robbob2112 -Adventures in Therapy

[robbob2112]

I should have posted a newer set of graphs - since I switched to the N20 airtouch mask my AHI has been under 1 with minimal leaks compared to before.  I switched this past Friday.

In the new graphs I woke at 1am, 3:10, and 5am.  Each time was waking up from a dream, once was falling the others were just pleasant and gentle.  Each time I remember rolling over so that would explain my leaks.

I am still getting used to the whole setup but I think I am on the right track.  My Sp02 has also been in the mid 90s the majority of the night.

[SarcasticDave94]

Congrats. That one looks better, hope it feels better.

Optional, if you want to try a bit less EPAP to start, you can edit mode to ASV Auto and give EPAP 5 - 9 a try.

[robbob2112]

Hi, 

What does the waveform at 1:27:20 for flow rate indicate.  I see the mask pressure spike, but very very narrow and I see the flow limit.  I just don't know how to interpret the graphs yet.

I have been reading the wiki on Oscar help and I see many examples of 'bad' waveform, but few examples of 'good' ones to compare to.  The other thing that seems odd is a lot of my graphs are mirror images of the ones in the wiki, i.e. they are reversed.  If there a page I am missing with examples of 'good' data?

I am left to wonder if I need to interpret the data from the ASV different than the standard CPAP.


Second topic - backup power - 

I have mine plugged into a spare UPS I had laying around but now I might rethink that to some sort of LiFePO4 setup.   Either a prebuilt battery bank with the BCM+inverter+battery included or something home brewed that does the same.  I have to check the O2 concentrator for voltage/current but it looks like my ASV PSU is 24vdc 3.2amp 90 watts.  I'll put the kill-o-watt on there to see what the actual draw is.  But seems like just making a cord and using a 24v battery would be more efficient without the inverter/PSU losses.

Anyone have a suggestion on what the current tech offers to power CPAP/O2 concentrator?  my head already hurts deep diving Oscar and I am not sure I have the brain cells to deep dive new battery tech too.



Robert


p.s. My lovely wife is joining hose-heads-united as soon as we pick her machine up.  Who knew when this journey started a year ago we would both end up with machines.

[robbob2112]

I live at altitude (9144ft) and need supplemental O2 when I lay down or sleep.  The sleep study was done at 9600ft in Frisco CO so it is close to what we have here.

In the sleep study I had a 80/20 mix of CA/OA so the ASV seems to be the correct machine.  I'll have to ask the Doc about the PS max and max ipap being set to 14 verse using ASVauto mode.  From my reading the machine docs the auto mode doesn't allow for higher pressures (I have to go find the reference).  But I am nowhere near the higher pressures so the auto mode may be correct.  I see the doc again in 3 weeks to talk about it.

And, he is very open to talking about what Oscar is telling me and looking at the graphs once I explained the data sources.

Robert

[SarcasticDave94]

As best as I can remember, when I was using ASV I was running 7-12 EPAP and 3-15 PS, giving 10-27 IPAP, however the ASV will max out at 25 IPAP. This was in ASV Auto mode.

Mixed Central and Obstructive Apnea should be treated fine with the ASV.

If you decide to change pressures, you can do so with no script change. I had to run my own pressures the whole time I had ASV. The doctors and RT in this area were pretty clueless about ASV period. The RT told me she guessed at initial setup, of which it lasted till 5 minutes after I got it out home. I got in Apnea Board and learned how to set it myself.

[robbob2112]

My latest nights sleep.   last night was 0.20 and the day before was 0.42 and before 1.6 ..... 

Using a N20 airtouch mask (the one with foam, the silicone one kept causing scabs on my nose) and mouth tape but only on both corners - I couldn't stand it totally covering my mouth, but the corners is enough to keep my yap shut and still let me not feel claustrophobic

[robbob2112]

So, I switched to the F20 airtouch mask and since then I don't need mouth tape or chin strap and I have fewer leaks and am sleeping better.

I posted a zoomed in graph and what I would like to understand is the flow rate waveforms.  What are they trying to tell me just before I have the Hypopnea?

The other question is why are the flowrate waveforms spiked at the bottom and stair stepped?  If I am reading it right, it looks like I exhale all at once then inhale, pause part way through and then finish.  Is that normal or strange?

[robbob2112]

I've looked and there are to many hits with the words mask and ride when I search.  Something about Sleeprider commenting on MANY threads to help folk.

I currently use the F20 airtouch, but have tried many other masks.  ALL of they seem to want to live on my forehead.  Several times a night I wake and tug it back down into place.  The nasal plugs and pillows act the same and end up killing my nose.  The N20 rides up and cuts off my air eventually.

The only way I avoid it is to tuck my hose in and snuggle it when I am falling asleep, but that is only 50/50.

I've toyed with a velcro strap from either side of the mask to under my chin but the results aren't satisfactory for a number of reasons.  I need to get the sewing machine out and make a strap out of an old T-shirt or something similar but I think that would stretch.


Does anyone else have this issue?  Have you got a good solution?

Robert

[mushroom]

i use an N20 but i find that i have to tape it to my face in order for me to not rip it off at night. maybe tape could help keep it in place?

[SarcasticDave94]

Your newest charts look well on the other thread, in reference to recent settings edits.

If I can help let me know, I think you said something about *not* liking higher pressure. With .12 and 0 AHI at those settings, you should be able to build a good therapy record.

I found EPAP to be better to be lower than PS, as I felt EPAP was constant where PS was intermittent. At least for me. Assuming events were treated that is.

Fun tip, if you know you need X IPAP Min or Max, sliding EPAP and PS around means you can get there several ways, one of which should be more comfortable and tolerable to you.

Example IPAP Max 20 can be attainable by EPAP 4 PS 16 or EPAP 10 PS 10 or EPAP 8 PS 12, and so on.

PS must have minimum spread of 5 between Min and Max.