New User - Optimization Help Please!

[Sam R Squared]

This is from last week
   

[Sam R Squared]

Bumping my previous posts, as well as to ask if anyone has solutions to scalp acne due to CPAP headgear?

Thanks everyone for all of your help!

[Sam R Squared]

       

Data from last night after increasing to 8.4 cmH2O.

Looking better, but hoping to hear some feedback on what else I can do to lower the AHI! 

Thanks in advance!

[Sam R Squared]

Hi SleepRider,

I was hoping I could get some input from you. I've been consistently getting 6.5-7.5 hours of sleep the past few nights, take modafinil in the morning, and despite this, I keep falling asleep during lectures.

I've been able to get my AHI down to <5, with the past few nights being around 3 w/ a few CAs and a low FL 95% > .10

I don't feel refreshed in the morning, but I force myself out of bed and sit on my desk w/ a S.A.D. lamp while I go through my morning routine, which includes exercising at least 30 minutes.

My resting heart rate is ~45-55 bpm currently. I'm not sure if this has something to do with my fatigue.



Do you see anything I can change with my current CPAP setup?

Thanks so much!

[Gideon]

first, a profile change to indicate EERS-18 to remind all of us as this never shows up on OSCAR.

Do you have a recording Oximeter? I would like to see overnight results, especially since your diagnostic study showed Severe DeSats (45 min <=88%) I'm not expecting issues as your titration study showed adequate O2 Levels but it never hurts to periodically check. Low oxygen could cause tiredness.

Could you post a few 2-minute segments of your more normal breathing, just to look and see if your breath-form is normal outside of events?

[Sam R Squared]

Thanks for letting me know, I've added EERS-18 onto my profile.


I do not have an oximeter that I can upload data and sync to OSCAR at this time, but I have just purchased a Wellue O2 Ring.

It doesn't seem like my O2 Saturation is going down much, but this was 10/05-10/06, where there is two drops near 92%: 

   

Last night:    

    - 2 minute normal breathing

I woke up around 4am to a nightmare (I was getting mugged off my bike and was yelling help to a bystander, and I remember yelling help out loud as I woke up), then went back to bed and woke up again at 5:30am, putting my mask back on around then. 

Here is the report from my current oximeter:

[Sam R Squared]

10/05-10/06: 
2 Drops -     

10/06-10/07:
Seems relatively normal? -     

Sorry that I can't sync this to OSCAR at this time. I should receive the O2Ring today.

[Sleeprider]

Sorry for the delay getting back to this thread. The EERS seems to have reduced the CA event rate, however you still have flow limitation and indicate you are affected by aerophagia. In a perfect world, I would suggest the Aircurve 10 Vatuo which applies the bilevel pressure more effectively and lets us set the sensitivity for trigger and cycle. These characteristics further improve the problems you are working on with CA and aerophagia to further optimize therapy. It would be a good idea to keep an eye out for a reasonably priced used machine.

With your current machine, your event rate is just over 3/hour, and the variable pressure looks a bit better than fixed pressure because it seems to be resolving the OA, but increasing CA slightly. Your oximeter chart does not suggest a problem with oxygen saturation. I think you are doing very good with the 8.2-9.8 pressure range other than the CA events. The EPR 3 is keeping flow limitation in check, so a pressure range of 8-10 seems pretty reasonable if the aerophagia is not kicking in. Hard to say if a couple more inches of EPR would help at these higher pressure, but I know with the Vauto using similar settings, your event rate would be about halved just by setting trigger sensitivity to high.

We don't have many personal experiences with EERS documented on the forum. It would be interesting to hear more details of your fabrication and experience in using it.

[asliwx]

Please note that stimulants/wakeful agents like Modafinil have an active duration 15+ hours plus and add in the half life.
My experience while taking it was that my brain was still awake as the medicine is still active and did not let me actually sleep or go through the necessary stages of sleep to be restorative.   I ended up in a viscous circle of needed Mondafinil to be alert during the day but never "slept".... I used sleepimage device for months to give me daily sleep quality reports... I thought I slept but didn't at all... I finally realized that the reports looked the same as when I was awake..    This goes for caffeine/amphetamines ... 

Hope this was helpful