Help with Ed's Therapy

[SeePak]

Hi Ed.

If you had decent numbers, i would expect you feel something better by now?
But you say largely unchanged symptoms, right?

So what is your next step?

I see tendency towards CA events and still some OA.

With one adjustment, i think these could both be dealt with.

I know where i would be going here.....

and i think your oxygen desats will get better too.

[Expat31]

Hi,

I would suggest that you increase to 11/13, then 12/14, to see if any sign of improvement.

In my opinion, I think the focus really should be in looking into the significant ODI. This link gives a pretty detailed explanation, especially the section  "Other Causes". In this section, three main issues are described, followed by this particulular paragraph:-

 "Other conditions can cause problems with breathing and/or oxygenation during sleep and affect your ODI." , and [i]Several of these conditions contribute to each other, and OSA often coexists with other medical issues that affect breathing, such as COPD. With diminished lung capacity and/or heart function, the collapse of the upper airway may cause your blood's oxygen levels to drop more quickly and to a larger degree than they would if you had only OSA."[/i]

Dealing with your doctor seems to be difficult. It may be useful to ask probing questions (using what you have found from  your own research) on why  this, or that, cannot be considered. After all. you are only being proactive in your own health. 

Bye the way, one DIY thing you could do, is to check your lung capacity, using a really simple peak flow meter, which is just a plastic tube, with a sliding mechanism, not actually a precision instrument, but good enough for a start. My doctor gave me one of these, inexpensive, if I remember correctly only, about €20.

[Grateful Ed]

Having not experienced any symptom improvement over multiple nights with a 10-12 pressure range, I have moved to a constant pressure of 10.4. This is what my sleep specialist has recently recommended. I'm game to try it, and frankly, if I don't try her recommendations then there is little hope for any future dialog.

The data from my first night are attached. The numbers look good, although my leak rate was uncharacteristically high. Interestingly, my SpO2 desaturations were much lower (3.4/hr) than I typically see. This is only one night, so I'm not jumping to conclusions. I didn't think my sleep quality was any better, but I did experience some vivid dreaming, which is rare for me. I'm not sure if this means I spent more time in REM sleep, or again, it was just a one off. 

Expat31, you raised the issue of underlying conditions possibly contributing to my generally high ODIs. I have had lung function tests recently (all normal) as well as cardiac evaluations (also normal). I exercise regularly and have good exercise tolerance. So I think the data suggests there are no underlying pulmonary or cardiac issues.

I'll keep up with the constant 10.4 pressure setting and report back.

Ed.