hwnboy therapy thread

[hwnboy]

Hey Jay51,

Will the Vauto help to bring down those flow limits as well?

Last night, Oscar data shows it was a rough night, even though I felt like my sleep was pretty similar to the previous night. I didn’t wake up for any bathroom breaks and stayed in bed for over 7 hours, but I do have a slight headache this morning. Out of my 175 days of therapy so far, this night ranks as the fourth-highest AHI. Interestingly, my flow limitations weren’t nearly as elevated as they have been on other challenging nights.

I always wear an SCC and mouth Tape and use a flat CPAP pillow. I'm not sure if those clusters are positional. 

Wednesday, October 30th
   

https://sleephq.com/public/fb1ea177-4d1e...bede4ed520

[Jay51]

The clusters of OA's do look positional IMO (you have a clusters of H's at around the same time as well).  This would be great chart for evidence to help get a VAuto.    Lowered pillow height, possibly side sleeping instead of back sleeping, and a soft cervical collar could help this.

• 5.3Positional Apnea
                                                                                                                                                                                     .06 95th percentile flow limitations in this chart.  The VAuto has 2 tools to help combat both flow limitations and CA's.  For flow limitations, it has pressure support above the maximum EPR your current machine has.  Also, for CA's, it has a "trigger" setting to trigger an inhale much quicker and easier when set to either high or very high (default setting is medium I think).  
  

[hwnboy]

Tonight was a crazy night. Everything started like normal. I got up around 1 a.m., and the Bleep Eclipse was leaking. As much as I loved this mask when I first got it, I have really grown to dislike it recently. It never leaked in the first month; now, it leaks every time. I don't get it. I do the witch hazel thing and place the halos properly.  !?!

I changed to the P10 and got back in bed, tried to go back to sleep, and gave up after about an hour. I pulled the SD card to check Oscar and to my surprise, nothing. I guess I didn't have the card in all the way, only thing I can think of. So I wanted to stay compliant at least so I got back in bed for 3 hours and I'll do an hour nap later to get the 4 hours. I have never missed a day since starting therapy back in May.

Maybe I should keep my mouth shut at the doctor's appointment about the data from this day and it will be more evidence for the Vauto?  LOL, 15 centrals, no other events

October 31st
   

https://sleephq.com/public/bfa1efbb-1500...4a494f9862

[Jay51]

Great job collecting evidence.  You can show Dr. how you have to increase EPR to decrease your flow limitations; but at the same time doing that increases your CA's.  15 CA's is significant IMO.

[hwnboy]

I noticed something interesting on the spreadsheet I use for quick comparisons of Oscar data. This sheet lets me track daily changes in flow limitations and events at a glance. Recently, with an uptick in obstructive events, I observed a clear pattern in my EPR settings: between October 15 and October 28, when I experimented with EPR set to OFF, 1, or 2, I had zero obstructive apneas. Since switching back to EPR 3 five days ago, I've experienced obstructive apneas every night. I’ll disregard the data from October 31, though, as the SD card didn’t collect data for the first six hours (I hadn’t seated it correctly). The flow limitations column is also revealing. I expected a drop in flow limits after returning to EPR 3, as was the case earlier in my therapy when values typically stayed below 0.05. However, they’ve remained in the 0.06 to 0.09 range.


My Spreadsheet
   

Last night Oscar 11/02/24
   

Edit: added the SleepHQ link

https://sleephq.com/public/dd64addc-8f8c...6bf42e31b7

[Jay51]

The OA's look clustered, so it is most likely positional apnea and not the EPR 3.  You can try EPR 2 again if you think it might be better, but looks like positional apnea IMO. 

• 5.3Positional Apnea
                                                                                                                                                                                         Lowering pillow height, side sleeping vs. back sleeping, and a soft cervical collar might help if you start to see more of these OA clusters.  

[hwnboy]

Hey Jay51,

Ok, that sounds good. I'll stick it out and see what happens. I felt like EPR 2 had higher flow limits.  I use a Soft Cervical Collar and a flat CPAP pillow every night. I always sleep on my side, I prop a body pillow up behind me to make sure I don't roll over on my back. I stay in the same position all night for the most part, with the occasional flip to the right side. When I turn to my right, I don't pause on my back.

What do you think about my pressure, In all those experiments with EPR OFF, 1, and 2 my pressure was always at 8 cmH20 in CPAP mode. I've heard some on the forum recommend adding pressure as you raise EPR. Is that something I should consider?

Thanks!

[Jay51]

Sure.  You can do that.  Titration protocols call for raising epap if you are still having OA's also.  It wouldn't hurt to try higher.

[hwnboy]

Last night was interesting. I increased the CPAP pressure from 8.0 to 9.0 and kept EPR at 3. Around midnight, I had to get up because my Halos mask developed a leak. I tried to patch it up, but after 20 minutes of effort, I gave up, removed it, and switched to the Solo mask. I drifted in and out of sleep after that, probably asleep around 75% of the time. The first five hours, though, I was completely out, so overall, it was a pretty solid night’s sleep. I’m feeling fairly clear-headed this morning too, which is great. Also, it’s nice to see the flow limitations at a reasonable level. Interestingly, even with the eye leak from the Halos, Oscar recorded 0 leaks.

Sunday Nov 3rd
   

https://sleephq.com/public/91363faa-c17b...502129d201

[Jay51]

Not a bad looking chart there at all.  Leaks can start occurring though as pressure is raised.