First time therapy, settings and progress

[Schernenk]

Hey thanks for guiding the new member to start his own thread, I will get back to you later tonight.


I am currently pretending to be a HVAC tech. It is hot here in the Columbia Basin.


Amazon sent the wrong condenser motor.        


Hang in there. I'll be back.

Pay it forward, that's what I always say, you have all helped me so much, it's nice to return it, even a tiny bit. 

I too am in the Columbia Basin (as I think you know) and yes, lots of time on the water this weekend, it's spicy!

[Schernenk]

Hey Team;

I have been off the boards lately, for various reasons. I have not been doing PAP therapy for the last month as I felt like I was feeling worse, or at least not getting any REM sleep according to my sleep tracker. That is not to say that I had given up, but I put things on hold while I consulted with CpapFriend and tried to make sense of things. In the end he suggested three options, the most aggressive of which was to seek an appointment with Dr Anil Rama (aggressive because I am in Canada and he is in the U.S.). I decided that because I had the means that I would see Dr Rama.

Lot's of things came out of that appointment;

I have two nasal turbinate's that likely require reduction as my nose air flow is about half what he would like to see.

He slapped a blood sugar monitor on me out of an abundance of caution and it turns out I am flirting with type 2 diabetes (also a cause of fatigue)

He re-did my in home study with the WatchPat One system (as opposed to the belted chest system) which bore out my previous AHI of around 15....but I never had an RDI before, the WatchPat gave me an RDI of 29.

Take away's are, get blood sugar under control and get back on the PAP train, weight loss will help with both of these blood sugar and APNEA so that could be a win/win (weight loss is easier said then done) and look at finding a good ENT to do my nose. I had a thought that the PAP therapy was maybe more affective then I thought but fatigue from the blood sugar problems was holding me back from really feeling better.

Any input/thoughts are always appreciated.

[UnicornRider]

I am glad to hear you are still pursuing a medical approach to relief for your symptoms of fatigue. My brother went from 250+ at 6'3" to ~183#, started out by cutting out sugary drinks, fast food and junk food to a healthier diet with larger portions of vegetables, daily walking (we got a couple of puppies) and more physical activity such as lawn care, landscaping and gardening for us and for several elderly neighbors. He quit snoring, got off the CPAP, was able to quit his statin meds as his cholesterol came down, greatly reduced his blood pressure medications, and he came off the Pre-Diabetic listing the Doctor had put him on. We all benefitted from the dietary changes, I need to work on the exercise more. I did loose weight and reduced the number and amout of my medications.

 So I hope that adds inspiration for you to stick with the health routine, I know you have a lot of outdoor recreational opportunities up there, so start prepping for the X-country ski/snowshoe back country hunting season. That elk will taste a lot better after you pack it out from those deep canyons.

  Keep us posted with the OSCAR reports, take solace in the fact you have many of us pulling for you. We gain from your shared experiences and from your conquest of obstacles you have overcome.

[Schernenk]

Hey Unicorn

Glad to hear from you, I was starting to get a complex  Hope you are doing well.  

I'm fairly fit for my age, I think at least, I mountain bike and ski etc etc but can definitely stand to lose some weight, I would say 10lbs minimum but 20 would be better, as they say you can't out exercise a bad diet LOL.  The story about your brother is very inspirational, thanks for sharing that.  I have a follow up with my family doctor tomorrow, I am fairly certain I am flirting with or am pre diabetic (funny the U.S. uses a different and lower threshold then Canada), so I think I am pre diabetic if I lived in the US but maybe not since I live in Canada 

Having that RDI of 29 was a little vindicating, not that I should care too much about a number, but it explains how I feel and some of the difficulties with my PAP therapy.  Since I took about 1.5 months off of PAP I feel a little like I am starting over, which isn't a bad thing.  My sleep Doc said with a RDI that high I definitely need to be on it, while I work on my weight loss at least.  I just can't seem to get it dialed, I am sleep 6-7 hours with it but still can't seem to get the quality of sleep (no REM usually).  I will post some OSCAR's tomorrow and I have that connection with CPAPFriend as a resource.  I can't help but feel I am on the verge of something but just can't seem to put the final nail in it.

[UnicornRider]

I understand that cross border differences you reference, that is why I have to wait for the elk and deer to cross back over to the Washington side, from the Canadian orchards & vineyards in the Okanagan, before I harvest my venison.  That grain fed, fruit and vineyard sweetened meat is very lean and healthy eating.  

   What type of device are you logging your sleep stages on? Have I referenced you to "The Quantified Scientist"? His YT channel reviews of health monitors are some of the best I have found.

  Post up some OSCAR reports, be sure to include some zoomed in views of the good, the bad & the ugliest Flow Rate wave shapes you have. Perhaps we can help you dial it in.

   

   

[jefferyscott0]

Are you using a chin strap to help keep your mouth closed when using the nasal pillows?  I found a chin strap to be helpful before moving to a full face mask.

[Schernenk]

Hey Team, I've been learning a bit about myself over the last 10 weeks or so, trying to find a pattern.  I have made some progress and at least feel consistently better on PAP therapy though not consistently awesome, i.e. improvement but there still seems to be a missing piece I haven't figured out.  I do believe i do better with a static pressure (no auto mode).  I will post two nights here, last night and the night before, last night being on S mode on my BiPAP and the night before being on VAuto.  Most nights over the last night have been on S mode but I wanted to try an experiment to see if the static pressure (with pressure support) was what made the difference for me and I believe that is a large part of it.  Anyway, while my AHI was 15 during my last sleep test, it was discovered that my RDI was 30 and the balance of my respiratory disturbances can be hard to detect so I think that is what I am trying to resolve now.  My goal is to make my chart less "spikey", I can get very low AHI at lower IPAP numbers...say 10-11, but my chart becomes quite spikey, so I am slowly sneaking my pressure up, pressure over 12 seems to render better results but I do start to bump into some aerophagia.  Anyway, sorry this is a bit of a book but I could use some fresh eyes on this stuff.  Last night I feel was decent and I feel pretty good tonight, trigger was set to very high and cycle to low, peaks are pretty round for the most part.

[Schernenk]

Here is a zoom of a chunk of flow rate from last night.

[Schernenk]

And here is the night before when I tried V Auto again, and also the night before that at a pressure of only 11 you can see the difference.  Obviously one night is the end all be all but I am noticing this trend when I use lower IPAP below 12.

[Jay51]

Good job experimenting and finding this out for yourself.  0.00 95th percentile flow limitations is excellent.  Also, the close up looks pretty good.  The waves in front of the green line look near perfect (nice round tops, smooth, etc.); even though a few after that are not perfect.  

Excellent strategy slowly inching up pressure as well.  Threefold benefits:  easier to adapt to (less CA's and possibly less aerophagia) and of course less spikes and disturbances from a little higher pressure.  Keep posting updates.