pressure plateau

[Gideon]

You need 10 seconds to count as an event. And yes, smaller 'events' may be significant

[Sleeprider]

Your snores are all VS2 and don't affect pressure. Feel free to turn off the VS2 chart. A VS2 can even be recorded when the tube moves over a hard surface, so it's not a real good indicator of snoring. I actually suspect most of your events may be central, including the hypopnea. It looks like turning AFlex down may have helped. If you're willing to try someting differenct, I'd like to see you change settings to CPAP mode at a pressure of 9.0 and C-Flex 1.

[milboltnut]

I read that the APAP helps reduce stomach bloating....what can I do when switching to CPAP mode to prevent bloating. When I went to 8 cm and flex 1, the flex 1 at 8 cm was too much, so when I went to up the flex to 2. I belched a couple of times.

[milboltnut]

last nights OSCAR

I changed the minimum to 9 before I went to bed, and back to 8 when I woke up.... experienced mild bloating... a few little belches.

I can't PM for a bit.... so this is it for awhile.

Is CA's see better with flow rate expanded out all the way?
I see a FL on the pie side of info... but no graph like some others. I checked bottom left check box beneath the graphs....and it's checked.
the first clusters of CA's I was tossing a bit, had a hard time falling asleep (but going up to 10 would say I wasn't ?)
the OA's were most likely me taking deep breaths through my mouth, that's why I raised my pressure up to 9.... it felt better..but I think for now 8.5 would be better, I'll see tonight.
Around 3-3:30 I believe I had the same trouble as the first. But again the rise of pressure would say no.

Sleeprider.... I think I'd like the to try the CPAP.... maybe 10 is it, but the gas I got would be worse. That's why I gradually go up.

Ok, I'm open. (only please keep the it as easy as possible for me to understand, break it down.)

[SarcasticDave94]

I may have said this before, but you have to adjust as you see fit to maintain comfort. The air swallowing should slowly diminish, in regards to the likelihood of it happening. If that occurs, then you should slowly introduce more pressure. As is, your therapy is far from ideal.

I personally believe switching to ResMed would offer a noticeably better therapy. This latest chart shows a majority of CA events. Any event can cause sleep disruptions, and with what is shown here, I would believe your sleep cannot be very good.

I know there does come a time that we may be forced to say this is the best it's going to get and we have to just deal with it. I do not think all possible actions have been exhausted, so there's got to be something to do to address this mess of a chart. I would not accept this if it were mine. If this machine tool is doing its best, and this is the result, I think it's time to consider getting a better tool.

[milboltnut]

I may have said this before, but you have to adjust as you see fit to maintain comfort. The air swallowing should slowly diminish, in regards to the likelihood of it happening. If that occurs, then you should slowly introduce more pressure. As is, your therapy is far from ideal.

I personally believe switching to ResMed would offer a noticeably better therapy. This latest chart shows a majority of CA events. Any event can cause sleep disruptions, and with what is shown here, I would believe your sleep cannot be very good.

I know there does come a time that we may be forced to say this is the best it's going to get and we have to just deal with it. I do not think all possible actions have been exhausted, so there's got to be something to do to address this mess of a chart. I would not accept this if it were mine. If this machine tool is doing its best, and this is the result, I think it's time to consider getting a better tool.

That's my best way of gradually reducing my events and keeping them down... slowly raising pressure as I was doing.... but I guess just because the events were alot clearer when pressure did ramp up, doesn't mean I should raise my minimum pressure to fast. Still trying to grasp that operation. And yes a different machine as my Dr told me that. Hopefully I hear some news when I see him in July.

My sleep is best at 5-6 or below. I guess those numbers come when I stop waking up.. but the Centrals flag 10 seconds or more so...I noticed I stopped breathing even when I was awake last night, so I can imagine what I do when I was asleep. I went to a work retreat with some guys awhile before I got this machine and my bunk mate told me he noticed I stopped breathing while asleep, and he was concerned.

I believe Sleeprider suggested going to CPAP from APAP.. what do you say ? When say all actions haven't been exhausted, do you mean another machine or can I convert over with my APAP respronics?

Also what machine would clear it up and how ?

[Gideon]

A ResMed, with it's distinct and consistent EPR would allow for a lower average pressure thus lessening your aerophagia. It would also allow for a better treatment for hypopneas, flow limits, RERAs, snoring and UARS. Actually your argument is that you cannot tolerate your PR machine and that you need a BiLevel/ BiPap to help with your aerophagia via it's pressure support (flex and even EPR are only 'comfort' settings). If you are successful then get a ResMed VAuto which is the best machine as long as you don't need an ASV.

[milboltnut]

A ResMed, with it's distinct and consistent EPR would allow for a lower average pressure thus lessening your aerophagia. It would also allow for a better treatment for hypopneas, flow limits, RERAs, snoring and UARS.  Actually your argument is that you cannot tolerate your PR machine and that you need a BiLevel/ BiPap to help with your aerophagia via it's pressure support (flex and even EPR are only 'comfort' settings). If you are successful then get a ResMed VAuto which is the best machine as long as you don't need an ASV.

 (UARS) is caused by a slowing or blockage of air in the nasal passages during sleep, disrupting it and causing fatigue.

I have been dealing with nasal congestion..

Would that be the culprit? night before last I was down event wise, however , I think the centrals were borderline. 

I've been taking Sudafed... and it works well, but nasal congestion is via blood pressure lying down and inflames the passages?

Maybe I need to sit up when I sleep.

[SarcasticDave94]

I forgot to address the FL you were asking about, as pertaining to being a left panel statistic vs a graph. I think that's the way Respironics displays the FL. ResMed displays FL as a graph as I recall.

Changing from CPAP to APAP should be helpful. If Sleeprider suggested it, I'd go with it. He's better at seeing things that form that suggestion that I sometimes miss. I'd go with his suggestion over my own.

To me, an APAP introduces adjustable pressure. This can be good for several reasons. Pressure needs can change even in an overnight segment of time. You may need 6 to start, but 3 hours later 8,9,10 may be better. You can't just wake up and edit the pressure, so have a machine that can do the adjustments. These settings are not suggestions only discussion examples.

EPR on the ResMed would give a limited of up to 3 PS BPAP. This can be helpful to some. However, I am a bit concerned about the dominant event count of CA for you. In cases like this, pressure swings can make this worse, so it needs to be monitored closely.

I don't know what level of machine is best for you, but I do believe a ResMed in any flavor will serve you better than Respironics.

PS bonjour touched on an aspect, I suggest noting all comfort and complaint issues, present it to doc and say a ResMed up to VAuto would help tremendously. Myself, I would not accept this therapy you're showing on OSCAR past yesterday.

[milboltnut]

I forgot to address the FL you were asking about, as pertaining to being a left panel statistic vs a graph. I think that's the way Respironics displays the FL. ResMed displays FL as a graph as I recall.

Changing from CPAP to APAP should be helpful. If Sleeprider suggested it, I'd go with it. He's better at seeing things that form that suggestion that I sometimes miss. I'd go with his suggestion over my own.

To me, an APAP introduces adjustable pressure. This can be good for several reasons. Pressure needs can change even in an overnight segment of time. You may need 6 to start, but 3 hours later 8,9,10 may be better. You can't just wake up and edit the pressure, so have a machine that can do the adjustments. These settings are not suggestions only discussion examples.

EPR on the ResMed would give a limited of up to 3 PS BPAP. This can be helpful to some. However, I am a bit concerned about the dominant event count of CA for you. In cases like this, pressure swings can make this worse, so it needs to be monitored closely.

I don't know what level of machine is best for you, but I do believe a ResMed in any flavor will serve you better than Respironics.

PS bonjour touched on an aspect, I suggest noting all comfort and complaint issues, present it to doc and say a ResMed up to VAuto would help tremendously. Myself, I would not accept this therapy you're showing on OSCAR past yesterday.

So what the Resmed would ramp and stay at that higher pressure?

I don't accept therpy from yesterday eithier.... the lady from my Dr's office..."the CPAP machine coordinator" says  "it's alot better then where you were from your sleep study".. yeah so....? I feel my best at 5 or below. 

But I look at my sleep regiment... or better pattern. My wife says I wake up easy... with the exception in REM sleep.

I don't think I get enough REM.... I recollect two different dreams (two REM sessions ?) night before last, and only one last night. My Primary told me that you need at least three? (three REM sessions?)

As far as comfort.... I keep the room dark, puffed up my pillow, wear a chin strap, I ordered a N20 kit that won't be here till september, I take a warm shower and down a light snack before turning in, and run an air purifier to drown out the wifes total gym work out downstairs, I don't use the afgan just sheet and light top blanket, it's not heavy at all. Temp wise I am comfortable. 

What did I miss?