I could use a little help, please!

I could use a little help, please! - Printable Version

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RE: I could use a little help, please! - Sleeprider - 02-25-2017

Hockenberry, I notice you do not use the AFlex on your machine. Have you ever tried it? Also, after considering your flow rate graph, I think you are still exhaling through your mouth, and this may be a coping mechanism for the CPAP pressure. AFlex may help that, but my comment on bilevel would be more applicable if this is so. If you are unable to exhale against pressure, you are losing therapy on every breath. A bilevel machine could make that tolerable and give you much better, more restful results. As an interim measure, I think you should turn on AFlex and see if it helps to mitigate this problem. It's a long way from bilevel (BiPAP), but perhaps better than nothing.

RE: I could use a little help, please! - Hockenberry - 02-25-2017

(02-25-2017, 10:37 AM)Sleeprider Wrote: Hockenberry, I notice you do not use the AFlex on your machine. Have you ever tried it? Also, after considering your flow rate graph, I think you are still exhaling through your mouth, and this may be a coping mechanism for the CPAP pressure. AFlex may help that, but my comment on bilevel would be more applicable if this is so. If you are unable to exhale against pressure, you are losing therapy on every breath. A bilevel machine could make that tolerable and give you much better, more restful results. As an interim measure, I think you should turn on AFlex and see if it helps to mitigate this problem. It's a long way from bilevel (BiPAP), but perhaps better than nothing.

I was using AFLEX, but turned it off because it seemed out of time, with my breathing. I don't think I can be mouth breathing, even on exhale, because, I still use a chinstrap, or my mouth drops open, and big leaks occur, also, I don't wake up with dry mouth, during the night, or in the morning. I do snore on exhale sometimes. I will try turning the AFLEX back on, to see if it helps. Would CFLEX be better, if you suspect it's an exhale problem? Also what setting?

In your other post, you asked about my sleep study. It was in the late '90s and I don't have a copy, anymore. I remember it taking 45 minutes or so, to hook up all the wires, and they said I quit breathing 50 times, in the time I was asleep, I think I'm going to have to have another study done, I discussed it with my GP at my physical, last month, and he'll refer me, when I'm ready. I've been wanting to get medicare, to pay for some of this, but I'll wait till I see my ENT, on the 16th.

RE: I could use a little help, please! - Hockenberry - 02-25-2017

(02-24-2017, 11:01 PM)Beej Wrote: I've had some sinus issues myself. My ENT recommended using saline rinses when a sinus infection started up, to help rinse out infectious material and help you breathe a bit better. Do check with your doc on that if you have any reservations or concerns about doing this.

Thank you for the input Beej. I recently started using my Neti pot again, and thanks to your post, I did a little checking, and found that I wasn't using enough salt, in my rinse, (my memory failed me yet again). How often do you think is wise, to rinse?

RE: I could use a little help, please! - Sleeprider - 02-25-2017

Hockenberry, I'll be very interested to hear what your study reveals. You may not need an untreated diagnostic study, so be sure to specify you want titration study. If nothing else, a 2-part study with diagnostic and a titration should be scheduled to avoid extra costs. You have a very unique respiratory pattern, and I hope you will discuss this with your doctor ahead of scheduling a study. At the very least, an oximetry evaluation of your nightly SpO2 should be done to see if your fatigue is related to serious oxygen desaturation. I think you'd benefit from bilevel therapy, but obviously this is something that a professional should consider. Just as an example, here is a clip of my respiration on bipap, and a far more typical pattern:

[Image: XSMHAy4h.png?1]

RE: I could use a little help, please! - Beej - 02-25-2017

My ENT said that when an infection is coming on to go with 5 - 6 rinses spread out over the day.

He also indicated that a very minimal amount of using something like Afrin nasal spray would help some. Since it may be a bit stimulating, I'd only use it in the morning. Also, regular use may result in the tissues adapting to the drug presence and then trying to discontinue it results in some rebound congestion for several days until the tissues reset to normal function.

RE: I could use a little help, please! - Hockenberry - 02-25-2017

(02-25-2017, 06:56 PM)Sleeprider Wrote: Hockenberry, I'll be very interested to hear what your study reveals. You may not need an untreated diagnostic study, so be sure to specify you want titration study. If nothing else, a 2-part study with diagnostic and a titration should be scheduled to avoid extra costs. You have a very unique respiratory pattern, and I hope you will discuss this with your doctor ahead of scheduling a study. At the very least, an oximetry evaluation of your nightly SpO2 should be done to see if your fatigue is related to serious oxygen desaturation. I think you'd benefit from bilevel therapy, but obviously this is something that a professional should consider. Just as an example, here is a clip of my respiration on bipap, and a far more typical pattern:

I will definitely keep you informed, Sleeprider. It will probably be later in March, as I want to see my ENT first, at least, that makes sense to me. And thank you for taking the time to look at my data, and posting your thoughts.

RE: I could use a little help, please! - Hockenberry - 02-26-2017

Here is the new data, with AFLEX turned on:

And, with the flow rate zoomed out:

This is fairly typical of the whole graph, some small areas look better, and some look worse. Even though the AH/I rate is higher, I actually feel a little better today.

RE: I could use a little help, please! - Sleeprider - 02-26-2017

Hockenberry, if you want to see if higher pressure can help resolve some of the hypopnea, you can do a trial at higher pressure. I'm not seeing anything negative from using Flex, and I think the hypopnea events are a natural consequence of your respiratory pattern. Since you feel better today, that's a good thing. I would take pressure increases slowly and see what direction things trend.

It would really help if you would post your graphs on Imgur since every time you replace them as attachments, we lose the information as a reference point. The name of the game is whether things are getting better or worse, and when the previous data goes away, that is a hard judgement to make.

RE: I could use a little help, please! - Hockenberry - 02-26-2017

(02-26-2017, 06:06 PM)Sleeprider Wrote: Hockenberry,

It would really help if you would post your graphs on Imgur since every time you replace them as attachments, we lose the information as a reference point. The name of the game is whether things are getting better or worse, and when the previous data goes away, that is a hard judgement to make.

Rookie mistake, won't happen again. I posted them on Imgur again:

RE: I could use a little help, please! - Hockenberry - 02-27-2017

(02-26-2017, 06:06 PM)Sleeprider Wrote: Hockenberry, if you want to see if higher pressure can help resolve some of the hypopnea, you can do a trial at higher pressure. I'm not seeing anything negative from using Flex, and I think the hypopnea events are a natural consequence of your respiratory pattern. Since you feel better today, that's a good thing. I would take pressure increases slowly and see what direction things trend.

Sleeprider, I raised my pressure to 15.5, and the AH/I went up with it. I'm guessing it's positional, maybe my chins to close to my chest, since some of the OAs are in clusters. I think I'll try using my wedge tonight, and see if that helps, what do you think?