Plmnb's Never Ending OSA Journey (Data)

[Plmnb]

Hi.

Very restless night last night.  My husband even noticed I was up and down numerous times.  Below please find charts.  I had max pressure set to 20 as was suggested.  I again slept with the soft cervical collar.  I had many, annoying, issues with my mask.  I see my RERA count down from last night, (1.27 vs yesterday of 4.51, but my AHI went back up a bit, (yesterday the AHI was down to 4.68, but today it is 6.58).  And for the first time since I adjusted humidifier pressure up higher, my mouth was dry.

I don't know how to approach things with this new dr. I am supposed to see this morning.  Do the esteemed members her still think I have this "chin tucking" issue?  I know bonjour was surprised with the outcome of my cervical collar test.  There has also been evidence of the possibility of UARS.  But I have been reading information online about UARS and I don't understand what I am reading.  I believe the fact that I have OA events means I probably would not have UARS?  (I have Oximetry study results that show my minimum O2 saturation asleep was 75% and other data.  This does not usually happen in UARS?).  I tried to find info on having both but have not had much success.

My last post of yesterday did not provide any suggestions of questions for me to ask the dr. but perhaps this morning someone might be able to guide me in this matter?

Here are charts from last night:

[attachment=18178]
[attachment=18179]

[Gideon]

If I discount your UA events which are highly correlated with really high spikes in your leak rate your AHI is essentially what it was yesterday. These leak spikes are likely from movement (positional).

Your flow limits are erratic and grouped and could be indicating positional issues, possibly chin tucking.

Try to collaborate with your doctor, not confront him, show him the OSCAR daily charts and ask him if all else aside and ignoring any insurance issues, doctors hate insurance, if he thinks a higher pressure support will help you be more comfortable and thus more compliant. Follow that with do you think it will help with my snoring and flow limitations?

[Plmnb]

Thanks bonjour.

Quick question, I could post in software related if need be, but if I were to bring my SD card with me to appointment and the dr office tried to read it, will that mess anything up as far as using the card for my OSCAR reports?

Plmnb

[Osiris357]

No. Give it to him locked and nothing will happen to the data unless he/she unlocks it

Then there is a chance if they mess up somehow but the chances of that happening are slim

[Sleeprider]

This thread kind of got ahead of me and both Osiris and Plmbd asked if minimum pressure should be raised. My assumption was that flow limits will cause pressure to increase to the maximum setting and an increase in minimum pressure would not make much difference. That appears to be true based on results posted above. I think we can see some improvement here in flow limitation and RERA, but in this case pressure support is going to be far more effective and comfortable.

An Aircurve 10 Vauto affords higher maximum pressure and more pressure support and is clearly where we need to go to improve results that have not responded adequately to normal CPAP pressure or to positional aids like the cervical collar. I think it will help to continue with this higher pressure for a while and discuss the use of bilevel with your doctor. The fact your pressure goes this high and leaves important issues unresolved will help to to formulate an argument for the medical necessity of a bipap machine.

[Osiris357]

Thanks sleeprider, that’s what I was curious about.

[Plmnb]

SUCCESS!!!

I don't think I could have done it without ya'll helping me!

After another hiccup, I finally met with a different doctor in the medical practice.  He was much more approachable and acknowledged my needs.  AND he even took a second to look in my throat, albeit very briefly, as well as he listened to my lungs.  (Also, his nurse was fabulous).

Much was discussed, including how the practice should never have just told me to pick-up CPAP machine and not have scheduled me for a titration study!

He said his first goal is to fix my RERA situation and all the types of my apnea episodes.  He does not feel at this time that I have a UARS situation going on.

He also knows about my primary doctor referring me to an ENT based on a hearing test I recently had, so that dr. can check for obstructions while he is at it.

Bottom line, he fully agreed with me that I should have the bipap system.  I have been scheduled for 12/27 for a titration bipap sleep study.  He also told me to bring my soft cervical collar so that I could be tested with it on and with it off. 

Thank you everyone for the support and information.

Plmnb

[ApneaQuestions]

SUCCESS!!!...

That's great news!
Maybe some of your stress and anxiety will dissipate and that can only help your sleep situation.
I don't want to sound like your mum but.... If those anxiety meds haven't arrived yet... give it a few days first to see if things suddenly improve with your feelings and thoughts.
Just a thought.  :-)

[70sSanO]

Congratulations. Glad that found a doctor that is both knowledgeable and takes the time to listen and review your data. The mere fact that you came prepared probably went a long way to getting his attention. Good job!

One doctor down, one million to go.

John

[Plmnb]

SUCCESS!!!...

That's great news!
Maybe some of your stress and anxiety will dissipate and that can only help your sleep situation.
I don't want to sound like your mum but.... If those anxiety meds haven't arrived yet... give it a few days first to see if things suddenly improve with your feelings and thoughts.
Just a thought.  :-)

ummmm..lol, thanks ApneaQuestions...have already gotten into them.  The pharmacist says they are low dose, 10mg.  The medication is HYDROXYZINE HCL.  Seems it is firstly an antihistamine, but it is also prescribed for anxiety.  They gave me 30 pills, but it was to last 10 days because I am supposed to take them 3 X per day.  It also says on the label, No Refills.

It seemed to take the edge off pretty decently the first night.

Plmnb