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Please help with treatment review
RE: Please help with treatment review
3 kinda stray comments about your latest screenshots.

1. it's odd that oscar reports your min ipap as 9 & epap as 6.98. epr accounts for the difference but your set min is 15. 15 & 13 reported under med should be your min.

2. do you often see indications of csr? it's usually just recovery or periodic breathing but noteworthy if you see it often & for longish periods if time. maybe Gideon can tell us if it's anything to worry about.

3. lately most of your events have been ca & most seem to appear toward the end of your nights. if this is consistent, they may be sleep wake junk.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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RE: Please help with treatment review
Long time ago I had comments about CSR. I had even less skill with OSCAR than now.
I'd bet money on sleep junk as I awaken.  I try to sleep to 6:30 on week days.  I've woken up a lot at 5:00 then a run to the little room,  and back to bed.

I'll look at the reports to figure out the other.

Thanks so much!

Dave


EDIT:  I see min EPAP as  you said.  I don't understand it.  

So:  in clinician's settings
* Verified that EPR was on; it's EPR=2.  Min P and Max P are as we said.

So:  
* turned EPR off.
* turned it back on.
* set EPR=3
* set EPR=2 as it was before....

So min EPAP should read properly next time I do a download and print a screenshot.  It it's not, I don't understand what's happening.  I don't understand why it read as it does. 


edit: I've gone back a number of days.  min EPAP reads differently every day. Lowest I saw was 5.00!  Strange.  

I don' know what mn EPAP is.  Why does it change?  Shouldn't it be set at minimum Pressure - 2 with (2) as the setting?
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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RE: Please help with treatment review
sheepless I'm sorry. I see min EPAP the same as you do. However, I don't know what min EPAP is, and where it is set on the machine.

My apap is the S10 *for her*.   I'll go into the clinician's menu and see what I can learn.

Dave


edit:  I checked OSCAR back about a month. min EPAP changes every day.  So I don't understand.  I would have thought that min EPAP was minimum Pressure -2  which is my EPR setting...

I'm confused.
Dave
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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RE: Please help with treatment review
Dave, I should have clarified, the odd min numbers may be an oscar issue, or at least something the oscar folks might want to look at to determine if it's an oscar issue. I assume they'll see this.

and I assume Gideon or others comfortable with interpreting periodic breathing and csr will see this and take a look at yours.

epap is expiratory pressure. with cpap and apap without epr, epap = ipap (inspiratory pressure). epr is exhale pressure relief (or something like that) and reduces ipap, so if your machine is set to min 15 max 17 epr 2, epap is 13 min 15 max.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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RE: Please help with treatment review
hey you, both. the min epap and min pressure is just a software glitch, and will be present each and every night until a new version of OCSAR is generated. poly-guy says he made the original setting of ignoring the first xx seconds from past software into ignoring NONE of the seconds. The first few seconds, when the machine is still starting up, the values are somewhere between zero (off) to your minimum (on). do not worry.

QAL
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RE: Please help with treatment review
Thanks QAL.

Much appreciated.
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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Sleepless!--good night last night following your advice.
I listened.

* ResMed N20 medium mask
* Wedge--Dakota under my chin.  That's all.
* no pillow. no tape.  no KDB cap.

I woke up at 6:00 am.  My alarm is set for 6:30 am.

So--sleep deprived; less time. Yet I feel better.

Thanks sleep rider!  


first clue---checked sleep report on the app on my iWatch 6.  I only woke  up once during the night!  It was at 5:00 am.  I usually wake up 2-3 times then go back to sleep.  So this is a huge change.

EPR and pressure settings are as indicated before  

I'm so grateful that I feel better than usual this morning.

(My Dakota pad stap is about worn out.  That's why I stopped using it some time ago. I'll search for a new strap or consider making one.  Darn Dakota pad was $63 CDN by the time I got it to the door when I bought it.)

Dave
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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RE: Please help with treatment review
Here is my sleep report from last night. 5 Dec 21

I woke once during the evening. 5:00 am.  I usually wake at least 2 times during the night

Even though I got up early I feel quite rested. 

That’s happened about 10 times in almost 35 years

I feel good!

DaveL

Used Dakota pad and N2 mask

Dave
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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RE: Please help with treatment review
it's great you feel rested!

what do you attribute the good night to?

does the report tell you anything about movement?

how does your oscar chart look for the same time period?
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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RE: Please help with treatment review
I have no ideas to add regarding your settings and charts, Dave. You are in good hands getting far better recommendations than I could make. I believe you are an engineer so will give extra details to enable your go or no-go decision early (and I'll have this post to inflict again on others Smile  who do come along with the leak problem we have shared. Oh-jeez )

But I can offer an idea and method to stop your lip leaks. (With as wide a collar as you can find and then adapt to (after several days), I claim there is no need for a chin strap which may aggravate upper airway obstruction anyway.) Warning: your eyes will glaze over and you will go to sleep reading this.

I was once an envious person who "could never use a P-10": a mouth breather in sleep with leaky lips to boot.  But always awakened by various FFMs' leaks, I got to the point of doing whatever it would take to stop mouth breathing (and supine sleep) so I could use the highly praised P-10 with its minimal perimeter to be sealed.

The link to my image below shows two solutions that have worked almost totally without failure for more than about three years.  Not shown is my cervical collar. For two years I wore the vest along with my first 3 1/2 in. collar, but found, after about 2 years, that I could go without the vest with a 4 in. collar (as now for several months).

In the pictures, ignore the vest and boxes, as were put inside its pocket, and ignore the chin strap, which was the best and last one I improvised or bought, but cast aside 4? years ago. I do still use the anti-asphyxiation device, largely because its 90 degree turn makes hose management easier, hose draped off my headboard as it is.

Most of all, I recommend the non-prescription Silipos Gel-E-Roll seal you see. It is a mineral backed fabric (from a 4 in X 48  roll) which is elastic length wise. That is my lip seal. It clings, even with occasional drools, but it does-not/will-not adhere like tapes. The first couple seconds against the face it feels like a clammy dead fish. I wash it gently with soap, not often enough, probably, and one seal lasts 6 months or more.

You must have a retainer to hold the seal in position on the face with traction and to press hard enough to keep the seal against lip leak pressure. You need some way to apply a normal or radial force inward toward, say, your uvula. 

My first improvised seal retainer is pictured beside the ruler. It is the top few inches of an old elastic compression stocking. It has double thickness elastic fabric where most needed at the top of the retainer (and stocking), about 3/4 in wide. With the top edge of the seal matched to the top edge of the double layer elastic the pair work fine with a P-10 when the upper edge is placed within 1/8 to 1/4 inch below nostril openings, even a bit lower. The velcro straps are attached to the ends of the retainer, overlapping it a bit there, the hook end being quite short. 

My pose (without my then-usual c-collar) is with the later professionally sewn successor of my DIY retainer and a smaller piece of Gel-E-Roll (2 in x 6 in).

Think of the sealer and retainer pair being similar to the old inner tube and tire pair: the tube for sealing, the tire for tube shape and size restraint against pressure--forgetting about all durability issues.  

Moments ago, I folded a 20+/- in. square bandana on the diagonal and folded that triangle's  long edge down again to have four layers of cloth (for about 3 inches) to cover and compress my upper lip and more before tying it in back. My bet is that bandana would work as a retainer in a pinch and could be improved with some velcro, elastic from a fabric store, scissors and a good stapler. 

One learns techniques for donning all easily. With seal lying as shown on retainer (lower right pic), with two hands grab and pinch together seal and stocking at upper right and left left corners of seal. Stretch it a bit (preloading it) and press it in position against upper lip. Slip fingers around the top edge without losing its preloaded tension, to make the velcro strap connection at side or back (however you designed that). After fastening, with the elastic seal and an elastic retainer one can carefully move them a bit for best alignment and most comfort. With a bandana, it would take more fiddling to get tension right, particularly, to keep from losing tension during placement and when raising or lowering chin after fastening. 


Two caveats: 

---My 95% IPAP is just below 14 cmH2O and I believe the method would withstand much more pressure with more tension in top edge and strap connection of retainer. 
---Chin shape or its relative position to neck fleshiness and size may not allow the method.

One other advantage: Radial inward force is applied to the skull and upper teeth roots, not to a hinged jaw which has anterior-posterior play and can recede a bit causing airflow problems for some persons.

Links: 

---My attachment I've posted a few times attachment.php (889×577) (apneaboard.com)
---My Gel-E-Roll source with the most reasonable price and related non-prescription gel products (4 in. squares and circles) Gel Solutions: Solve Prosthetic Fitting Issues with Gel | Amputee Store . I need a roll of Gel-E-Roll from them, again, but will also try their 4 in x 4 in gel pieces as a substitute after noticing them a moment ago.

Whether you try this approach or not, I wish you good luck, Dave, and improved sleep and therapy.
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  

Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.



 
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