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+--- Thread: srwilsn3's therapy thread | APAP -> BiPAP (/Thread-srwilsn3-s-therapy-thread-APAP-BiPAP)
RE: srwilsn3's therapy thread | APAP -> BiPAP - srwilsn3 - 01-23-2024
Thanks PLAP.
I'll go the slow and steady route of .2 a night, monitoring as I go.
Still have to mention that the difference between "tired" now (which still sucks) and "tired" before I moved to BiPAP is immense.
RE: srwilsn3's therapy thread | APAP -> BiPAP - srwilsn3 - 03-10-2024
Hi all.
Seeing a lot (50% of total AHI) Clear Airways. My sleep continues to be mediocre.
Would love advice. Lower EPAP slightly? Increase PS slightly?
RE: srwilsn3's therapy thread | APAP -> BiPAP - Sleeprider - 03-10-2024
That is not "a lot" of clear airway events. On average it is well under one per hour. It might help to look at a zoomed image of the flow rate at 2-3 minute resolution to see why it seems skewed towards expiration. Results don't suggest any changes are needed, but you can see if very-high trigger feels better or not, and it might clean up the few remaining CA.
RE: srwilsn3's therapy thread | APAP -> BiPAP - srwilsn3 - 03-10-2024
Yes. "A lot", I should say, in relative proportion. I'm not worried about any of my numbers in the abstract; all are quite low. I'm just still getting mediocre-to-poor rest from my sleep most nights.
I will try very high trigger. Perhaps that will change my subjective restedness.
RE: srwilsn3's therapy thread | APAP -> BiPAP - srwilsn3 - 03-10-2024
I am also attaching a zoomed in flow rate.
RE: srwilsn3's therapy thread | APAP -> BiPAP - grubsztyl - 03-10-2024
Your flow chart shows an unflagged RERA. The CA that you see is actually due to you hyperventilating after an arousal due to hypopnea, you can clearly see your flow flattening, it's so-called post arousal central apnea. The answer is to solve your hypopnea in the first place. I would say that you actually need more pressure. A lot of subtle arousals like this don't even get flagged... they might be the reason you don't feel rested even though your AHI is good.
RE: srwilsn3's therapy thread | APAP -> BiPAP - Sleeprider - 03-10-2024
Your flow chart confirms that you have a relatively rapid expiration that rebounds to near-zero flow for a second before inspiration begins. That contributes to the uneven expiratory side of the flow rate charts. There are two large inspiratory peaks in the zoomed chart that may be arousal or movement. There is some flow limitation following the first one, but that recovers to normal breathing. I don't see any flow limitation ahead of the second arousal or movement, so that is not RERA, but I do think it is a significant shift in position and the CA is a breath-hold. These gasps or arousals are a frequent feature of your charts and they are regularly spaced through the night. Whatever that represents, may be the culprit in your unsatisfying sleep. You may need to use a night camera or accelerometer (movement detector) to identify it and correlate it with what we're seeing your chart. Overall, your therapy and respiration looks good, but there are those frequent anomalies. The Y-axis range tends to accentuate them as you are set to -50 to +50. You could probably expand that y-axis to about 100 mL.
RE: srwilsn3's therapy thread | APAP -> BiPAP - UnicornRider - 03-10-2024
You have what appears to be a double CA down there about 01:45. could you zoom in on that ? Try to catch a little more of the breaths after the events.
Did you scroll through the zoomed in Flow Rate graphs to look for arousals outside of the flagged events?
Your leak rate is not sufficient to interfere with the AirCurve 10's ability to provide therapy.
But your leak rate may be sufficient to cause arousals and dry eye.
Have you reviewed the Mask Primer?
https://www.apneaboard.com/wiki/index.php/Mask_Primer
Be sure to read all the way down to "How to achieve the perfect mask fit - GUARANTEED! by Jeffy1958"
Jeffy1958 does an very good job of putting all of the information together for a good leak free fit.
I liked the Fit 20 mask with the memory foam, until I changed (probably weight loss) and could no longer get a good seal.
.
RE: srwilsn3's therapy thread | APAP -> BiPAP - srwilsn3 - 03-11-2024
Thanks all for the input as I try to track down why I'm still getting mediocre sleep. As a general trend, despite my numbers being so low, I tend to find my sleep is much more restful on nights when my numbers are exceptionally low, like last night. My AHI was 0.2 and I slept quite deeply and felt quite rested. Incredibly, an AHI of just 1 more can sometimes result in feeling unrested. A minor quantitative difference but a massive qualitative one.
Sleeprider:
I'm happy to use a night camera to capture and correlate my movement/position with my OSCAR charts. I will do so. What, in particular, should I be looking for? The conditions surrounding these CAs?
UnicornRider:
What would indicate an arousal outside of a flagged event in my Flow Rate graphs? I will look so I want to be sure what I should be looking for. Also, UR, as you requested, I have posted that zoomed in Flow Rate graph for my double CA. Please let me know if you see anything illuminating.
RE: srwilsn3's therapy thread | APAP -> BiPAP - Sleeprider - 03-11-2024
In monitoring sleep, you have those respiratory spikes about every 15 minutes. They are pretty easy to pick out on the charts. We don't know what those are, so the idea is just to observe if those correlate to movement or are just a deep breath.