Fired My Sleep Doctor

[Julie]

Why don't you quit horning in on other people's threads.

[Paper_Nanny]

Paper_nanny, you don't give your location. Someone might know of a good sleep specialist in your area. Or, if you're near enough to a major metropolitan area to make occasional visits, you might look into a sleep specialist at a major medical center or university hospital.

I updated my profile to include a general location.

That's what I'm doing--I'll be traveling 4 hours to Los Angeles and staying one night in order to see the fellow who wrote the book on REM behavior disorder, who is at UCLA.

Oh, that sounds promising! I hope you get the answers you are hoping for.

I'm wishing you the best in finding a solution!

Thanks.

[Paper_Nanny]

12/13/16-- Surgery to replace medication pump. Resulted in dose change. (AHI went up, events were almost exclusively central apnea).
03/10/17-- Increase in medication dose.
03/21/17-- Sleep doctor changed settings on machine. (Events now almost exclusively hypopneas).
04/07/17-- Change in timing of medication, but no change in overall dose.

In case this adds anything, here are some Sleepyhead Overview Screenshots of the various time periods. I don't think usage or session times really add anything, but I couldn't decide what to put up there instead. If anyone has any requests, I will put up different shots.

02/28 to 03/09-- Ten days prior to medication change on 03/10



03/10- 03/20-- Medication change to change in settings



03/21- 04/06: Change in settings to change in timing of medication



04/07- 04/23: Change in timing of medication to change in machine settings



04/24 to 04/30: Changes to machine settings

[Paper_Nanny]

Last night, I reset my machine to the settings it was at following the appointment with my doctor on 03/21, with the exception of the BPM. He had set it at auto and I left it at 6. Although these settings produced inconsistent results, it seemed like overall, they were better than with the machine set less restrictively. I don't know why that would be the case.

Settings were:
Max Pres: 16.0
EPAP Min: 7
EPAP Max: 12.0
PS Min: 2
PS Max: 6.0
BPM: 6

After posting the various overview screen shots yesterday, I saw that there was a four day trend of decreasing AHIs between 04/20 and 04/23. I wonder if the medication change on 04/07 was causing some instability in my breathing and by the 04/20, my brain was figuring it out. I'm not sure the data supports that much, or if it is more my desire for understanding that is behind that. I will be having additional medication changes in the future, so I will see what happens with those.

I am hoping the results from last night weren't an isolated improvement. I would hope that eventually, I could get my AHI lower.

One thing I noticed in the results from last night are there are a lot of flow limitations flagged. I haven't really seen that in my results before. I was sleeping on my back quite a bit. The two nights before that, I moved so little in my sleep that my body hurt on the side I had been sleeping on. I was too sore to sleep on either side last night.



There were a few times the flow rate looked messy. My breathing during that time wasn't following the pattern for several breaths. It may be just one of those things people do in their sleep that looks interesting on a graph but doesn't mean much.