Hi All:
I wanted to post an update on my progress and seek additional advice. First thank you to all who have posted suggestions and to others who have helped as I have read the range of posts on the forum.
Changes I have made and result:
1. switched to P10 nasal pillows with my own adaptation. Apparently the angle of my nares is different than the majority and I was losing the seal during the night as the weight of the hose pulled in my sleep or ?? - Anyway, I now use 1/2 of a silicone ear plug shaped into an oval and placed between the two pillows and just below to hold the mask in the best position. This has worked great - I need to reshape the silicone piece every now and then as the heat of my skin tends to flatten it. When I want to remove it to clean, it comes right off - but will stick until manually removed. See attached picture.
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2. I have turned EPR on to 2 (thanks yrnkrn). I tried 1, 2 and 3 with 2 feeling most comfortable. This has somewhat tamed my flow limitation graph (tho it is still not pretty), and has changed the trace shape of my individual breaths so that they are a bit more rounded and not quite as sawtooth. Also, I am feeling much more rested most nights.
3. I use a double layer of micropore tape along with Zonker's headband idea over top. This has really improved my leak line and I am no longer getting large leak warnings.
4. I requested oximetry testing per Pugsy's suggestion - it took forever to get this scheduled as the DME had persistent problems with the computer software to read it. However, it is finally done and that leads to my questions.
I have a Dr. appointment for this coming Friday to go over the results of the O2 testing. This appointment was originally scheduled for yesterday with the nurse practitioner, but I got a call the day before from the office telling me that they had rescheduled this with the actual sleep Dr.. I am apparently beling "squeezed in". I have never met this man as my only two appointments with this sleep dept. office have been with a PA and the NP - the usual wait for an appointment for the sleep Dr. is 4 - 5 months. So...I am a bit alarmed! I want to have my ducks in order when I go and while I know that I want to address the O2 testing results and flow limitations, I was hoping that others could look at my sleepyhead chart of that night and give suggestions.
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You will see that ugly cluster of hypopneas (the whole reason I requested the testing). I don't always have that many - but I do usually have clusters which I assume are when I am in REM sleep. Am I looking at bipap? - Do I need to revisit EPR 3? Raise pressure?
As a side note, this is a higher AHI than I have had for a bit - I am usually running in the range of .8 to 1.3 or so. I was having trouble sleeping with that wrist thing for the testing. Also up 2 X with my legs - have been taking magnesium with fairly good success - but was having more difficulty that night - usually I am only up 1 X often about 4 -5 hours into the night.
Thanks so much!! xcountry gal
Any help appreciated.