Candidate for bi-level?

Ran a little experiment last night... turned off APAP and ran 14cm straight no EPR all night. Ended up having a series of RERA FL's with attendant leaking... interesting how the graphs track each other... along with the O2 desats... I must have had too much to dream last night.

Anyway my AS10 would normally ramp me up to 16 or 17 during these.. I show no movement during the RERA episode and the machine did not flag most of the RERAs. There was no movement so I assume I was really asleep the whole time. Normally I run 14-20cm APAP EPR 1... been off EPR completely last few nights.

Note the dipped waveforms that are pissing off the FL algorithm. I'm assuming that bi-level would help punch these back up. Anyway we'll know soon enough because I have a sleep titration coming up in a week... I'll come back with results.

https://drive.google.com/file/d/1zBJ-kY ... sp=sharing

Do you find it useful to track movement?

human wrote: ↑

Tue Mar 12, 2024 2:30 pm

Do you find it useful to track movement?

Well, yeah... that RERA episode had zero movement... whenever I wake I make a point of rolling to the other side, so I get a Movement reading. If I did wake it was not very much... which is bad too.

Paid the 1500$ in advance today... requested an Ambien from the sleep doc... which was approved. Dual CPAP/bi-level titration night of the 19th.

Had an excellent night at VitalSleep, Austin Heart Hospital, Jared Baker was my tech and he was awesome, we hit it right off. Folks, be nice to your tech, they can do a lot for you... but I'll never go back to that Austin Sleep Center lab again after cadillacking here! Hospital AC instead of commercial AC, ceiling fan in room, just more homey, there was a bottle of water on the nightstand! Snacks afterward, I got the cheese crackers. Nice thick walls, never heard a peep.

The machine used was an older Respironics biPap... seemed up to the job... I'd have preferred to have humidifier and heated hose, they did not provide that... the Ambien helped gloss over that. I did leave feedback about that. Also once inside the hospital you see they're on the 3rd floor... but no signs up there to direct you. Left feedback. Online registration asked for an 'MRN' number, which I did not have. Feedback done.

It did take a while to get to sleep... the tech spent more time on the biPap portion I think, since that was my main interest. Your conversations with your tech can help direct the therapy, be aware. He ended up the CPAP portion with me at 13cm, 1cm below what I run at home... but I never got on my back until the biPap part started. Took the pill around 10pm, my normal bedtime is much later... Ambien highly recommended, big guy like me take 2.

Around 01:30am I sensed the funny pressures and woke up... could tell he was adjusting them... I told him I was a side-sleeper mostly but he said I should give him some supine to work with during the second half. He worked his magic and I ended the night on my back and not choking! Turns out that the pressures needed to make this happen for me were 22 over 18... a territory I would not have dared enter. PS zero, no flex etc.

Now of course I haven't seen my study report... that's why you get chatty with the tech... these informal numbers can slip out. I drove home at 6am and put the 22/18 into my hack project Airbreak... worked a charm... here's the graphs... with a zoom showing nice rounded waveforms at the bottom.

https://drive.google.com/file/d/1PvbQ0w ... sp=sharing

Also, he had expressed reservations about mouth taping but I made a believer out of him... not sure exactly how (I tape with FF mask)... perhaps because I held the pressures no problem. I may add PS later... back sleeping is a biggie for me since I have wrecked shoulders.

Bonus: I get to keep the brand new mask and hose! The mask has a different partnum and the sticker says 'Not for resale, intended for short-term use only'... looks and works like the real deal. F&P partnum VIT1MSL, as opposed to the normal VIT1MA... dont' care, will use it until it falls apart. Both hecho en Mexico.

Conclusion: Do not take a sleep study without CPAP unless you're a) a new patient looking for a diagnosis or b) you're trying to get off CPAP and you've done some amazing work on yourself like lost weight, operations, mandibular devices etc....*especially* if you have very severe OSA (>100AHI). Just convince your doctor that all you need is a titration, these are a walk in the park comparatively. And once you add pounds and age to the equation bi-level starts to be the best solution at the higher pressures.

After thinking I've come to the conclusion that using those pressures is not sustainable and am now shopping for mandibular advancement stuff. This one from WalMart looks like it's worth a try, combines heat-moldable with adjustable:

https://www.walmart.com/ip/SnoreMD-Anti ... /983382357