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+--- Thread: Soon to start CPAP - Question on dehydration (/Thread-Soon-to-start-CPAP-Question-on-dehydration)
RE: Soon to start CPAP - Question on dehydration - Gideon - 12-17-2018
6 is the minimum that most people can tolerate so let's start there. Expect us to help you titrate up to a comfortable level, but with longer periods of time. Your comments as we do this will be very important. It is likely that we will titrate you up until you get aerophagia, so we know what you can tolerate and then pick a value for continued treatment.
RE: Soon to start CPAP - Question on dehydration - picante - 12-17-2018
(12-17-2018, 10:15 PM)Sleeprider Wrote: I'm suggesting fixed pressure at 6.0 not auto. The plan is to start at 6.0, and compare that to 7.0, not only for events, but for comfort. Set the minimum and maximum pressures both a 6.0 and set EPR to off or 1.
Okey dokey, then. I'll just switch over to fixed pressure. The oximeter will be here Wed. And I have my SIBO breath test that morning, so who knows what my guts will feel like! I have to take lactulose for that. I'm not a sugar lover.
RE: Soon to start CPAP - Question on dehydration - picante - 12-17-2018
(12-17-2018, 10:22 PM)bonjour Wrote: 6 is the minimum that most people can tolerate so let's start there. Expect us to help you titrate up to a comfortable level, but with longer periods of time. Your comments as we do this will be very important.
Thank you so much! It's a bit confusing just judging from gut-aches, since I've been getting those just from eating. That's why I've been losing weight since spring.
But the aerophagia is a whole 'nother level of gut-ache, and it doesn't come on suddenly from eating; it comes on slowly during CPAP; and every time I get up in the night I burp, plus some flatulence (but not nearly enough to relieve the gut-ache). Night before last I even felt a sensation in my esophagus once, of it being blown open. I swear.
RE: Soon to start CPAP - Question on dehydration - picante - 12-17-2018
In my panic over accelerated weight loss, I've neglected to mention some of the benefits I've been getting from nights when I'm getting more sleep or perhaps just more O2 into my bloodstream.
This does not follow any indicator I can discern, like AHI or event numbers or time spent on the machine. Some of my better days have followed nights with lousy statistics. I've been tracking this in the notes section of Sleepyhead.
1. No daytime air hunger - when this happens, it's life-changing. It's my most disabling symptom. It's why I spend a lot of time horizontal.
2. Brain feels more awake, energized and clearer. Like someone took Windex to my brain. Less drifting & getting sidetracked. Better information processing and focus.
3. My daily neck spasms go away. (An immune activation symptom, along with swollen/congested neck lymph.)
4. Less daytime polyuria, less dehydration. (A post-exertional & autonomic symptom.)
5. Blood pressure more stable (no plunges into 80s/50s). (An autonomic symptom.)
6. Greater tolerance for exertion (which is severely limited for me). I've actually been running some errands the last couple weeks, other than medical appointments.
RE: Soon to start CPAP - Question on dehydration - picante - 12-18-2018
Well, that was enlightening! I'm back in compliance at 4h 16m. Flow limitation is a more compact graph, with a lower max, but 95% is as high as I've gotten. Tidal volume down a bit.
Only 1 obstructive, and CAs are down.
[attachment=9457] [attachment=9456]
RE: Soon to start CPAP - Question on dehydration - picante - 12-18-2018
I took a break from 1:10 to 5:40, hoping my sinuses would open up, but no dice, so I did a 2nd sinus rinse and put the mask back on.
I was far more comfortable with EPR than without, which always seems suffocating. In my backpacking, XC skiing & peak bagging days, my worst weather experiences were high winds. Suffocating.
I'm tired and a bit brain-fogged, but not groggy. Nowhere near as brain-exhausted as yesterday, when I was also in an anxious state, wearing myself out trying to get ahold of doctors' offices. Trying to get around all the machines and talk to a person.
No air hunger yet. I do have a gut-ache, but it must be residual air working its way out -- that and taking ascorbic acid at 1:30 am to relieve constipation. Since I've been a breatharian, my bowels have gone on vacation 3 or 4 days out of 5. Trop déssechée pour déféquer. (That's in French bc everything sounds better in French.
) Anyway, Mg at bedtime and ascorbic acid did work.I had no burping getting up at night, and no awareness of swallowing air, except maybe once. I'm hoping for more hunger today. Already had 2 eggs and 1/2 piece of toast.
RE: Soon to start CPAP - Question on dehydration - Sleeprider - 12-18-2018
Let's stay at 6.0 pressure with EPR 1 and make sure we have good results. Based on a good event rate and no aerophagia, this is a good setting for you. I think we will want to see your oxygen results. The events are short duration and completely acceptable, but your tidal volume is low enough that I think adding oxygen will make this the best option. We can try a higher pressure of 7.0, but I would advise against higher pressure at this point. Events are 75% central here and higher pressure is not the solution.
RE: Soon to start CPAP - Question on dehydration - Gideon - 12-18-2018
Looks good!!!. I would suggest leaving the settings as they are. They seem to be working for you. Let's wait and see what your O2 readings are once you get that setup, that is as long as this holds up and is good for you.
RE: Soon to start CPAP - Question on dehydration - picante - 12-18-2018
(12-18-2018, 03:53 PM)Sleeprider Wrote: We can try a higher pressure of 7.0, but I would advise against higher pressure at this point. Events are 75% central here and higher pressure is not the solution.
I agree with staying at 6 cm for at least the time it takes to get the residual air out of my intestinal tract. Fluctuations seem to be the norm for me, anyway, so I'm expecting some. I may actually learn to breathe deeper at low pressures; my body's been fighting hard against the 10-12 cm pressures! It may decide to fight less.
Looking at the 2 tables: What is the column Sleep %? Percentage of time I was asleep or percentage efficiency? The 100% on the first row is extremely suspect. It's just as suspect as the low desat and low apnea & hypopnea on the last row.
RE: Soon to start CPAP - Question on dehydration - picante - 12-18-2018
(12-18-2018, 03:59 PM)bonjour Wrote: Looks good!!!. I would suggest leaving the settings as they are. They seem to be working for you. Let's wait and see what your O2 readings are once you get that setup, that is as long as this holds up and is good for you.
Getting another titration with 02 is going to be a challenge, since I can't get an appointment anytime soon with either the sleep doc or the neurologist. The sleep doc will have openings at some indefinite time in January when he adds more consultation hours. I'm not holding my breath. The neuro is booked up through March.
Tell me how the system works. Can a PCP refer me for another titration? I can see her as soon as January 9th. Can she simply order oxygen without doing the titration? (Probably not -- how would you know what settings.)
Can the GE refer me? I'm seeing her tomorrow for the SIBO breath test. Note: she's a PA, not an MD. The sleep center here is good about getting insurance pre-authorizations.