My Wife Keep Waking up at Night!

[gumleafau]

Thanks you for your help!
My wife will be appreciated very much, and at I can have some sleep myself as well!

[Gideon]

Mar 2nd chart I think is Key, At about 2300 she stopped a large leak, the Flowrate to 2315 is irregular indicating awake. some mask tweaking abt 2333 on the detail I see an arousal at 2344:50 and I think asleep abt 2355, with corrected leaks 0011, 0025, and 0040 with an obvious arousal/wakening. The rest of the night I think she did pretty good. Bottom line is I'm seeing a mask fit problem. 
While at 1st glance they look Central most have a small bump in the flow rate indicating effort but not being able to overcome the resistance and this is in a period that I question being in a sleep state.

1 March had a significantly higher base leak rate than 2 March.

Additionally, Evelyn is experiencing pain, purportedly from the C-collar. I suggest removing the collar for 1-2 weeks to recover from the pain. I do like the Idea of lowering pressure to help with the leaks. I'm thinking 15 Max, and PS to 3 and then evaluate again.

Fred

[gumleafau]

Hi Bonjour,
I will try the settings you suggested tonight and shall keep you informed!
Thanks you the quick response!

[ajack]

I read that your wife is 38kg and 147cm. I would go back to the doctor, she may need another sleep lab test, or at least blood taken for a blood gas test, to see if she is retaining Co2 and perhaps may need a machine with backup breathing rate. To increase her breaths per minute and the amount of air per minute.
Like others here, I'm not medical, but the numbers don't look right. the median liters of air per minute is 4lt. The breaths per minute is 9.6

[gumleafau]

Hi ajack,
Thanks you for the response!
I am learning something new here! 
How did you get the numbers on the " median liters of air per minutes 4lts' and "the breaths per minute is 9.6"?
What are those figures for a normal 67yrs old lady?
Once I understand them, then when we see the sleep doctor I can ask him the question!

   

[gumleafau]

Hi ajack,
Thanks you for the response!
I am learning something new here! 
How did you get the numbers on the " median liters of air per minutes 4lts' and "the breaths per minute is 9.6"?
What are those figures for a normal 67yrs old lady?
Once I understand them, then when we see the sleep doctor I can ask him the question!

[attachment=10636]

[ajack]

In the 'med' or median column. If you hover the cursor over the 'minute vent' it will tell you that that is the amount of air per minute and the corresponding number is 4. The same with the 'resp rate, breaths per minute and the tidal volume. I would discuss the numbers with your doctor, to see if he thinks a blood sample first thing of a morning to check blood gases to see if she is retaining co2 and an overnight recording oxygen sensor would be needed. He may also want to redo a sleep titration study, to adjust the pressure support on your machine or try another, or add oxygen.

I would guess you have spent enough to have minimal co-pays, with your wife's other issues. You can do all this at home, if financially you have to. It wouldn't be my first choice, given your wife's medical situation.

[gumleafau]

My wife went to see a neurologist a few days ago about her shoulder pain! 
She had a nerve conductor test on her shoulder and the result is not conclusive. But the doctor suspect the pain is most likely caused by the slightly enlarged syrinx (fluid-filled cyst forms within the spinal cord). Also the doctor recommended to her not to wear the soft cervical collar for two weeks to see whether the pain subside.
Without the collar, the AHI went up to over 30 last night. I reset the machine back to old setting of 8-18, PS=4 and wearing the old F&H Simplus, which she experienced hardly any leaks at all.
She will be seeing the sleep doctor very soon as suggested by other member in this forum, to discuss her resp rate, breath per minutes and tidal volume. 
As "ajack" suggested, she may need a cpap machine with backup breathing rate to assist her breathing! Maybe that will solve the problem of keep waking up at night!

[attachment=10659][attachment=10660][attachment=10661][attachment=10662]

[ajack]

The forum is excellent and you are getting good advice. It's a shame the collar may be causing other issues. It was obviously helping. Perhaps changing pillows to encourage the head to tilt back within her limits may help? When you see the doctor, I would keep the questions simple and ask whether because of the multiple issues, if a BiPAP titration sleep study is required. Another machine is one option among a few, if needed.

[gumleafau]

Hi Sleeprider, Bonjour and ajack,
Last time when my wife went and saw the sleep doctor, about 9 months ago, I shown him the chart from SleepHead, which indicate that the
machine detected events of CA and OA!
I blown up the detail of CA and he reckoned it is not CA, but I have reservation on his interpretation!
Because of her shoulder pain in using a normal soft cervical collar, we modified it (see pic) and the AHI is just over 5!
The IPAP was 12.39 and EPAP was 8.39. PS=4
To go back to interpretation of CA, I attached the record from SleepHead of last night, and I would like to hear your interpretation of it!

[attachment=10848][attachment=10849][attachment=10850][attachment=10851]