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1 month review please?! - Printable Version

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1 month review please?! - FrankNichols - 05-04-2016

Well, I have survived 1 month. I have flip flopped between the F10 and P10 and ended up with the F10 because I was unable to conquer my mouth breathing. (I will visit that beast again later...I really like the P10)

I have a Doctors followup in 2 days and I plan to take a netbook with SH on it so we can review my data if he doesn't look at it in ResScan.

Overall I have averaged around AHI 7.5, I hit 3.5 ONE day and have hit as high as 25 one day. Most of the time during any one night my AHI is around 2 or 3, but I tend to have clusters which drive the overall average up. Those clusters go as high as AHI 50 to 60 for 20 to 30 minutes per cluster. Usually 1 cluster per night, but on really bad nights 2 or 3 clusters. The clusters seem to be related mostly to highly variable breathing rate areas - which some here have indicated could be REM sleep periods. (none last night)

I have attached two shots from last night. A full night with a lead in nap during the afternoon, and a zoom in on a very small (almost not worth calling it that) cluster.

RERA's seem to always make the highest percentage, or they are in second place. CA and OA flip flop between 2nd and 3rd place percentage wise.

Interestingly, I tend to do things backwards, now that I am starting to get this under control, I am sleeping less. Previously I was sleeping maybe 8 to 9 hours a night with occasional naps in the day time. I never really needed a nap, but if I was in the mood, or wanted to test something, I could lay down and fall asleep for 30 minutes easily. Now, I am down to 5 to 6 hours at night with a nap if I want to during the day, but in general I am still basically tired most of the time.

So, I would appreciate some help evaluating this and interpreting it for what to do/focus on going forward. I "think" the leaks are mostly under control at this point, obviously they could be better, but I will take what I have, I am pretty sure the only "large leak(s)" are when I scratch my nose.

[Image: SH1.png]

[Image: SH2.png]

RE: 1 month review please?! - zonk - 05-04-2016

The machine report RERAs but RERAs are not part of AHI
If were me, I set the machine on auto, something like 8-12, let the machine do the work and see what pan out
I use nasal mask and the chinstrap helps minimize mouth leaks YMMV


RE: 1 month review please?! - FrankNichols - 05-04-2016

(05-04-2016, 03:32 AM)zonk Wrote: The machine report RERAs but RERAs are not part of AHI
If were me, I set the machine on auto, something like 8-12, let the machine do the work and see what pan out
I use nasal mask and the chinstrap helps minimize mouth leaks YMMV

Apparently Sleepyhead considers RERAs to be part of it's reported AHI - Sad

I tried several versions of chin straps and never succeeded. I even took a 4 inch ACE bandage and wrapped my face up so I looked like a mummy, and managed to breath through my mouth somehow - lol...

I am holding off using Auto mode until after I speak with the doctor. He was opposed to getting an Autoset to start with saying that my sleep study contra indicated APAP mode, I think he was mainly concerned with the Centrals in the Sleep study. That is one thing I want to discuss with him Friday.


RE: 1 month review please?! - zonk - 05-04-2016

(05-04-2016, 03:39 AM)FrankNichols Wrote: Apparently Sleepyhead considers RERAs to be part of it's reported AHI - Sad
Not really ...
1st chart ... AHI 7.68
CA 3.43 + OB 1.38 + Hypopnea 2.45 = 7.68

The AutoSet in autoset mode only score central apnea but does nothing for it, no pressure increase
Only increase pressure in response to apnea (obstructive), snoring, and flow limitation (pre-cursor to obstructive apnea)



RE: 1 month review please?! - FrankNichols - 05-04-2016

(05-04-2016, 03:54 AM)zonk Wrote:
(05-04-2016, 03:39 AM)FrankNichols Wrote: Apparently Sleepyhead considers RERAs to be part of it's reported AHI - Sad
Not really ...
1st chart ... AHI 7.68
CA 3.43 + OB 1.38 + Hypopnea 2.45 = 7.68

The AutoSet in autoset mode only score central apnea but does nothing for it, no pressure increase
Only increase pressure in response to apnea (obstructive), snoring, and flow limitation (pre-cursor to obstructive apnea)

Oops! Thanks for pointing that out. Since the pie chart shows the RERAs I never bothered to add them up. Maybe including RERAs in the pie chart should be optional.


RE: 1 month review please?! - sdb7802 - 05-04-2016

Frank,

When I first started cpap, I used a nasal mask and a chin strap (for the mouth breathing). After a while, I ditched the strap and basically stopped mouth breathing and eventually moved to the pillows. Every now and then, I have a problem but it's rare. I seemed to have trained myself to keep my mouth shut (at least at night). Still working on the rest of the day.

RE: 1 month review please?! - FrankNichols - 05-04-2016

(05-04-2016, 05:22 AM)sdb7802 Wrote: Frank,

When I first started cpap, I used a nasal mask and a chin strap (for the mouth breathing). After a while, I ditched the strap and basically stopped mouth breathing and eventually moved to the pillows. Every now and then, I have a problem but it's rare. I seemed to have trained myself to keep my mouth shut (at least at night). Still working on the rest of the day.

well, I tried two chin straps, no chin strap and an ace bandage over a period of about 2 weeks. Here is one of my better days - notice the large leaks - lol...

[Image: SH3.jpg]

RE: 1 month review please?! - sdb7802 - 05-04-2016

What about surgical tape. No joke. Not an insult.

I realize your post is mainly for SH analysis.

RE: 1 month review please?! - FrankNichols - 05-04-2016

(05-04-2016, 06:01 AM)sdb7802 Wrote: What about surgical tape. No joke. Not an insult.

It's possible, I am going to use my F10 for a while until I get my AHI down below 5, then one that is stable, I will try again to find a way to keep my big mouth shut - it has always gotten me into trouble, now it is doing it here too Smile


RE: 1 month review please?! - OpalRose - 05-04-2016

Hi Frank,
I notice you don't have Periodic Breathing listed in your events graph. Be sure it's checked on the drop down box at bottom right of page.
It's possible you didn't experience PP, but would be good to see along with the Clear Airways.

It's looks like going from a pressure of 10 to 11 caused even more clear airway events.

I would be curious what your doctor will recommend. Putting you in APAP mode with a higher pressure may or may not cause even more clear airways, but will take care of the hypopneas, Obstructives, and RERAs.

RERAs are important (even though they are not counted in the AHI), because they disrupt your sleep. They cause mini arousals.

They will probably try bipap, but it's possible you will need to be on an ASV machine. Dont-know