Lygodia Therapy Thread: Optimizing My Airsense 10

[lygodia]

I considered the Bleep! It's still on my mind if it turns out I need to try yet another mask. I appreciate you popping in to offer advice.

[lygodia]

Thank you for checking in! I did try 8.4 - didn't notice much difference - but I also spoke with the NP I work with. She wants to try dialing back EPR to 0, and also wanted to reset back to an 8 pressure minimum. (Also wanted to ensure the algorithm was on Standard, not Soft, which it has been since the beginning, I believe.)

I haven't noticed much difference with dialing back EPR - either in terms of comfort (it's not really noticeable) or effect (still waking up every 90 minutes). Here's the last 3 days of charts. (On Friday, I was able to stay asleep for what I think was two sleep cycles. Can't tell if that was a fluke or not!)

           


Also - I haven't been able to get a straight answer on this. I know waking up while adjusting to CPAP is normal. But is waking up every sleep cycle like this abnormal? From what I can tell, the answer is "yes, that's really frequent", especially since I typically woke up at most once without my CPAP. I know this is going to be variable from person to person, but it feels really isolating to have such a bizarre problem that no one can explain or even contextualize.

[UnicornRider]

All of your charts look good! What feels the best for you? Going forward, you know you have viable options for tweaking and tuning, if needed.

I have been on *PAP since 2014, this last year when they had to increase my therapy pressure, it was really hard on me. I thought with over 9 years experience I would easily adapt to the increased pressure and BiPAP. No, it was a very challenging time period for me. A lot of compliance issues, CA Events and waking at night,  It has only been the last month the CA Events dropped drastically, compliance is not 100% but better than before and I have more full night's sleep. Looking forward to the new year, I know I will have minor adjustments, but nothing like this last year.

 I really doubt you will have as long an adjustment period as I have, you keep posting back and know that we are here for any obstacles you come across.

[lygodia]

Thank you for the vote of confidence. It's been a trying week. A quick question - I know I'm supposed to keep everything in one thread, but I don't see a way to edit the title to indicate this is my therapy thread. Is there a way to change the title that I'm not seeing?

I'm trying to persist with "keep the mask on through at least 3 wake-ups" to see if that helps my brain relax & sleep through some cycles more. I expect that will take time. I would also like to up the number of wake-ups at some point, but 3 seems like the edge of my tolerance right now. I'm also trying to limit going to the bathroom unless I do feel I need to go.

A few more charts in case anything is notable here. (The leaks in particular last night look super weird - though I don't remember them happening. Then again, I don't felt like I slept well last night either...)

           

[UnicornRider]

Those are some very impressive graphs. Keep up the good work! Try increasing your time of usage, you are making your compliance but full nights are better for your health. Your Leak Rate and Flow Limits look really good.

The leak rate on the 4th, follow your mask pressure, a very slight adjustment of your head gear should address those.

If you were to zoom in for about a 3 to 4 minute display of your Flow Rate at the time of the start of the pressure increases (04 Jan @ 01:08 & 02:55) you will probably find some distortion of the Flow Rate wave shapes. As you scroll across them you will see continued distorted wave shapes until the pressure starts to drop again. That is the Resmed doing it's job trying to give you a better nights sleep by opening the upper airway with increased pressure.

  Post a couple of zoomed in views of those time frames so we can better see what type of flow limitations you were faced with at that time.


Take care,

[Sleeprider]

Lygodia, I took a shot at a title change. Let me know if you want something different.

[lygodia]

That works for now - I'll let you know if I want to change it at all in the future.

[lygodia]

I'm doing what I can! I don't struggle to hit compliance anymore - at this point, what is limiting me is the mental/emotional exhaustion of waking up. I'm doing what I can, but trust me, I wish I could keep it on "all night". (I wish I even knew what a full night was. It's more than 4 sleep cycles, at least.)

My care team recommended a sleep medication to see if that will help. I'll be trying it tonight. (It's generic Lunesta - eszopiclone.) We'll see if that helps with me falling asleep more quickly, waking up less, and/or going back to bed more easily. Or not! It's hard to say without trying it.

Here are the zoomed in graphs!
       

[Sleeprider]

You were doing a bit better and sleeping more hours with EPR back at Post #16 in this thread. https://www.apneaboard.com/forums/Thread...#pid494900 I think you do better with EPR and there was no reason to move away from that setting. The key is hours of sleep and therapy, and as long as you are under 6-hours of sleep, you're not going to feel you've had adequate sleep or feel refreshed. As I see it, you get in a few hours and quit and get up in the middle of the night. I hope the sleep-aid helps. Your problem is not the therapy or the settings, it's time in bed.

[UnicornRider]

Nice capture of the start of a "Flow Limit" event  developing, Your Flow rate wave shapes did not look nicely rounded leading up to this event. Some of us are sensitive to that level of Flow Rate wave shape distortion. 

Read this page, it will help you understand what we are requesting you zoom  in on and why we would be interested in those zoomed images. Look at the images in the link for similarities' to your graphs:

    https://www.apneaboard.com/wiki/index.ph...ng_therapy

    Be sure to keep good notes in the left hand side bar of your OSCAR Daily page under the "Notes" Tab, they come in very handy in the future.  I am glad I can go back and review my OSCAR Reports for dates related to my care these last couple of years. It has helped me understand the effects of my BiPAP therapy, and appreciate them also.