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Numbers getting worse, any advice would be appreciated
#51
RE: Numbers getting worse, any advice would be appreciated
It looks like the suggestion of a full face mask might do the job. The other idea of a collar, could be put on hold for now. This may be all you need.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#52
RE: Numbers getting worse, any advice would be appreciated
Last night was much better.  Overall AHI was reduced.

I feel like i got the leaks under much better control and got a solid 7 hours or so in.

Even with the pressure maxed out at 8 most of the night my OA's were quite low.   However, the majority of events were still CA's.

I have no idea how to interpret this.  Would love some input..

https://imgur.com/a/Amepk


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#53
RE: Numbers getting worse, any advice would be appreciated
Comparing this to what you had, I'd give it a week to settle down. Your body has to get use to your new treatment plan.
With good OA/H, snore and flow rate numbers, there isn't any need to do much. See how the CA go, it normally settles within 12 weeks for most people. Try min 8cm, max 9 when you are ready.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#54
RE: Numbers getting worse, any advice would be appreciated
If you throw out the last half hour due sleep/wake junk. Than throw out the CA's due to leaks your AHI would've been around 1.
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#55
RE: Numbers getting worse, any advice would be appreciated
Well Wednesday and Thursday nights with a pressure of 7-8 were quite uneventful, good ahi, etc.  The pressure stayed maxed out pretty much maxed out all night so I tried pushing the max pressure back up to 9.0 last night.

Leaks were under control which is good, but the centrals came back, overall AHI jumped to 6.09.  Not horrible, but a noticeable jump, and almost all centrals.  I am beginning to think this is pressure induced but would love some feedback.

I have a recording oximeter I'm going to try to see if my oxygen is dropping during these centrals.

My plan is try at 7.5-9.0 tonight and moving forward for a few nights to see what happens unless someone has a better suggestion!

Thanks to everyone for sticking with me thru this.

If you want/need to see a part of the data zoomed in, just let me know and I'll get it posted.


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#56
RE: Numbers getting worse, any advice would be appreciated
I think I'd leave it at 7-8 or even go fixed pressure at 8. I don't think increasing pressure is going to work. At least right now.
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Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#57
RE: Numbers getting worse, any advice would be appreciated
Well, an update for anyone who cares....

Since the 3rd, which was the last chart I posted, things are hanging in about the same.  I changed my pressure to 7.0-7.6.

I'm still having a majority of central events although my AHI remains in the 5-7 range.  So not bad, but I'm still concerned as to why all the centrals.  

I have been using an oximeter the last few nights and my O2 has been decent.  As low as 87.

Last nights chart is attached.

I think my pressure is low enough now that obstructive events are starting to happen more often.


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#58
RE: Numbers getting worse, any advice would be appreciated
I think it's time to try some variable pressure again. 7-12. You did fine on it before:

[Image: yBw7DbV.png]
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#59
RE: Numbers getting worse, any advice would be appreciated
Spent the last 5 nights back at min 7.0 max 11.0 which is where I spent over 6 months with an average AHI of .97.

These last 5 nights I am averaging about 6.5 AHI, last night was 8.9.

Last night I had 32 Clear airway events ranging from 10 to 20 seconds in length, 2 of which happened during a large leak.
I only had 2 obstructive events, and 21 unclassified events.

Anyway, I will keep my pressures here and see what happens, but it doesn't seem to be improving and I still wake up feeling tired.

What is the criteria I would need to meet to think about going to BiPAP or ASV? I know next to nothing about those machines.

Thanks again
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#60
RE: Numbers getting worse, any advice would be appreciated
I'd say your at that point now. You might want to get in touch with your sleep clinic and discuss it.
Download SleepyHead
Organize your Sleepyhead Charts
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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