenshot of graph I made.

I will definitely retry the cervical collar.

Aside a bilevel machine any other suggestion I could try to improve.