app1nag - Therapy Assistance Thread

[app1nag]

[attachment=2021] This is last night and I am feeling tired today. Do you think these leaks are unacceptable? I spoke with my doc and he said everyone has leaks. I brought a 30 day compliance report for him to review but he provided very little insight. Sometimes I wonder if I know more than him about cpap therapy

[Sleeprider]

You've got enough large leaks that those are potentially as disruptive as apnea events. I don't know how anyone can tolerate air leaking around their nose and eyes and expect a refreshing sleep. Your profile shows you occasionally try nasal pillows. Have you tried the airfit p10? It's a lot easier to get a seal with a nasal pillow than a nasal mask.

[Sleepster]

Do you think these leaks are unacceptable?

Between 2:40 and 4:40 you have a 2-hour period where your leak graph looks great. If it looked like that all night long the quality if of your sleep would be much improved.

I spoke with my doc and he said everyone has leaks. I brought a 30 day compliance report for him to review but he provided very little insight. Sometimes I wonder if I know more than him about cpap therapy

My doctor specializes in CPAP therapy and isn't able to look at a leak graph despite the fact that her assistants download my data and print a report for her. I had the same leak issues as you and had to self-diagnose the problem.

If you are not wearing a chin strap you need to try one and see if it fixes your leak issue. If you are wearing a chin strap you need to try a full face mask.

Your doctor is wrong to dismiss your leak issue so flippantly. If I were you I'd find a new doctor. At least I can talk to my doctor about these issues and she can give me recommendations on what to try. I adjust my own pressure, tell her what settings I'm using and why, and she at least seems to agree with my reasoning. At my next visit I plan to ask for a prescription for a new A10 VPAP Auto, and she will likely provide it. My insurance should cover a new machine, if not now then in November when I pass the 5-year mark.

[app1nag]

Thanks very much for all the feedback

the graph above was with nasal pillows...I have been going back and forth trying to achieve an optimal combination. I have been a mouth breather in the past but thought I was doing a good job keeping my mouth closed since going back on therapy in December. I have a hybrid mask that I tried one night but could not get a good seal during the mask test. And I got odd results the next day when I imported the data.

[PaytonA]

My feeling about your leaks is that they were not great but not that bad. I also tend to think that they were mouth leaks, so a chin strap might help. I use a full face mask but still need to keep my mouth sealed to avoid dry mouth. I do fine for a period of time and then I need to go back to the chin strap. I guess my body forgets and has to be reminded.

Best Regards,

PaytonA

[app1nag]

thanks for the feedback!

[app1nag]

[attachment=2049] Based on recommendations posted here, I recently purchased a CMS 50D+ oximeter. I finally got things up and running and was wondering if I could get some feedback from users that have been using an oximeter for a period of time. I've attached last nights results and am concerned about the drop in oxygen around the 2am time period. There are also gaps in the graph where oxygen levels are at zero. Is that a software issue or am I actually getting no oxygen during that time? AHI for the night was less than 2.

Thanks in advance for all your great advice.

[app1nag]

[attachment=2050] I guess looking at the data itself (not in graph form), makes it look like I had a decent night, oxygen-wise.

[Possum]

Overall your oxygen levels are excellent. You only have one "witching hour" starting around 1:50 AM and ending around 2:30 AM, but it actually doesn't correlate very well with features in the flow rate graph. You had a couple of hypopneas, but not until around 2:15 AM - I wonder if the clocks on your CPAP and oximeter are out of sync? You might want to check that, as both have a tendency to drift. In any case, once the machine caught the hypopneas and started increasing pressure, your witching hour ended, but it seemed to take a little longer than it should have. As for the gaps and spikes, those are probably just interruptions in signal from the oximeter. Your SP02 levels don't reach 0, unless you're dead.

In short, it appears that your therapy is going well, and I wouldn't be too concerned. If you really want to nitpick, you could consider raising your minimum pressure slightly to see if cleans up some of the H and OA events.

[app1nag]

That's excellent news...thanks ! My at-home sleep test showed oxygen levels in the 75% range for far too long of a time frame. I thought a zero oxygen level may have meant I stopped breathing for a bit.
I will try a higher minimum pressure this evening. Lastly, I wonder if there is a way to better sync up the two devices.