hookedonstitch - Therapy

[hookedonstitch]

Sleeprider,  ah Dr. Krakow .... I forgot about him.  Yes that is an excellent article.  He makes many good points, like what you don't look for you won't see.

So flow limits and UARS, he said are interchangeable.

I think this helps Angela indirectly.

Angela, when  you talk to your doctors about your issues maybe you could bring them a copy of this wiki article.  Ask your doctor if they know about UARS and discuss how it impacts your sleep and energy levels.

Years ago, a doctor I knew said being a good doctor was like being a good Detective.  The patient comes in with a bunch of clues or symptoms and the doctor then sorts through them to determine what is relevant to come up with a diagnosis.

Thank you Cpapian for this information.  For some reason I was not notified about your new replies and I'm just revisiting this thread now because I've had a few awful nights to post and hopefully get some insight into what is happening.  I'm almost at the end of the rope with the frustration levels my sleep is causing me!

[hookedonstitch]

This wiki on Apnea Board explains UARS and the use of bilevel therapy well.  I am not a fan of using ASV for flow limitation and UARS, although it is being done by the doctor that wrote the article in our wiki, it just isn't usually the first choice.  http://www.apneaboard.com/wiki/index.php..._and_BiPAP

Thanks for linking this Sleeprider, will read it in a moment

[hookedonstitch]

The past few nights have been like hell on earth.  Insomnia really bad over the weekend with very little sleep because I stopped taking the gabapentin so I restarted it last night and stayed asleep but my AHI while in the good range is off the charts bad for me and the worst that I have seen since starting therapy.

My central events are increasing in duration and time per event, now up to 18 seconds in length.  I just feel like crying, I am so tired and so frustrated.  I don't know what I am doing wrong.  It's probably still these stupid flow limits!

I'm also wondering if the 12 pounds I have added on the scales since starting the gabapentin for restless legs/insomnia has changed my therapy?  I want to stop taking it but whenever I try I spend the whole night trying to fall asleep.

I'm going to talk to my family doc this week and see how open he is to sending me to another sleep doc.

My pressure ranges between 7.0-9.0 with EPR of 3

[Cpapian]

Angela, you have got a lot going on there in terms of sleep interruption

Restless leg
Iron deficiency
Apneas
Central
Flow limits

Your APAP is only designed to fix the Apneas and to some extent flow limits, but not to the extent of yours. But each and every one of them needs to be sufficiently addressed in order for you to feel awake and have enough energy to run your life.

When talking to your doctor let him know the impact on your life and how desperate you are feeling.

On a side note, I don't know how restless your legs were, but perhaps the garbatin is not so much making you gain weight as the lack of restlessness when you take it. I have seen a video of a person who could have been doing a full workout during sleep.

It is a double ended sword .... to tired to exercise ..... weight gain making sleep issues worse and around it goes.

On a different side note, you might have to reset you notifications.

[hookedonstitch]

Angela, you have got a lot going on there in terms of sleep interruption

Restless leg
Iron deficiency
Apneas
Central
Flow limits

Your APAP is only designed to fix the Apneas  and to some extent flow limits, but not to the extent of yours. But each and every one of them needs to be sufficiently addressed in order for you to feel awake and have enough energy to run your life.

When talking to your doctor let him know the impact on your life and how desperate you are feeling.

On a side note, I don't know how restless your legs were, but perhaps the garbatin is not so much making you gain weight as the lack of restlessness when you take it.  I have seen a video of a person who could have been doing a full workout during sleep.

It is a double ended sword .... to tired to exercise ..... weight gain making sleep issues worse and around it goes.

On a different side note, you might have to reset you notifications.

I got an appointment to talk to my Sleep Dr. but it's not until Sep 16th!  Not sure what I am going to do while waiting.  I don't know whether to stop taking the gabapentin or not.  I'm basically just a hot mess, I feel like giving up on trying to fix anything it's starting to feel like nothing I am doing is helping.  

Thanks for the feedback, I will check my notifications and try to fix the error messages in my OSCAR data.

[hookedonstitch]

The centrals are new, I've never had them that bad before this weekend.  What am I doing wrong?

[Sleeprider]

Centrals at that level are not something to be concerned about, so I think the best thing to do is to continue to focus on comfort. With the Aircurve 10 Vatuo (bilevel), we have some settings that seem to eliminate these odd centrals that pop up from time to time, but that doesn't help you now. The CA you featured arises out of a flow-limited series of breaths, and I suspect it is improperly flagged.

[hookedonstitch]

Centrals at that level are not something to be concerned about, so I think the best thing to do is to continue to focus on comfort. With the Aircurve 10 Vatuo (bilevel), we have some settings that seem to eliminate these odd centrals that pop up from time to time, but that doesn't help you now. The CA you featured arises out of a flow-limited series of breaths, and I suspect it is improperly flagged.

What should it have been flagged as?  I'm so confused.  If I understand correctly then this is caused by the flow limits too?  

[Cpapian]

I just looked at the ADP schedule and it surprised me. The Air Curve V Auto is scheduled at the same price as an APAP $1,020. Definitely worth getting sleep doctor's Rx for this.

[Sleeprider]

What should it have been flagged as?  I'm so confused.  If I understand correctly then this is caused by the flow limits too?  

Central apnea can take a number of forms, but it typically involves a gradually diminished respiratory volume going into the event and following it. This comes from reduced respiratory effort. Your event has the signature of an obstructive event, with flow limitation and respiratory effort leading up to it, and recovery breathing following it.  It simply does not fit the pattern for central apnea we expect to see.  I believe this is either an obstructive apnea, or a pause in breathing from movement or arousal.  Nothing about this event looks like a central to me. In fact, right after the flag is a big inhale, and a breath-hold, followed by a strong exhale and increased respiratory volume. This is most likely movement or change in position.