JKan Therapy Analysis

[Expat31]

EPR at 3 should greatly improve flow limitations, but the downside is that as some expiration pressure is being lost, therapy efficiency could be compromised to a certain extent,  and perhaps some centrals reappearing. 

You don't really know until you try. 

The final EPR may be the midpoint value, and the fixed pressure may be up to 10.

Only time will tell.

Finished for the day here.

[JKan]

Hi,

Your suggestion had a great effect on my flow limits. (0.04), as expected, an increase in the CA's. I tried something new tonight; I don't think it had much effect on me, as I didn't take very much. I picked up a CBD tincture (100:1) CBD:THC. In hopes that it would help me sleep better. I only took 10 ml; Reddit suggested that as a start. The normal dose, according to the bottle, was 200 ml. I feel good this morning, no issues whatsoever. Even with all the CA's, I feel like I had a decent sleep.

It looks like we are down to very slight tweaks here and there. Should I stay at a fixed 9.6 EPR 3 for a few days and see what shakes out? Or do you see something worthy of a tweak?

Here is last night's Oscar. It looks like some SWJ just before I got up around 3:45 am.

   

Also, including SleepHQ , maybe being able to move around in their site may give you some new insight

https://sleephq.com/public/96bd4add-1fac...f19ee6f8f6

Thank you, Expat31!

[Expat31]

Well, I would stick with this for a couple more days. 

Perhaps afterwards, try EPR 2 as I indicated in my last post

I don't know much about CBD, except a doctor told me  "OK'ish" if obtained from a proper certified farm, without pesticide use. Never wanted to try it. I am not sure if it can encourage centrals....

[JKan]

Hi,

I just woke up from a rough night. I will make two back-to-back posts so I can get all four Oscar charts up.

The last two nights, I've used the CPAP setting for the fixed rate of 10 and had EPR on 2.

I've been having some shoulder pain the last couple nights. I sleep on my left side. Two nights ago, I woke up around 1:45 am and was tired. I wanted to continue to sleep.

I thought, Do you just get out of bed from the sore shoulder or do you flip over to your right side? I flipped to my right side at 2:00 am

Typically, when I flip to my other side, I get a cluster or two. Sure enough, I got the cluster along with some CSR.

The fixed 10 and EPR 2 were fine; no issues.

I took a nap at 7:30 am and had 1 RERA event during that session. I had gone back to the auto ramp the last couple days to ease into the 10, felt normal, and had no problems.

Here is the Oscar for July 14th, the first night of CPAP mode 

   

I will make another post with last night's Oscar's. There are three charts: the first half of the session until I couldn't take the shoulder pain any longer, the second half by itself, and the complete night on the 3rd.

Sorry, I feel like I'm regressing some how. I'm not sure how to deal with this shoulder, I know I can't sleep on my back as that couple day test last month was a disaster.

[JKan]

Last night, the first session felt pretty good.  I woke up just shy of 2 am with the shoulder pain and thought I would like to sleep later. I had actually flipped a couple times from the pain and was expecting to see a cluster or two. I was surprised to not find any on Oscar.

The first part of the night before I got out of bed at 1:52 am
   

I checked Oscar, felt pretty good about the night and thought I would get a couple more hours of sleep. My nose was pretty sore from the P10, and I thought I needed to go to another mask and put on the Vitera. I guess I was a little cocky since I got away with turning side to side a few times earlier with the normal cluster's I get. Every time my shoulder hurt, I would turn to the other side. Here is the result of that session.
   

Here is the whole night in the final Oscar, with both sessions checked.
   

I'm not sure where to go from here, I do feel like I am regressing

Thanks for the help, as always!

[JKan]

Hi,

I was a bit down yesterday. I thought I'd go back to a number I've had success with before.

I was happy to find this Oscar this morning after a solid 7 hours of sleep. Only 5 CA's and better yet, the flow limits at 0.05

I think I will stay here for a few days and see what happens. I didn't turn last night and was able to stay in the starting position all night. Sometimes, that is tough. I do wish I could go from the left side to the right at will. Funny how I am finding behaviors that have a positive effect on my numbers.

   

[Expat31]

Hello, 

Looking at your two night's data, the issue is the clusters of events. This is being demonstrated when you put the two segments of the 15th together. Look at the comparison between the two! 

The first segment  of the 15th was apparently clear of any clustering of events in the flow graph, inspite of you flipping on your back several times. Why not flagged by OSCAR?... 

Most likely you were not long enough in the supine position for entry into a deep sleep phase where semi paralysis kicks in, muscle tone is lost, then the airways can get blocked. 

I won't go into the physical machanics again, as I am sure you understand the process already. 

Sorry about your shoulder issues that are disrupting your sleep, and your mask issues. 
The former I cannot comment on as not having any experienced of this. Bit beyond the scope of apnea therapy. 

Regarding the soreness from the p10, maybe try a dab of lip salve just before fitting. 

Otherwise your settings look pretty optimal, as evidenced in the first segment of the 16th. It seems the trouble started in the second, with considerable clustering. The root cause seems linked to pain issues,

So concentrate on pain relief with a doctor. 

Suggest leaving settings alone, except for eventually stopping ranp, where you get little protection against appnea events occurring.

[JKan]

Hi,

I've been plugging along, seeing more central's as of late, and my usual clusters here and there.

7.17.24
   

7.18.24
   

7.19.24 - I tried to tighten up the window this night, I went from the prior 10/12 EPR 3 to a 10.2 / 11.8 EPR 3 - and that didn't go well. I realized only one night of data, but I changed the numbers the following night.
   

Looking back at these clusters, it probably wasn't the smaller window but a bunch of positional issues.

Oh, one thing I forgot to mention earlier when we last messaged each other. When I described "flipping" from side to side, it was a complete flip from my left side to the right side. I don't pause on my back for any time whatsoever. I learned not to lay on my back for any reason early on. I use a body pillow on both sides of me to insure I stay on my sides. I'm basically hugging these pillows, whether I'm facing left or right.

[JKan]

7.20.24
   

7.21.24
I opened up the window this night, not sure why. I didn't know which way to go
   

7.22.24
I returned to 10/13 EPR 3
   

[JKan]

Here is last night
7.23.24