srwilsn3's therapy thread | APAP -> BiPAP

[srwilsn3]

SR: I see them now. I will set up a night camera and see if I can't get to the bottom of what I'm doing.

[Sleeprider]

It may be nothing at all, but it could be a good project for a behavioral scientist...I do know the tedious hours of observation you guys are known for.

[UnicornRider]

The following graph shows normal breathing going into distorted wave shapes resulting in a Pulse Change. If you look at the Events Flag area, the only flag in the zoomed area is Pulse Change (PC)  from my Wellue Pulse/Oximeter. I started coming up with 0.00 AHI reports, the only thing left to chase on the events graph was PC & SD (SpO2 Drops).  


   

Your Double CA  showed some distorted wave shapes afterwards. From your spike in leak rate I suspect you held your breath, shifted position, your mask  re-adjusted therefore the leak spike and leak rate settling at a lower rate after that, the following Flow Rate wave shapes would suggest a possible Upper Airway Restriction.

When I have a double CA  of 24 seconds duration it will drop my SpO2 below 80% to the 70% range, Yours was ~40 second duration, my O2 would have pegged at 70% SpO2. That is the lowest my Pulse/Oximeter will report.

But then again I'm a sensitive type of person.

We each have our own reasons for using *Pap.

[srwilsn3]

Thanks all. I haven't done any follow up except for changing the trigger to Very High yet. Plan is still to observe my sleep with a night camera soon. That said, my CAs have been eliminated the last 3 nights. Subjective restedness is slightly improved.

UR, I am learning I am quite, quite sensitive as well.

I don't know what this board's stance on UARS is, but I am becoming quite convinced it's a separate (or at least cognate) pathology from OSA that is characterized, in part, by a low arousal threshold.

[UnicornRider]

As for UARS:  https://www.apneaboard.com/wiki/index.ph...ome_(UARS)

Dr. Steven Parks has some YT videos and podcasts of interest, he likes to sell books & stuff, as a behavioral scientist you might find his approach to sleep hygiene a logical approach to doing all that we can to prepare for a restful night of sleep. 

https://doctorstevenpark.com/sleep-apnea...e-syndrome

Dr. Barry Krakow is interesting.You can google some of his YT videos and podcasts.

https://barrykrakowmd.com/about-dr-krakow/

[srwilsn3]

Hi all. Just checking in. My sleep, overall, is better than it was 9 months ago. However, I still have the same slew of problems: unrefreshing sleep, headaches, tiredness, high blood pressure. I'd rate my overall sleep as a 4/10, poor-to-fair.

I've been trying to chase the apneas and "unspecified events" though increasing Pressure Support. Honestly, I don't know what I'm doing here. It doesn't seem to improve my AHI or FLs, although I thought it would by increasing IPAP. Any advice?

I'm trying to manage the leaks you see all over the place here. I'm going to try switching from a FFM to nasal mask.

[UnicornRider]

I have not forgotten you, I need time to review your threads. I will post back later.

[srwilsn3]

No problem, UR.

Here's last night. I've continued the algorithm of reducing PS and increasing EPAP to combat CAs, but I feel like I'm then not dealing with my OAs.

The leaks are just out of control. I'm continuing to try to combat that. I've tried a variety of masks, but it seems the F&P Vitora FFM does NOT work for me. As soon as a new cushion arrives (tomorrow probably) I'll see if it's just the age of the mask or whether I need to abandon Vitora for good.

Overall, it seems like I'm increased breathing effort every 5-10 minutes most of the night (see last image). My machine isn't flagging these as anything, but they are represented as peaking in my breaths followed by a drop in airflow and then a rebound. I really, really suspect this is the cause of my unrefreshing sleep. I really wonder what you think of these.

[srwilsn3]

Checking in.

A few nights into following the algorithm of reducing PS while increasing EPAP by .2 as I track events.

I've also moved to Resmed F20 for the mask. Hasn't really helped a ton. Median leak rates are still high. Still troubleshooting.

Breathing continues to be weird, although my machine isn't flagging these as events of any kind. Do I hold steady for awhile on these settings, or do I continue increasing EPAP?

[srwilsn3]

Wondering if anyone can advise?

My guess is that perhaps I'm suffering from FLs (see above) that's causing arousals. Outside of even these weird jags, I take deep breaths about every 15 minutes all night. I wonder if these are unflagged FLs that are causing me to recover with a breath.