Please help with treatment review

[DaveL]

Dave L,
Going back and little deeper in your charts and writings:
1_in terms of apneas themselves, it appears you are in good shape...,,regard FL's it is not clear yet...
2- based on your tidal volume and flow rate, and comparing with my experience on my wake-up calibrated graphs, it appears you have a very disrupted sleep (either shortly waking up or not going into deeper sleeps);
3_ your wrote: "I have untreated wrestless leg syndrome. That was diagnosed over 30 years ago when I was first diagnosed with severe sleep apnea" . 
This is something!!! RLS/PLMD  is my still-remained main issue after a two-year therapy. I have already gone into details of my case elsewhere in this blog. During 1.7 years I strugled with CPAP, AUTOSET, masks, mouth breathing, and so on. Finally, since april, 2019, I moved to bilevel VAUTO and FFM airfit f20. Pretty much worked out FLimitations, PML's were highlighted. Even after significant improvements and better life quality, FL+PLM's still wake me up some 3 to 4 times/hr. However, I realized, after very careful observations, data plotting, medical literature, this number of awekenings are not so much important for my HDYF (how do you feel index), while SleepEfficiency (SE: % of time sleeping/time in bed), yes, it is. With SE of 85 to 90% I am dancing in the streets rather than walking. Therefore, these days I am totally focused on getting higher SE, either trying and evaluating medications, supllements, and hard working on sleep hygiene.

GL

Thanks so much.
I don't know what to say.
Tonight I activated EPR. increased my pressure to 14 from 13.  Set EPR at 3.
I'll use my Dr Dakota wedge even though it's hard.
Meantime I'm ticked  that I've had sleep docs I can't trust, and didn't really help.

Reinforces my belief that I can be my own sleep advocate and achieve sleep quality in spite of doctor's help. Frustrated and scared.

[mper6794]

DaveL,
I think just to have got at this blog you start moving foreward for the first time, maybe more than in 30 years. It may happens people here would be strongly motivated to help you. However, we would need to go further on your OSCAR outcomes aiming at separating respiratory issues from Restless legs/PLMD. In your FR general picture appears to me rather good, but is missing some important information on your pictures, such as events chart with OA, CA, H, RERA..
Could you please make an additional effort and plot full night charts, organized from top down, say:
_Events
_FR
_FL
_Tidal Volume
_Leak

Then some 10min duration windows along them ?

Just to share some additional things with happened to me in this two years therapy (three months with OSCAR), which eventually could be similar yours: minor OA apneas were easily work out; then move to tame FL, which was a little harder, but suceeded with bilevel VAUTO, studies, and scrutinizing this blog. Mucch much more harder, though, it has been calm down may PLM's; first hope were that tame FL would work out PLM's, it did not. Only medications/supplements can handle PLM's; I have been experienced a great deal of types and selecting best balances (wrote about my PLMD elsewhere in this blog).
good luck
Good luck

[mper6794]

DaveL, in time....
 It would be of great value you plot de median line on the tidal volume chart (Just click on the left of the chart an select It)

_Events
_FR
_FL
_Tidal Volume
_Leak

Thanks

[Grandpapa-G]

DaveL, In Ontario you can now get a Resmed A10 auto "for Her" with a straight cpap perscription. Apparently OHIP accepts the for her model as a cpap machine and you will not have to jump thru hoops needed to merit an apap.

[DaveL]

Thanks very much. Grandpapa-G

[DaveL]

Changes...
woke up at 6:00; didn't sleep after that.

Pressure increased 13 to 14
EPR turned on
EPR difference 3

Dr Dakota wedge under my chin done up tight.

[Sleeprider]

Dave, most of your issues related to CPAP are resolved and the real challenge is to find ways to maintain the effectiveness while improving comfort. There may be alternatives to the Dr. Dakota and the other tools you use that work equally well, but are more tolerable. Many members even find their need for chin support diminishes in time as they train not to tuck their chin. While the Dr Dakota forces a higher chin position by blocking the chin, other cervical supports merely support the back of the jaw, encouraging your mouth closed, jaw forward and upward. I'm confident you will get there, if you think through your needs and focus on ways to accomplish them while improving your comfort.

[DaveL]

Thanks Sleeprider.
Changing my pillow helped. CPAP pillow now.
Been doing this for over 30 years with inadequate medical help.
I'll work at comfort.

Much appreciated

[DaveL]

DaveL,
I think just to have got at this blog you start moving foreward for the first time, maybe more than in 30 years. It may happens people here would be strongly motivated to help you. However, we would need to go further on your OSCAR outcomes aiming at separating respiratory issues from Restless legs/PLMD. In your FR general picture appears to me rather good, but is missing some important information on your pictures, such as events chart with OA, CA, H, RERA..
Could you please make an additional effort and plot full night charts, organized from top down, say:
_Events
_FR
_FL
_Tidal Volume
_Leak

Then some 10min duration windows along them ?

Just to share some additional things with happened to me in this two years therapy (three months with OSCAR), which eventually could be similar yours: minor OA apneas were easily work out; then move to tame FL, which was a little harder, but suceeded with  bilevel VAUTO, studies, and scrutinizing this blog. Mucch much more harder, though, it has been calm down may PLM's; first hope were that tame FL would work out PLM's, it did not. Only medications/supplements can handle PLM's; I have been experienced a great deal of types and selecting best balances (wrote about my PLMD elsewhere in this blog).
good luck
Good luck

Here they are reordered....I don't know how to isolate 10 minute duration windows, and then share them.

[DaveL]

Is this better?