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+--- Thread: JasonR newbie... looking for advice! (/Thread-JasonR-newbie-looking-for-advice)
RE: JasonR newbie... looking for advice! - Sleeprider - 03-23-2021
I think with your very low pressure need and history of CAs, I will suggest starting at EPR 1 or 2 and not jump straight to 3 cm. Increasing minimum pressure to 6 or 7 will stabilize therapy.
RE: JasonR newbie... looking for advice! - JasonR - 09-16-2021
It's been a while so I thought I would give an update and see if there are any settings I can tweak. My most recent charts attached!
I've been adjusting the pressure over the last while and I think 7 works well for me. EPR off, otherwise my CA's increase. Maybe I'll introduce EPR 1 at some point but I don't feel like I really need to. I'm surprised how different I feel on days when my AHI is < 1 vs > 1. Mask leaks have been an issue recently which I'm attributing to the fact that my headgear is now 6-months old and perhaps the velcro has stretched.
I was wondering if there is any benefit to lowering my max to around 9 to stop the machine from pushing too much air when a mask leak does occur? (according to my stats 9.44 was the 95% rate for the last 30 days)
Any hints or tips are appreciated!
RE: JasonR newbie... looking for advice! - JasonR - 10-06-2021
I bumped up the pressure to 7.2 and I feel even better. More vivid dreams if that's an indication of anything! There was an increase in CA's but I don't feel the drag in the afternoon that I was at 7.
Recent charts attached.
Be well! Jason
RE: JasonR newbie... looking for advice! - staceyburke - 10-06-2021
You are doing much better, congratulations. Your central are low and in fact they may not be real centrals by now. When we turn over or pull up a blanket we hold our breath and those are recorded as centrals (ca).
I would like you to look at the flow limits chart. A flow limit IS APNEA just like any obstruction type of apnea (both O and H events). They can and do cause sleep disturbances so once you get to the point you are at I would like to see if we can make the flow limits less.
Flow limits are made less using EPR. Yours is turned off. I would like you to turn it on and set it to 1. See how that effects your flow limits. And also see if it effects you centrals. If after a couple days and both look better go up to EPR 2. And if again, things are going well move to 3.
RE: JasonR newbie... looking for advice! - JasonR - 10-08-2021
Thanks for the advice staceyburke!
I've set my EPR to 1 for the past two night. New charts attached. How can I tell if it's making a difference? My CA's seems to be around the same.
RE: JasonR newbie... looking for advice! - quiescence at last - 10-08-2021
Just a personal view, but idiopathic CAs tend to occur more as the more washout of the lungs occurs, as the lungs like to have at least some CO2 left in them. Read forward, this means the more EPR you dial in, the more washout, and the likelihood of CAs that are not brain injury CAs will go up. Your treatment seems very effective at EPR of 0 and of 1.
Brain injury CAs will just be there pretty much alot and all the time. That is clearly not an issue with you.
Welcome, and enjoy wonderful restorative sleep.
QAL
RE: JasonR newbie... looking for advice! - staceyburke - 10-08-2021
I would go to EPR 2 and again check for centrals. If the stay under control your therapy will be better and your sleep should improve. Give it a couple of days and see if we need to move EPR UP OR DOWN.
RE: JasonR newbie... looking for advice! - JasonR - 07-18-2022
Thanks staceyburke! EPR set to 1 drops my flow limitations down. So that's good.
Just thought I would post some updated charts. I've been playing around with the user flag settings to get a better sense of any apneas that don't quite meet the definition but may still impact my therapy. I think 6-7cm is too low (feel starved for air) so I've bumped it up to 9 for the time being but have tested fixed pressures, etc. I can probably drop the max down to 11 or so since it rarely goes above that and most likely just disturbs my sleep when it does.
The o2 ring data allows me to better determine what are true CA's. From what I understand, a true CA is always followed by a drop in o2. From the charts you can see I have some true CA's but not many. I'm not sure what the CA's that are not followed by a drop in o2 are though. Maybe sleep wake junk? I have found my CA's most often occur in the latter half of the night for whatever reason.
Most recent charts:
[attachment=43381]
[attachment=43382]
[attachment=43383]
RE: JasonR newbie... looking for advice! - JasonR - 09-05-2022
At EPR 2 and 3 my flow limitations look great, I think. I've found with EPR 3 that my flow rate was more stable but I think it was dropping my EPAP too low so over the course of a couple weeks I did not feel as good. I switched back to EPR 2 and it's been better. I'm thinking of bumping my min pressure up to 11 and setting EPR back to 3 to see how that goes. Any thoughts on that?
As far as my mask goes... I've been using the N20 with mouth taping and that has been going well unless I sleep on my side and the masks gets pushed off by my pillow. I was thinking of trying the Evora Full Face mask thinking it might be a little more stable for side sleeping and I wouldn't need to tape every night. I've tried the P10's thinking something smaller would interfere less with the pillow but I cannot tolerate the sound they make when you exhale with them on. The N20 is a very quiet mask and I really like that. Any suggestions or recommendations for side sleeping masks?
Recent charts posted below. Please let me know what you think.
Jason
[attachment=44368]
[attachment=44370]
[attachment=44369]
RE: JasonR newbie... looking for advice! - JasonR - 10-14-2022
I wanted to do some analysis on my data so I exported it to CSV but I noticed there are some differences between what's on the detail stats page vs the CSV. Is this normal? Please see the attachment for what I'm referring to.
I was always looking at the stats on the detail page thinking my flow limits were OK at less than 0.1 but in the data, for last night, it's 0.19 (at 95%) which isn't so great. Just curious which data is correct? have I messed up a setting in Oscar somewhere to cause this?
[attachment=45247]
Thanks!