04-06-2024, 04:00 PM
RE: mallar's therapy thread
Pete: thank you again. I see in my charts that sustained flow limitations are accompanied by the APAP increasing pressure. If I'm understanding you correctly, it's possible that I'm arousing from the breathing issues instead of the pressure increase that accompanies the breathing issue? Aren't my flow limitations relatively low 95% < .1?
You can more easily control the pressure changes than flow limitations -- so it's a good trial to see if a single pressure results in fewer arousals.
Jay: thanks for the response. it's very possible that I have some physical breathing issues. I very recently went to the ENT to examine why I get a lot of sinus infections. I had a septoplasty as a teenager (about 25 years ago) to fix my deviated septum. It seems that the septum has "re-deviated", at least in part, and that I have some other issues going on with my nose that could be hindering my breathing. It's hard for me to tell subjectively if I have a hard time breathing through my nose: I've breathed this way for so long that I don't remember it being any different. I am having a CT scan of my sinuses as part of this whole nose/breathing assessment this coming week.
Absent a possible surgical intervention for my nasal breathing, is it still possible to get better results from a regular APAP/CPAP machine? I still would like to have buy in from my sleep medicine provider, and want to get the machine put on settings "approved" by the provider from a titration -- which hopefully they'll approve.
I think what I'm going to do is try a continuous pressure of 8 for a couple of nights. If the results are markedly better (I stay asleep longer), I'll keep it and advocate for keeping it that way with the provider. If not, I'll advocate for the titration. The titration may or may not work, but at least i'll have the provider's acknowledgement that it's not working. And discuss the possible physical breathing issues as well.
And I'll of course be open to further optimizations suggested from the Apnea Board community!
You can more easily control the pressure changes than flow limitations -- so it's a good trial to see if a single pressure results in fewer arousals.
Jay: thanks for the response. it's very possible that I have some physical breathing issues. I very recently went to the ENT to examine why I get a lot of sinus infections. I had a septoplasty as a teenager (about 25 years ago) to fix my deviated septum. It seems that the septum has "re-deviated", at least in part, and that I have some other issues going on with my nose that could be hindering my breathing. It's hard for me to tell subjectively if I have a hard time breathing through my nose: I've breathed this way for so long that I don't remember it being any different. I am having a CT scan of my sinuses as part of this whole nose/breathing assessment this coming week.
Absent a possible surgical intervention for my nasal breathing, is it still possible to get better results from a regular APAP/CPAP machine? I still would like to have buy in from my sleep medicine provider, and want to get the machine put on settings "approved" by the provider from a titration -- which hopefully they'll approve.
I think what I'm going to do is try a continuous pressure of 8 for a couple of nights. If the results are markedly better (I stay asleep longer), I'll keep it and advocate for keeping it that way with the provider. If not, I'll advocate for the titration. The titration may or may not work, but at least i'll have the provider's acknowledgement that it's not working. And discuss the possible physical breathing issues as well.
And I'll of course be open to further optimizations suggested from the Apnea Board community!
