Please help with treatment review

[DaveL]

The part that interests me is where it indicates the sleep state. That and the time stamp.
It shows that  I often wake up 3 times a night. All your ideas are good. I believe i"ve made substantial gain with your suggestion of a soft collar instead of the two choices I had made.  My home-made pad was worn out; time to replace. My Knightsbridge Dual Band at best works 50% of the time.

I've had such bad medical care from the onset of OSA that I don't trust doctors.  I've had conflicts between prescribed medicines. I have a good family doc now. Except she is typical--trying to move me along the prescription/surgery path to solve a problem.

My operation to set my broken ankle (5 breaks) and put 2 plates in place resulted in horrific infections from the hospital I was operated in. I'm inclined to do naturopathic work now...

Thanks for all your help.  It means a lot to me every day and every time I sleep.

edit:  I seem to have a habit of napping daily.  Living Room couch.  Just happens. No machine; it's upstairs. Sleeping seems natural there.  complaints of snoring....

I'm trying to find simple causes for unrest and lack of sleep.  As a has-been motor tuner I've learned to do one thing at a time. And look at the simple things first.  

What you've done is incredibly valuable to me.

[nightgagger]

I don't know if I'd give up on the Knightsbridge (KB) cap just yet.

I bought the cap back in April, I think. Used it with the P30i, N30i, Simplus and F30i. All these masks didn't really work with this cap. I realized that I was wearing these masks outside the KB cap, and I believe this didn't help with leaks.
Moving forward, I went back to the N20 and wore it under the KB cap and I notice my leaks decrease ( along with taping with the BSN cover roll tape).

I then used the Brevida with the KB cap and cover roll tape and it really started to work better with leaking.
Finally, and most recently I started to use the P10 mask and that's been the bullseye on reducing leakage and it fits nicely under the KB cap.

Now if I could get rid of my stress (divorce) that's going on....

[DaveL]

Thanks nightgagger.

Status--I have been using a soft cervical collar for about a week now. It's been incredible. First night was awful. 

So my routine for the first 5 days was tape/mask/collar Feelings--woke up feeling refreshed for 2 of 3 nights. Amazing feeling.

Last night I didn't tape. I had better AHI than the night before.  I am so pleased! Feelings--woke up having trouble breathing  Sleep wasn't restful last night. Felt like my nose was plugged, or someone had put a pair of pliers on my ResMed hose.

I've been trying to limit changes to one per night.  And I've been *trying* unsuccessfully to limit my expectations to having everything work perfectly now.

I'm trying to simplify my treatment life. And get decent sleep quality.  I haven't had sleep quality in over 30 years of cpap/OSA treatment.

Larry makes the best cap I've tried. the Knightsbridge.  But my results change from Perfect to Absolutely Terrible in a night. Overcompensating, I've hurt myself with the Knightsbridge doing it up too tight.   
He changed his website since I started. He now shows the cap being worn over the mask as well as mask over the cap.  WhenI bought 2 caps form him I had to buy a new mask with larger headgear.  ResMed LARGE comes with a Large insert. That mask cost me $300 Canadian from my DME supplier.  So his new advice on his website will help new users a lot.

I've had exceptional help here from wonderful people.  I have some things left to try.  Video observation to see why I move so much when I sleep.  

And find a holistic remedy for this movement (restless leg syndrome too.)  I don't trust doctors who get to go on trips as rewards because they read a pamphlet and then prescribe medicine that masks symptoms without solving problems. I can buy a weighted blanket and do that myself.


It ain't easy being a hoser.

[DaveL]

Tired. Not rested.
N20 nasal mask
tape
soft servical collar

myAir sows 100%
2.7 events per hour 
Good mask seal

OSCAR
leak rate ok
countless flow limits
2.54 clear airways.

I didn't wake during the night

edit: iWatch 6 shows a lot less movement.
and, I've rediscovered a holistic remedy and will start taking it to resolve restless leg syndrome.

I haven't rigged a camera to record my night sleep. That spooks me. I commend people that have done it.

[DaveL]

looking much better I think. let's hope it holds. increasing min a hair looks like a good move as your oa and ca are lower, there's no flagged periodic breathing (csr) and leaks are much better than at higher pressure. the latest screenshot showing far fewer mouth leaks. idk if that's from lower pressure or tape or both but it's the result that counts. a good fitting collar should help with residual mouth leaks and the few relatively clustered oa you're having. your ca is minor and seems to mostly occur during the troubled breathing/hairbrushy areas. if those areas reflect plm, you may be holding your breath against the insult of movement. hopefully you're feeling better at these settings but if you continue to get these results for a while and still feel poorly, I think the next step is to look into what's causing those hairbrushy areas and some treatment for plm. nothing I've tried stops plm completely but an inexpensive TENS/EMS unit (transcutaneous electrical nerve stimulator/electronic muscle stimulator) used on my lower back and rear upper thighs for 30-60 minutes in the evening is the best thing I've found so far to relieve mine.

I"ve bought Dr Ho's tens device. Thanks for the suggestion.
And the soft cervical collar is working so well.

so is the tape that a member here suggested.
Boiron Zincum metallicum is the holistic remedy I'm just starting to take tonight for restless leg syndrome.

Thanks everyone. I feel I'm sleeping better; I'm waking up much less.

Out of ignorance tonight I'll increase my minimum pressure to 11 to see if they flow limitations drop off. Don't know what I'm doing. Firing in the dark.

Dave

[DaveL]

P max 15
EPR on; 2

13 is the pressure prescribed by my sleep doc after my sleep study.

taped
soft collar
N20

[DaveL]

Feelings last night==not rested. numbers don't mean a thing.

I had leaky mask disease. I was awake for about an hour too. Mask is virtually new. It's interference with the soft cervical collar I bought from amazon dot ca.

So many flow limits. I bumped the pressure up one on the cpap.

Second night tonight using Zinc metallic as a holistic remedy for restless leg.

I have never worked at anything so long and achieved so little. OSA.

Dave

[nightgagger]

You switched your machine from APAP to CPAP?

I noticed in your previous charts, Dec 18-19, a range from 11-17.
Dec 22 fixed at 15.

That seems high as your median on those previous nights was around 11.
Seems to me that I would have set the fixed pressure to 11.

[DaveL]

I've increased it due to feelings of unrest and poor sleep. Last night I woke 3 times.

I've read Gideon's Bible over and over again.  It's incredible. However, I have  so much to learn.

Last night I used tape, the cervical collar which likely is too high, and my ResMed N20 mask.  

I woke up so-so.  Mind is racing as much as it can....I can't remember squat these days.


I truly appreciate you looking! I appreciate your suggestions.  I have 2 screenshots showing last two nights if I did it right.



I just had a long talk with my Brother who lives in a halfway house. I'm his legal care-giver. He's 8 years younger than I.  Schizophrenic since he was 18....I'm so happy he is still alive.  I hope I help him.  I try.

Merry Christmas and Good Health to everyone....

Dave

[sheepless]

I feel for you. I know firsthand how frustrating it is to have so much trouble getting the restful sleep we all want.

I don't think you need that much pressure but it's tough to argue with your latest low ahi and flow limitation stats. otoh, while you've had worse leaks, they continue to be too high. along with rls/plm, I think leaks are the main reasons for my waking up and my leaks aren't any where near as high as yours. given your latest charts, if not for the leaks, I'd say no way apnea and cpap are the cause of your feeling unrested. my earlier suggestion to reduce pressure was to help reduce leaks. ahi and flow limitations might go up some but the idea is that effects of a marginal increase in events will be minimal and/or that managing leaks could offset the effects of a marginal increase in events. unless there are other health or sleep hygiene issue (your racing mind might be a clue!), I'd be amazed if you didn't feel better once you get a handle on your leaks and rls/plm. unfortunately, not easy tasks, but your willingness to persevere should get you there eventually.