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+--- Thread: I could use some help (/Thread-I-could-use-some-help)
RE: I could use some help - tiredaf - 02-13-2023
Noted. I've made the changes of EPR 1 and pressure range 6-13. Looking forward to seeing what happens. Thank you
RE: I could use some help - quiescence at last - 02-13-2023
All your charts I've seen from about 20 Jan to present showed that you are getting OAs in EPAP pressures below 7.0. Your current setting of EPR=1 and pressures of 6 - 13 will have you bobbing up and down from EPAP of 5 - 12, and I would expect that OAs and Hs will happen as much as before.
Did you read up on license and know that compliance is contingent on AHI below 5.0? I never looked into that, but usually compliance is based entirely on usage of 4 hours for xx% of the last xx days.
We will wait to see your chart, but would suggest your sweet spot may be more like start pressure of 9.0 and EPR=1 (which would get your EPAP starting at 8.)
QAL
RE: I could use some help - tiredaf - 02-13-2023
Yes, I may be compromising my OAs but right now, these CAs are the majority of my problem. The OAs can possibly be mitigated by side sleeping which isn't an issue IF I can keep the air leaks down, hence the small drop in my pressure range.
FAA compliance for new diagnoses is 75% of 30 days with 6 hour usage with AHI of 5 or less. Then 90 days, then yearly.
RE: I could use some help - tiredaf - 02-14-2023
I wouldn't say it was wildly successful, but it was a pleasant surprise to see an improvement after turning the pressure and EPR down. I'm hoping the TECSAs eventually clear up with continued treatment. I realize that one night isn't a trend but I'm keeping my fingers crossed, thanks again for all the help and advice.
RE: I could use some help - Sleeprider - 02-14-2023
This has gotten to more acceptable levels, and I expect you will see further improvements in time. We have a rarely used trick up our sleeve that can reduce CA by conserving a small amount of re-breathed air to increase CO2 slightly. Its called Enhanced Expiratory Rebreathing Space (EERS) and there is a wiki. http://www.apneaboard.com/wiki/index.php?title=Enhanced_Expiratory_Rebreathing_Space_(EERS)
I'm not suggesting you need this, but if you're particularly handy, it's not a difficult modification to the mask.
RE: I could use some help - tiredaf - 02-14-2023
Whoa, that's really interesting. I'm hoping it doesn't come to that but it's good to know there are other avenues if needed. Thank you!
RE: I could use some help - tiredaf - 02-19-2023
I'm going to post 3 consecutive nights after I made the last pressure changes. This is a good summary of what has been happening since I started treatment, I began using the machine every night in earnest on December 27th and have only missed 3 nights since. After every change I make, my CAs drop, which is very encouraging...but then they slowly climb back up every night.
Last night, out of discouragement, I slept without the machine and honestly I forgot how nice it was to sleep all night without waking up, trying to get comfortable, fidgeting with the mask, trying to convince myself that this machine is actually helping. If sleep is so important, how is it healthy to be up tossing and turning all night messing with this stuff??
If it weren't for the FAA requiring me to get my AHI below 5 asap, I would've given up by now. I'm still holding out a bit of hope that the CAs are TECSAs but any idea how much longer will this take? I'm willing to keep trying but I feel like all these adjustments are just temporarily showing false progress. My sleep doctor is all but useless so I can't express how much I appreciate the help I've gotten from you folks but man, this is so very discouraging.
RE: I could use some help - tiredaf - 02-19-2023
I tried to include this 4th night in my previous post but it would only allow those 3 nights.
Something I should include, I'm currently being treated for hypothyroidism (which I've read can be linked to CAs) even though my numbers are now within acceptable range and I was being treated during my initial sleep study which showed very few Central Apneas (2)
I've also recently started taking magnesium threonate an hour before bed to help keep me asleep throughout the night.
RE: I could use some help - Gideon - 02-19-2023
By any chance can you get a ResMed VAuto for a trial?
If it wasn't for your need to be immediate for your FAA compliance I wouldn't worry about it.
There is a setting called Trigger which slightly modifies the VAuto's response by making it more sensitive to the change from exhale to inhale thus you spontaneously initiating a breath where a Central Apnea would have occurred.
If not do the EERS. I doubt you will need it long term but this can keep your CO2 levels above your apneic threshold.
Between the two I'd prefer the VAuto.
RE: I could use some help - Sleeprider - 02-19-2023
Please post a zoomed view with a 3-minute duration showing how any central events evolve. Be sure to include the flow rate, mask pressure and flow limitation. I think we are seeing incorrect apnea flagging, but only the close view of the event will tell us.