nearenough - Therapy Thread

[Gideon]

I'll add that both of the above charts look awesome to me. Statistically the differences are insignificant.

Once you have achieved good numbers such as you have shown above both Sleeprider and myself favor comfort vs numbers.

[clownbell]

Hi Near - You are two months into the process, and thus may be experiencing so-called "treatement-emergent" central apneas. Because you breathe more efficiently with CPAP, you blow off more CO2 which causes the centrals. As your body adjusts over a period of time, these will probably diminish or disappear in time, leaving you with a super duper AHI. In which case, comfort rules.

If you subscribe to the strategy of using the LOWEST pressures that will handle your obstructive events, as opposed to the highest pressure you can tolerate, the answer is pretty clear. Personally, I would try lowering the minimum to see if you still can have a low AHI. If you do, remember to keep a setting for several nights, maybe a week, because one night is not a trend.

[nearenough]

Quick, 2 part update after 4 days at at 13cm.

I feel less tired than at 16cm.  Still tired, but not on the brink of exhaustion.  AHI is staying under 1 every day. 

My historical flow limit 95% at pressures 14cm and higher were always 0.00 to 0.01.  At 13cm it's hovering between 0.02 to 0.03.

I'll post the 3 days of 13cm charts and second posts zoomed in at the difference in inspiratory flows.

[nearenough]

Looking closer at flow rate in particular, I see at 13cm there are a large percentage of abnormal inspiration curves.  At 15cm and up the average flow tends to be more sinusoidal on average.

Typical curve shape @ 13cm leading up to what looks like a RERA to my untrained eye.
   


Typical mixture of inspiration curves @ 13cm showing various flow limitation patterns
   


Contrasted by 16cm which tended to look more sinusoidal on average.
   

[KeepSmiling]

I would say quality of sleep/how you feel.

With a big BUT, how long do events last, how low does oxygen get because this can cause health issues beyond feeling tired.

If you can handle EPR turned off, I would suggest Auto, 12 to 16.5. Then go up or down from there.

[nearenough]

Following up, as recommended, from a previous post.  

Subjectively I'm not as tired at 13.8 cmH2O (EPR=3) as I was at higher pressures.  Still experiencing fatigue, but it's not debilitating. 

Averages over the last 14 days
AHI - 0.55 
Flow Limit 95% - 0.01

The numbers seem good.  There's relatively few events, although it's clear zoomed in there is still SDB episodes that are too brief for the device to flag.

I'll post charts to take a look at.  Zoomed in to 2-3 minutes there appear to be RERAs and lot of deformed inspiratory flow shapes.  I'm not sure what to make of those, or whether they suggest Bilevel is worth considering.  

Thanks for taking a look as always.

[nearenough]

Zoomed out:

[Crimson Nape]

nearenough - We prefer that you keep your topic related posts in the same thread.  I have merged this thread, "Follow-up post" into your thread, "Choosing Quality over Quantity".  Please let me know if you wish to have it renamed and the title you want.

- Red

Edit: Actually in looking at all your threads they are related to your therapy.  I will be merging them and retitling your thread to, "nearenough - Therapy Thread".

[nearenough]

nearenough - We prefer that you keep your topic related posts in the same thread.  I have merged this thread, "Follow-up post" into your thread, "Choosing Quality over Quantity".  Please let me know if you wish to have it renamed and the title you want.

- Red

Edit: Actually in looking at all your threads they are related to your therapy.  I will be merging them and retitling your thread to, "nearenough - Therapy Thread".

While I appreciate that, two issues arise.  First, Gideon explicitly asked for a follow up post, hence the new thread.  Second, threads go dead once someone asks for a week of metrics.  No one replies after a week of collecting data - threads just goes dark. It's remarkably difficult to have a therapy discussion when no one will reply to an ongoing thread.

[Brazen]

I think now that it's labeled as a therapy thread that will improve.