Paula's - Therapy Thread

[paulag1955]

If I can get this result, or close to it, consistently I will be happy. I'm thinking about trying to get an EERS effect by partially blocking the exhaust vents on my P10. It's mostly a mental exercise as PAP therapy doesn't have any noticeable effect on how I feel.

   

[CPAPfriend]

You have a considerable amount of flow limitation. Have you trialed bilevel or enabled EPR on your CPAP before?

[PeaceLoveAndPizza]

The question for you is, is this as good as it gets? Are you happy with the therapy? Feeling better overall? Do you think this is as good as it gets?

We can always tweak things. Plenty of nerd knobs and geek gadgets to fiddle with on the machines and masks. Only you can answer if the juice is worth the squeezing…

[paulag1955]

The flow limits are about the same with or without EPR enabled. They go down improve slightly, but AHI goes up.

[paulag1955]

I know this sounds insane, but I don't feel any benefit from PAP therapy. I didn't have apnea symptoms before; I was referred for a sleep study for symptoms that resolved when the dose of my thyroid medication was increased. I do have apnea...it just doesn't cause any symptoms that I notice. In fact, I stopped therapy for several years and have just re-started as an act of faith that my health will benefit from not stopping breathing 40-ish times an hour. 

Still, I'd be interested to hear what suggestions you might have. I've recently turned off EPR, which improves my AHI but has a negative effect on my flow limits.

[gainerfull]

Have you ever investigated what higher pressure will do for you? What's a night at 9 cmH20 or 10cmH20 look like for you? There's a common misconception that only EPR / bilevel handles flow limits but the primary solution is higher pressure ...

[paulag1955]

At a higher constant pressure? I'm not sure. Even turning it up to 8.4 resulted in the feeling that I was choking on air, which is why I stopped therapy before (unsympathetic sleep doctor). I did have it set on APAP with a minimum pressure of 7 and a max of 10. It rode the upper limit of that all night and my flow limits were .17-.23. With the max set at 9, .11-.30, .11-.21, .14-.21, .15-.25, .16-.27, .15-.23 and so on. But my centrals were consistently higher on APAP than CPAP and an AHIs of over 4 were common. And there were occasional AHIs over 5, up to 8-something.

[paulag1955]

I'm happy with anything under 1, but .61 has me very pleased. 

This was my third night with my mask exhaust partially blocked. I haven't found it to be excessively stuffy. My flow limits, which weren't good to begin with, have gone up, however. If I have to choose between lower AHI or lower flow limits, which way do I go?

I'm going to continue with the blocked exhaust for a week and then re-evaluate.

   

[gainerfull]

I'm happy with anything under 1, but .61 has me very pleased. 

This was my third night with my mask exhaust partially blocked. I haven't found it to be excessively stuffy. My flow limits, which weren't good to begin with, have gone up, however. If I have to choose between lower AHI or lower flow limits, which way do I go?

I'm going to continue with the blocked exhaust for a week and then re-evaluate.

The most important measurement is how do you feel when you wake up? Everything else is just details ...

There will be nights where my machine registers obstructive events but I have no dip in sp02 so I just let it ride because I feel great the next morning.

[paulag1955]

I feel the same whether my AHI is .6 or 8.5. Other than snoring, I never had any symptoms that could be attributed to SA, even though my initial AHI was over 40. I was referred for a sleep study for symptoms that were resolved by increasing the dose on my thyroid medication. So I can only go by the numbers.