Doubts about my diagnosis? (Test results + First night with CPAP)

[IAXEM]

I'm intrigued by the fact that your doctor's office didn't like that you went rouge and bought the CPAP before they could sell you one. They're probably very worried about the lost revenue.

Yeah thats kind of the impression I got, and somewhat soured my otherwise good experience with Lofta. They even said they could sell it at a discount, which was tempting. I didn't want to go through the hassle of returning the one that was already on the way for only a few dozen dollars in savings, though. 

Granted, most people probably aren't as informed by resources such as this forum. The person on the phone argued the C2C version was a bad deal because, among other things, there was no way for the therapy to be adjusted except by mailing it back to the supplier, plus the inconvenience of relying on an SD card to share data with a physician. The average person won't know that the clinical settings are easily accessible, and thus would be in for an inferior experience. I dunno. 

It appears that you are making progress.

As to Sleeprider's suggestion...Sleeprider has more Sleep Apnea knowledge in his little fingers than I have in my whole body.  

Gotcha 

I thought I'd comment on what I see in this graph where we were looking at the flow spikes.  At the very beginning of this snip, there are high flow limitations which results in reduced respiratory flow and rapidly rising pressure. This culminates in about 3-breaths of recovery breathing and triggers a periodic respiratory spike at 40-second intervals. The really large arousal at 1:08:40 fully satisfies respiratory needs and causes a pause in breathing at 1:09:10 that resolves.  The Hypopnea flag simply notes the 30-50% flow reduction for that period, but is probably a false flag without desaturation.  I can't explain the periodic spikes, but it looks like movement from the bleachers here.

This really brings me back to the previous recommendation I made to increase minimum pressure and EPR to avoid those flow limits that arise near your current minimum pressure.

Thanks for the insight - I find all of this very fascinating. 

Looking back at the footage, I can confirm those spikes coincide with movement. As for why they're at 40-second intervals... I don't know. Coincidence, maybe? It stops after I wake slightly and adjust my mask. 

I've gone ahead and set the minimum pressure to 7 (with a maximum of 12 still, as per Old Steve's recommendation earlier) ahead of tonight's sleep. I'm off the next two days, so I can sleep in and hopefully get good data. 

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In the meantime, here's last night's data. I took my mask off at one point in the middle of my sleep  My girlfriend came to the rescue once more when she went to bed and woke me up once she noticed. According to her, I said I thought I was getting up for work soon (even though I had at least 3 hours of sleep left) when asked why I took it off. I had no recollection of any of this until I watched the footage, and now I vaguely remember the details. A real bummer, but hopefully won't happen again. 
I otherwise recall waking up a couple of times to some slight leaking. Maybe I didn't tighten the headgear very well this time around.    

   

[IAXEM]

Morning everyone. 

Tonight was a little rough. And I have an appointment with my psychiatrist in about an hour, so I couldn't sleep as longas I'd liked (but I also went to bed pretty late so that's on me. Sleep hygiene is something I really want to work on as I go through this).

I'm starting to feel like maybe the Dreamware cushion is slightly uncomfortable. Its beginning to irritate the bottom of my nose a little and I encountered more leaking at some points while I laid on my side. I tightened the headgear, but that only made it a bit more of a pain to wear. I'll keep adjusting, maybe even switch sizes, until I find something that either works or I decide I need to swap to another one. I did order the nasal pillows next (just the cushion piece) which should be arriving sometime next week to give that a try. 

I did find (by matching footage at the time) that the OA's I experienced coincide with movement, so I'm not sure if those would be false alarms. At times I'd move a few seconds into the apnea, however.
As I stated, some of the leaks are me readjusting the mask, while in some instances the mask was cracked just enough for air to seep out (which I promptly corrected).

Temperature wasn't any different from previous days, but at times I felt like it was a little warm to my liking. I may tweak it for next time. 

   

[IAXEM]

Alright. Yesterday was slightly better, and last night better still. 

I've switched to the small size Dreamware cushion and I think that's largely improved the leaking/comfort situation. Using the sizing guide, my nose is on the upper end of small - And I felt like medium was more comfortable than the other. But now... Small may be the way to go after all? 

Which sucks because just yesterday I got the pillow cushion in medium. Dreadful. It would not stop leaking with the slightest shifting. But maybe I also need a small for it. Tempted to return it and try the small just to rule it out, but I can't say I like the feeling of the pillows sitting just inside my nostrils. 

Here are my results. It seems that, so far, somewhere between 9-10 is my ideal pressure range? What follows next? Do I eventually tighten my pressure range even further if starting out at 7 may still produce events? 

Also, I'm not sure why the cutoff at around 1:30. I don't recall removing my mask, and unfortunately I wasn't recording footage last night. 

   

[SarcasticDave94]

Leaks were well controlled in that session at 4.8 under the 99.5% column.

[IAXEM]

Some progress last night. 

So the past couple of days have been dreadful. I'm currently on duloxetine, and a few days ago I increased my dosage. Similar to when I first started taking it, I felt an ungodly amount of fatigue and drowsiness for a couple of days but today I feel fine.

I think I've got my mask leak situation under control again, and kinda took on the reins a little bit adjusting my pressure based on trends I noticed. It seems pressure under the 95% column is stabilizing at around 9.5 cmH2O, so I increased the minimum to 9 last night with a maximum of 12, further tightening the range. I had turned off ramp 2 nights ago, but turned it on again last night to ease myself into 9. 

Here are the results. (Please let me know if my largely uneducated assessment and shot-in-the-dark adjustment was a correct one) 

   

Only 2 'events'. 

This is only 1 night so far under these new settings, but a promising step? I woke up feeling energized even, though I'm not sure if its necessarily related to my sleep performance or the drug's side effects wearing off. 

Of course, I still have my doubts. For one, looking at footage, the first OA event is just me shifting and adjusting my mask, while the second one is just me getting up to go to the restroom 20 minutes before my alarm went off for work. So neither of these are 'real'.

So that raises the question... What about the other events I've been recording on past nights? 

I can't help but wonder if most of them are false positives, and this all ties back to the topic of this post; I can't shake the doubts off my head. Its too early to say if the CPAP is improving my EDS (especially with duloxetine messing things up), so I can't help but wonder if there was ever anything wrong at all. What if I'm just blasting air down my throat for no reason? 

I suppose I could always test sleeping without the machine sometime down the line and test how I feel then. Its just hard to feel good about all this without being sure this isn't all just in my head.

[IAXEM]

Hey all, been using my machine for about 7 months by now. As much as I still have my doubts (especially after a friend was recently diagnosed with 'severe' sleep apnea..)... I suppose its made an undeniable difference in my life. I'm still often sleepy, though I think mainly due to poor sleeping habits/depression. But not barely-functional as I was previously. 

I've narrowed down my pressures to a range that works better. Still, seeing my OSCAR data, its clear its not quite perfect - and switching to CPAP mode may be more than ideal. Here are some charts from a few different days:
           

So what I've come to notice is that I have fewer flow limitations when pressures aren't constantly shifting... And it typically appears to be most stable at just above 10.0. This is where my breaths also appear to have that nice "round" top. 

Is this an accurate assesment? Would it be best to switch to a single pressure of, say, 10.2? Or what else can be deduced by these graphs to further improve my sleep?