Lorrubdb Therapy Thread: Fine-tuning therapy with Oscar

[Lorrubdb]

Here's 130-133.  The first one I forgot to zoom, the second one I highlighted 130-133 and zoomed(F11 F12) but think they look the same.
Is this what you need? 















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[Sleeprider]

Well both of those look great and simply show a very healthy rapid exhale of tidal volume followed by a null flow before the smooth inspiration. It is the free-flow of exhaled air that gives the flow chart some asymmetry. Perfect. I bet in spite of the centrals, this felt pretty good.

[Lorrubdb]

Oh thank goodness, so relived to hear that!  I was afraid it was gonna be bad news since usually when you see something possibly amiss and ask for 3 min zooms there is something wrong. Wow you said "perfect and healthy"-that's a first and so good to hear. Does that mean it was only for those 3 mins and rest of night was ok but not as good?

You're so right, I felt really good today with amazing energy-like a normal person must feel lol!  I actually went to the market, haven't been to a store for 2 years-mostly because of the pandemic but also because I didn't have the energy/strength. I did today!

Thanks so much!

[Sleeprider]

That was a pattern common all night, but that looked to me like a good random sample.

[Lorrubdb]

Great! Looks like things are finally looking up. Couldn’t have got here without you

[Lorrubdb]

I've had a couple of bad nights and wanted to see what you think. Last night  seemed to be a lot of centrals, or more than usual. Re the time, I actually went to sleep at around 11:30 but forgot to attach the hose so that's why it starts at 1:38. Also my pressure looks a bit erratic , on 2 charts it's bumping against the max pressure. On 3/1, I'm missing around 2 hours again, not sure why. On 2/28 I really didn't go to sleep at 4:40, the machine just didn't go on although I have it on smart start. So I woke up and turned it on  but I actually slept around 7 hours. On all 3  charts my inspirations are so much higher than expirations. On 2/28-3/1 my expirations seem to just disappear at the beginning. I know the zoom looked good before but just wanted to make sure it's still okay or if if I need to make any changes.

Thanks Lorie

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[Sleeprider]

One rough night with under 3 AHI is a datapoint that we can compare to the other nights with about .5 AHI. We need to fucus on the successes and not the occasional disruptive night. Your results are on the whole very very good, and I don't see anything to recommend that would have made a difference on March 2. We set the max pressure to limit how much pressure variation you experience because it is disruptive to your sleep and generally not needed. Sometimes your auto-pressure bounces off that ceiling, but doesn't stay there long, so I think that is perfect. Minimum pressure seems adequate to control obstructive events, and the EPR is working to treat flow limitations while not causing excessive CA. No changes.

[Lorrubdb]

Great, thank you as always for your feedback/reassurance and for the explanation for the settings. I understand better the reason for them and how they’re all balanced out. I hear what you’re saying about focusing on successes so will wait for a few bad nights before I worry that I’m on a downward trend.

[Sleeprider]

At this point the good outweighs the bad by a significant margin. If we carelessly start making changes we could undo the good therapy we have accomplished, and I don't see what changes would be an improvement at this point. Therapy will be consistent with these settings, but therapy results may vary based on external factors in your sleep, health, diet, exercise, and many other possibilities. I think you probably share my satisfaction with the way things are at this point, but you may not appreciate the risk of chasing random variation in your results.

[Lorrubdb]

Please don’t misunderstand- I am beyond satisfied with how well my therapy is going. I was in rough shape until you took over and am feeling so much better. The last thing I want to do is undo any of the great therapy we’ve accomplished. And I do know it’s great! As I said before, you are extremely knowledgeable and I’m very fortunate and grateful  to have you to help me, as well as putting up with all my spinning when a night or two isn’t perfection!

 I actually do appreciate what you’re  saying, that it is foolish to make changes for occasional, little random events when not really needed and chance messing it all up. That makes no sense. You’re right too about other things maybe going on with my health, diet etc. For sure I haven’t been sleeping well -restless, moving all over the place instead of peacefully sleeping in one side or the other when my results are best. I do have to consider all that more instead of immediately thinking it’s my therapy.  I have complete confidence in your expertise and judgement and apologies if I came across like I don’t. I just get scared sometimes and want to run it by you and see what you think. As soon as you say no everything’s good, it’s just a bad night,  I’m completely happy and reassured. I’m just asking and am always glad when you say no changes because it reaffirms its all as it should be. Of course if you ever think a setting should be changed that would fine too. Because Im fully aware that you have a ton  of knowledge and I know nothing! Lol or almost nothing, I am learning a bit as we go along.