(06-17-2018, 02:57 PM)poppypete Wrote:

(06-16-2018, 04:18 PM)Sleeprider Wrote: In terms of SpO2 you're doing great.  Your AHI is not bad. The pattern of obstruction appears like positional apnea and events seem to be confined to a fairly short period(s) of time.  If you are still using the c-collar, just try to keep that positioned properly, and maybe we should expect that your AHI of 2-4 is just okay as long as you are feeling pretty good.  Your heart rate is not spiking and you no longer have O2 issues, so this treatment is helping you to heal, and we probably need to give that time.

The "answer" lies not in the numbers but how you subjectively feel.

Jason: "The mask pressure graph will show how your ASV is working to attempt to maintain the air volume and breathing rate to the last 3 minute rolling average your ASV was giving it all it had (25 cm’s of pressure)during this time but it was not sufficient. I would not worry about this low level of events, but as an education I see it as worthwhile question to ask and be answered.

I if you look at these apnea with mask pressure you will see the ASV is responding on a breath by breath basis attempting to encourage you to take a breath by boosting pressure support to the max but you do not breath yourself so an apnea is scored."

Sleeprider and Jason...

Combining the thoughts in these two replies from you both, and reflecting on my experience these past couple of months:

Last night:
I had 4hr 50min in my first session, mask on at 8.40pm...waking at 1.30am.
At 10.10pm (90min sleep), the mask pressure does reveal more...as hypopneas commence (questioning myself: have I gone over onto my back, or is this another sleep phase change happening?).
The second session commenced 5 minutes later @1.35am.
Again the mask pressure reveals change after 2.30am, but sufficient to only reveal 2H and a 17s apnea before I recall waking...but I did not rise this morning, choosing to recline and rest in lieu...until 4.4.48am.

Now given all my past experiences and to consider again the question I first raised related principally to what was happening to me back then; what occurred to me during my first oximetry reading 'test'; and what caused my hospital visit...the 'activity' I see today on my graph between 4am and 4.48am suggests strongly to me now, that the supine position (when I'm 'positional breathing' differently to when I'm on my side), gives me rise to think this may well be the final piece in my personal jigsaw.

So as Sleeprider so eloquently suggests: "The "answer" lies not in the numbers but how you subjectively feel.", my answer is that I did feel on waking, that my chest had had a workout (again)...however, far less severe than previously when I visited Emergency in concern.

When my partner later rises, I'm sure she'll add some comment to what no doubt disturbed her a little, after 4am...but in the meantime, would you two too, like to see anything more than this full graph of last night's results?

Cheers...and thanks again...poppypete

1. the Afib resolution;
   
2. patterns of sleep understanding; or just
   
3. time now required, over which time both myself and the machine will adjust more to each other...
   

• ...these 3 that is required for that greater improvement of lowering the AHI???
  

Thanks for your comments, as always...poppypete  

1. above 7hrs use;
   
2. mask seal;
   
3. less than 5 AHI; and
   
4. only 2 mask removals.
   

(06-19-2018, 02:23 PM)Sleeprider Wrote: Although the total number of hypopnea events are up, the UA is just about gone here.  I'd like to hold off on pressure changes until I see you try the soft cervical collar/ stop snore or similar positional therapy.  Most of your therapy time is quiet and uneventful, and this pattern of hypopnea and apnea events, just over one-hour in is becoming very familiar.

Something you probably didn't notice is your I:E ratio is in the normal range with longer expiratory time.  All hypopnea in your last chart are marked as 10 second, which is the minimum for Resmed to flag hypopnea, and may be due to the larger flows that precede them.  Resmed flags hypopnea based on a 30% reduction in flow for at least 10 seconds as compared to the 120 seconds prior to the event.  While I'd like to see  your respiration smooth out, what I'm saying is that these hypopnea may be non-events.

(06-20-2018, 02:04 PM)Sleeprider Wrote: Well I was beginning to doubt we'd ever see the day!  Congrats on the great results.  This is what we were shooting for.  Sorry it took so long.

(06-21-2018, 04:41 PM)Sleeprider Wrote: Mate, you're killing it!  What a great outcome for you.  Has your doctor had a comment?

What amazes me, is the breakthrough was just a small increase in EPAP min.

(06-21-2018, 05:51 PM)Sleeprider Wrote: How you feel counts. Are you seriously considering a return to CPAP?  Your choice if you choose to mention the use of the C-collar, but maybe sometime in the future, it's something to talk about so he knows it might help his other patients...they don't teach this stuff in school.

If I was in your place, they would have to pry my asv from my cold dead hands.  There is no comparison.