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+--- Thread: Please help with treatment review (/Thread-Please-help-with-treatment-review)
Numbers mean nuthin. - DaveL - 11-24-2021
Today AHI=.45 Massive leakage. Feel tired as a son of a gun
Yesterday AHI= 2.18 New mask. No leakage.
Life goes on. thank heaven.
edit:
2nd night for a new mask. Reason I changed to a new N20--extensive leakage. First night was ok; however, AHI was high for me.
Last night I fitted the mask better. I didn't tighten it; i just evened out the fit.
Lately I've been falling asleep. I've never fallen asleep driving. However, sit me down and I fall asleep in no time. Tired. No energy. Watching tv is a disaster, and that's been going on a long time. I'm trying to find the energy I need. Feeling darn old.
Snakes & Ladders - DaveL - 11-26-2021
When I got my Knightsbridge Dual Band headcap I thanked Larry. I had no leakage! It was the best chinstrap I've used.
Now I have a love/hate relationship with it. Actually with them....I bought two of them way back about a year and a half ago.
On days it works, I love it.
On days when I have serious leakage I hate it.
Larry has revised his site. It's better. He would have saved me a lot of money because I had to buy another mask and that cost $325 Canadian. Because the Knightsbridge Dual Strap interferes with my medium N20 head gear the way he had me put it on.
The new site says either:
* put the cap on first then the mask (that's how I interpreted his instructions and videos way back) Doing that the magnets on the lower straps popped off So I bought a large N20 with a Large insert
* or: put the mask on first then the Knightsbridge Dual Band on. Doing that the only downside is I end up with mask strap marks that last 1/2 a day.
Hate Love--see the leakage using the N20 medium mask with the KDB put on over it. This is a brand new ResMed N20 medium mask.
I've never seen the likes of this--angry at myself - DaveL - 11-27-2021
Last night I taped my lips. Wore my ResMed N20 mask.
Guessing I didn't tape right?
BUT I've never seen such rounded waves....
Please give me assistance. Thanks.
Reacting to issues with the Knightsbridge chinstrap I decided to tape. Figured I would see zero leakage. Nope. Bad leakage....
I don't know what it is. Mouthbreathing? Corners of my lips? Darn tape hurt my lips pulling it off. 3M white stuff. Won't this treatment ever work? Zero energy. Feeling brain fogged. what's the point?Been a hoser for about 30++ years.
RE: Please help with treatment review - sheepless - 11-27-2021
they say spikey leak graph lines are mask leaks and flatter topped ones that last longer are mouth leaks. looks like you had plenty of both but the biggest ones were mouth leaks. must have been a problem with taping. I've never used it so I can't help there. roughly 12 minutes over the red line: not great but not really bad either. leaks don't appear to have awakened you, at least not to the point of masking off. I don't see anything particularly unusual in these charts.
RE: Please help with treatment review - DaveL - 11-27-2021
Thanks sleepless! Much appreciated.
RE: Please help with treatment review - DaveL - 11-27-2021
sheepless please look at these two charts.
I am amazed at how regular and round my breaths are using just tape on my lips with my ResMed N20 mask
I've used chinstraps for years. And PapCaps and now Knightsbridge straps for years too. The other chart shows irregular breaths. That has concerned me as long as I've used SleepyHead and OSCAR.
Is there an advantage in having waveforms like this? Should I tape my lips in future?
Thanks,
Dave
RE: Please help with treatment review - sheepless - 11-28-2021
I see what you're saying. tough to compare only 2 charts and expect to understand what's going on though.
11/20/21, min 14 / max 19, epr 3, leak rate 21.6, flow limitation .01: higher ahi, mostly ca, and lower overall flow limitations despite the flow limited screenshot.
11/26/21, min 13.4 / max 19, epr 2, leak rate 24, flow limitation .06: lower ahi, higher overall flow limitations despite the less flow limited screenshot.
looks like you're proof that epr 3 is better for flow limitation and worse for ca. you're probably one of the many of us that has to thread that needle between fl, which is obstructive, and ca.
leaks in both charts aren't horrible but could be considerably better and may be influencing both your charts and how you feel.
so how do you feel? can you feel a difference between these 2 chart settings?
I haven't re-read 47 pages of posts and can't tell without full night charts but do you need pressure this high for oa? if dropping pressure doesn't substantially increase oa, it would help with leaks and ca and might allow you to set epr to 3 to help with the fl.
have you tried a tighter range between min/max or a fixed setting?
I have problems with lip leaks. for me, a collar helps the most, followed by keeping my pressure, especially max pressure, as low as I can. apap pressure can runaway against flow limitations so dropping that as much as you can might help.
I've no idea why taping would result in a rounder flow rate waveform (but remember, slightly worse overall flow limitation that night). it doesn't appear to have dropped your leak rate so one would think it's not very effective for you so far. it may take some tweaking to get tape to be more effective at which time it may be easier to draw conclusions.
how does taping/not taping affect your snore rate?
I'm not much help here, sorry. both charts are pretty good overall. I think it comes down to what feels better. personally I think I'd rather have higher fl and lower ca but that's just me.
RE: Please help with treatment review - DaveL - 11-29-2021
Sheepless I truly appreciate your help and comments.
I haven't been able to attach a photo of my sleep report from an app on my iwatch6
It shows 3 major interruptions (awake periods) on most nights. 2 very occasionally. A good night I have one hour of deep sleep.
taping
I've taped now for about 4 nights. The only difference is the very smooth graphs for every breath. I've always had extremely jagged graphs for every breath. That's not natural at all and has concerned me. I've been on cpap now for 30-35 years and wondered if I'm lazy breather with all this help.
I've never seen these gradual, symmetrical and pleasing graphs using my home-made pad or the Knightsbridge Dual Strap. My home made pad is a simple soft pad held in place with an old strap from some camera bag. Strap around my neck, and quite tight. I've used the Dakota pad thing. I've tried so many chin straps. My home-made pad works the best but the flow rate pattern zoomed in looks terrible for each breath.
setting
That's what was recommended when I started with my apap *for her* end of August over a year ago. Prescription is for 13 (after years at 11) That was after my first sleep study in more than 10 years. Prescription was for a cpap. (Ontario Canada thing...cpap nazis say "no apap for you!") The ResMed apap *for her* is registered as a cpap here in Ontario. So I'm at 13.4 IIRC, and using EPR=2.
Recently saw Lanky Lefty's video saying that pressure change wakes people up....
snore rate
almost always 0; maybe one incident a night.
taping
don't know how old the tape I have is...but it's super sticky. 3M for sensitive skin. I'm going to buy a new roll of tape. (I worked for 3M in a factory for 15 years. I'm allergic to some of their solvent based adhesives....but not this tape.) I've been watching what others are using and appreciate all their posts.
Feeling.....
Well O two is about 95% generally. I'm grateful for that.
Frankly I feel exhausted. As if the treatment isn't working. Or I'm not getting enough sleep. I keep trying to get more by going to bed earlier. Life gets in the way.
I used to think I could count the nights where I woke up refreshed on the fingers of one hand. Over 30 years of treatment...Now I feel it's getting better. But I fall asleep in front of the tv and then hear that I'm ignoring SWMBO.
Frankly I'm embarassed and angry at myself.
Dave
RE: Please help with treatment review - sheepless - 11-29-2021
check back through a bunch of your pressure graphs to see how high it goes. 1st see if it gets up near your max of 19. then look there & anywhere it's above your min, since that's already slightly higher than your prescribed pressure, say above 14, looking to see if these higher pressure areas are associated with flow limitations. I'm wondering if reducing pressure, max to start, & maybe min a little later, will help reduce ca, leaks and maybe allow you to use epr 3 which is more effective against flow limitations than higher pressure.
i've had central apnea since i was 17 and probably before that, morphing over the years into mixed apnea. untreated until i was 60. i was in pretty bad shape, physically & mentally, for years before pap. after 5 years of pap, i'm much better but nowhere near as rested & energetic as i'd like. I still wake to the point of masking off from 4 to 12 times a night. i have to remind myself that 1) apnea caused a lot of damage i might not ever fully recover from and 2) i have to consider that lifestyle, time & aging are likely to be contributing factors. at risk of stating the obvious, the point is that how we feel isn't only a function of how effective our pap treatment is. your charts look pretty good. if rounded curves feel better, even just psychologically, stick with the settings that produce that.
meanwhile, we aren't getting any younger; if you haven't done so lately, it couldn't hurt to take your concerns to your doctor to be checked for other health issues to treat or rule out. it's uncomfortable for some of us but it may be necessary to be insistent with our providers to get the attention we need.
RE: Please help with treatment review - DaveL - 11-30-2021
sheepless wonderful post.
I truly appreciate that you have helped so much.
I went after my family doc for a year and a half to get a referral to a sleep doc. And then it was his idea!
I'll look at my max pressures--I'm sure I can reduce them.