Plmnb's Never Ending OSA Journey (Data)

[Plmnb]

Bilevel?
My new machine is not bilevel.  before I went back to the new dr. after my new sleep study I researched a little about what type of machine I might need.  I concluded Bilevel.  But my dr. disagreed.  So I have an automatic CPAP from what I was told.

Well... obviously your doctor wasn't looking at flow limitations then.

Using a collar is a worth a shot but I won't be surprised if your severe flow limitations persist.

Hmmm. I think in addition to the collar I am going to get, I will TELL my dr. that I want a Bilevel machine. I am tired of being jerked around by these guys.  I have always been told I need a CPAP and obviously they haven't worked.  So, with a collar AND a Bilevel my chances of success should be greatly improved don't you think?

Since the doctor refuses to physically examine me and only spends 5 minutes talking to me why should I expect he carefully looked at ALL the data in my sleep study?  Also, my very first sleep study (over 7 years ago), they not only tested me for the baseline, they tested me in the lab after getting my first machine.  How come no dr. since has asked for this to be done after my studies?  Wouldn't having this done confirm what type of machine I should be on even if he didn't see the flow limitations on the report?

Regards,
Plmnb

[Gideon]

Based on your unplanned split night study, because the towel actually worked.
I would like to see 2 nights of data from you, and the goal is to take these 2 nights data to your doctor.
Both with the cervical collar
Night 1 with EPR = 3 (current setting)
Night 2 with EPR = 0 (Off)

The goal is to show that PS (EPR) does work to reduce flow limitations, RERAs and that the AutoSet is not working for you.
If your doctor doesn't agree and help you to get a bilevel (VAuto) you need to replace the duck.

You can call him every Monday, Wednesday, and Friday complaining (Squeaky Wheel syndrome) or replace him.

[Gideon]

Note: That CPAP can be a very generic term and can refer to all non-ventilator machines including CPAP, APAP, BiLevel (many models for different purposes), and ASV

[JoeyWallaby]

Agree with bonjour.

Also, my very first sleep study (over 7 years ago), they not only tested me for the baseline, they tested me in the lab after getting my first machine.  How come no dr. since has asked for this to be done after my studies?  Wouldn't having this done confirm what type of machine I should be on even if he didn't see the flow limitations on the report?

The test in the lab where they use CPAP on you is called a titration study. And yes, they should have done another on you... which would have shown what type of machine and settings are required to effectively treat your condition.

[Plmnb]

Based on your unplanned split night study, because the towel actually worked.  
I would like to see 2 nights of data from you, and the goal is to take these 2 nights data to your doctor.  
Both with the cervical collar
Night 1 with EPR = 3 (current setting)
Night 2 with EPR = 0 (Off)

The goal is to show that PS (EPR) does work to reduce flow limitations, RERAs and that the AutoSet is not working for you.  
If your doctor doesn't agree and help you to get a bilevel (VAuto) you need to replace the duck.

You can call him every Monday, Wednesday, and Friday complaining (Squeaky Wheel syndrome) or replace him.  

I AM the SQUEAKY WHEEL!  My husband actually complains sometimes about this but he says he admires me for my perseverance

I am on board for your suggested plan of action!  Just to clarify, I should try to wear the collar all the way through the night on both nights? Or should I do the split technique for each night?  I mean have the collar on at first and then take it off part way through the night?  I'll probably be taking it off anyway just naturally like I did last night.

?

[Gideon]

Wear the collar all night, both nights, I assure you that your doctor will be totally confused about why you are wearing the collar, I mean no neck pain, no 'reason to immobilize the neck, WTH are you doing that? followed by a that can't possibly work, or something like that. The collar will remove the 'noise and let us get down to the heart of your issue. Until you actually don't need the collar, if ever, you need it.

[SarcasticDave94]

I agree with what bonjour is suggesting.

IMO Give proof to Dr. Duck that should probably already had seen this and acted on it, which they obviously did not. The noting if he or she will see the need now is the tricky part. If at any time Dr. Duck fails to meet your therapy needs and/or support what you know is needed, roast the Duck...quack quack.
Best to your success.

[Plmnb]

Plan of action...check

Now in the spirit of having all “ducks” in a row:

Do these settings, in your collective opinions, seem appropriate:

Max pressure 15
Min pressure 8
Mask Full Face
Response Standard
Ramp Time Off
EPR On
EPR Type Full Time
EPR Level 3
Humidity Level 7
Tube Slim Line
AB Filter No
Essentials Plus
SmartStart Off

Min pressure was changed from 6 to 8 at forum suggestion.

EPR was changed to 3 at forum suggestion and will be at this number tonight.  Then changed to 0 for tomorrow night at forum suggestion.  Should I change it back to 3 after tomorrow’s test?

I need the humidity level at 7 because of dry mouth.

Smart start is off because on it was a pain in the butt.

[Gideon]

EPR =3 is your setting until
1. Flow Limits and RERAs are not a concern
2. You have a BiLevel (VAuto)

[Plmnb]

Good evening.

I am excited and apprehensive at the same time. I purchased my soft cervical collar. It is a 3M Futuro. Adjustable for height and width. The box says it will provide moderate support.

I am trying to research more information about this FLOW LIMIT thing you speak of as well as the RERA situation you mention. In my EVENT FLAGS chart and my FLOW RATE chart I found the yellow lines that indicate these RERA episodes(?)

I don't understand about the yellow lines. When I hover my cursor over the yellow lines a little pop up box opens and it is written RERA (0)

Why, if I am having a RERA is the number indicated a 0? They all have the 0. Yet in the box on the left where all the data is compiled it says for example on 12/14 my RERA HOURS are 4.31. (The day before my RERA hours were 1.49) ?

In the FLOW RATE chart there are not only the yellow lines, but light blue and dark blue lines. I see that the dark blue lines are stated in the pop up boxes as HYPOPNEA and the light blue lines are OBSTRUCTIVE. The numbers in these pop ups, what exactly do they represent? Is this a number of times per ? that I had this thing happen? I am curious because on the 12th, in the FLOW RATE chart some of these pop up numbers seem pretty high and this is on EACH of the lines. If for example, I hover over a line that pops up and says OBSTRUCTIVE (40) what the heck does that mean? The doctor said I stop breathing around approx. 50 times an hour. If one line has a 40 number, what happened?

Btw, I'm not sure these charts show it, but the doctor also said the sleep study indicates that many of my episodes have me stop breathing for a minute at a time. This he said is why my oxygen level drops and I have been having morning headaches. Which I have not had since I started on CPAP this past week. (I didn't have headaches EVERY morning, just some mornings).

What is the difference between FLOW LIMIT and FLOW RATE?

I am fine with doing the research on my own, have been reading quite a few interesting articles, but they are pretty confusing. I was hoping someone here could explain some of these questions in laymen terms.

I have many more questions, but I think this is plenty to ponder for tonight.

I Look forward to the assistance.

Plmnb