Heart went into bigeminy due to these events. ER visit.

[WarpedTrekker]

So now I'm having to pay out of pocket for another study which may or may not help me. Then after I have nasoplasty, I'll need another one at that time too.

Then why are you doing it?

Because I'm desperate and the other place charged even more for a sleep study. I'm desperate to get this partially fixed at least so I can sleep without my oxygen levels dropping and my heart going into AFIB or abnormal rhythm.

Plus I have a vacation planned coming up and want this fixed to an extent where I can enjoy my vacation. I don't want to feel like my heart was stressed all night long while on vacation.

[palerider]

So now I'm having to pay out of pocket for another study which may or may not help me. Then after I have nasoplasty, I'll need another one at that time too.

Then why are you doing it?

Because I'm desperate and the other place charged even more for a sleep study. I'm desperate to get this partially fixed at least so I can sleep without my oxygen levels dropping and my heart going into AFIB or abnormal rhythm.

Plus I have a vacation planned coming up and want this fixed to an extent where I can enjoy my vacation. I don't want to feel like my heart was stressed all night long while on vacation.

Well, since you're not willing to take advice here, I wish you the best of luck with your expensive dice roll

[WarpedTrekker]

Had my sleep study last night. I slept great and feel great this morning! I haven't slept this good since starting therapy. I'd like to know what the difference was and hope I hear back from my sleep doctor soon. I slept for a shorter period, probably less then 5 hours, yet I feel more refreshed and awake then when I sleep 8+ hours at home! And I didn't have any night sweats, no heart palpitations, and no feelings of stress on my heart or chest.

I wore my own mask, chin strap, dental appliance. The only difference is they used their machine which was a Respironics System One. I could tell right away the difference in breathing was different with this machine. It's hard to explain but it pushes air much differently per breath, versus my ResMed AirCurve. The tech said the machine is much older then my ResMed, but I wonder if I could benefit at home switching to a Respironics?

The only other thing I noticed, is the air in their room seemed much easier to breathe then in my house. I'm starting to wonder if I have an air quality issue in my house, or have issues with allergens/pets. I have three cats. But I've had the cats for a long time, but my sleep apnea I probably had for ten years too, and didn't know about it back then. I had my home air quality tested for mold, etc, earlier this year and they didn't find anything. Maybe I should have it retested by another company.

If my sleep doctor doesnt get back with me tonight, I will increase the maximum range, per your suggestions and try it out for one night.

[Gryphon]

Do you use the humidifier on your cpap? If you dont... or don't have it turned up much. I would recommend you try a inline bacteria filter for your cpap that will filter all the air you breath, much much better then the filter on your standard cpap. If all the sudden your problems get better that would make me believe you do have air quality issues in your home or you have developed an allergy to your cats or something else in the air. Mold or dust or some kinds of seasonal pollen can seriously mess you up if you have a significant allergy to them.

One thing I would try [though you seam hesitant to do so] is to raise the max pressure your machine can go to to 20 and see where it wants to go... if your pressures go higher but your apnea get better then you could save your self a lot of headaches... literally.

Rest well,

Gryphon

[WarpedTrekker]

Well, since you're not willing to take advice here, I wish you the best of luck with your expensive dice roll

I never said I wasn't willing to take advice. I see where you are going with wanting to raise the pressure more to 20. I was waiting to hear back about my sleep study. They just called me today. I made a thread about it. Anyway, to summarize, the "sleep tech supervisor" relayed what my sleep doctor recommended to me. During my sleep study, I had only 1 OA during 5hrs. They said I was doing better at lower pressure EPAP 5, IPAP 9, PS 4 and at this level all night. The tech supervisor kept telling me how she has done titrations for 15+ years, and that PS 3 is not standard for bi-level, and could be causing issues, just like the higher starting pressure that I raised it to. Now they reset my machine to lower pressure EPAP 4, IPAP 8, PS 4, IPAP Max 14. I guess you would say they don't know what they are doing, even though they are trained and went to school for it?

I did extensively question that damn tech, and I told her my machine kept pegging out at IPAP 16 Max. But she kept saying that more pressure isn't in the answer, and could be causing the OA's, instead of helping. Should I believe that or not? I've never heard that more pressure could cause more obstructions. Centrals, yes. Obstructions, no.

[Pugsy]

Well...if it we me I would at least try the max at 20 and see what happens.
Then try what those supposedly professionals suggest...and see what happens.
And then go from there.
One night at each setting and see which works the best.

[palerider]

I made a thread about it.

And, this is why you should keep all your stuff in one thread...

viewtopic/p1272270/Here-is-what-a-Sleep ... l#p1272270

[palerider]

those supposedly professionals

I see what you did there..

[WarpedTrekker]

those supposedly professionals

I see what you did there..

I see as well. lol.

So what do you guys think about Lanky Lefty and his sleep diagnostic service where you send a week's worth to him for review?
I was thinking about just doing that since he is sleep tech, and from all his videos, he seems to know his stuff.

[palerider]

those supposedly professionals

I see what you did there..

I see as well. lol.

So what do you guys think about Lanky Lefty and his sleep diagnostic service where you send a week's worth to him for review?
I was thinking about just doing that since he is sleep tech, and from all his videos, he seems to know his stuff.

Sure, he's definitely one of the better techs

However, if it were me, I'd do what Pugsy said first... and if that doesn't make things better, THEN spend more money... but that's entirely up to you.

[palerider]

But she kept saying that more pressure isn't in the answer, and could be causing the OA's, instead of helping. Should I believe that or not? I've never heard that more pressure could cause more obstructions. Centrals, yes. Obstructions, no.

I've only been doing this stuff for 9 years, but I've *NEVER* heard that kind of crazyness...

I'll warrant that no manufacturer of auto machines has either, since they all *raise* pressure in response to obstructive events.

[Pugsy]

So what do you guys think about Lanky Lefty and his sleep diagnostic service where you send a week's worth to him for review?

I think it is your money, your time and your health.
You are free to spend all of those commodities as you wish in your search of someone who will agree with whatever you are thinking...which at this point I simply don't understand what it is that you want to hear but obviously no one so far has told you what you can believe or want to hear.

I have a pretty good feeling that Jason won't tell you want you are willing to listen to or want to hear either.

Did you know that both PR and myself are active over on Jason's forum...and did you know that we get a lot of our ideas after running our ideas by him to see if they hold water? I do it all the time...and I am pretty sure PR has done it as well.
We don't just pull our ideas out of our butts or the magic eight ball.

[WarpedTrekker]

ok thanks guys. I just Jason's video on why a full range pressure of 4-20 is a very bad idea. That makes sense to me as well. Yeah I've seen you guys over there on his forum as well. I wonder how the sleep doctors are that Jason works for and if they do this nonsense of full wide ranges or if they work with their patients to optimize levels individually?

It just irks me that after having a couple sleep studies this past year, and going to two different doctors, that they don't individualize the machine settings more. It's what I'm paying them for, to "fix" my apneas by adjusting my machine to whatever they find. They are the ones that have doctorate and pulmonology degrees.

If I have issues at any time during tonight, I'll increase the settings. But like Jason suggests in his video, a full range of 4-20 is a bad idea in the long term. Just use it to figure out where you need to be. I still don't understand how I could have been at such low pressures during the sleep study. Unless it was a "good" night for me.

[palerider]

ok thanks guys. I just Jason's video on why a full range pressure of 4-20 is a very bad idea.

The main thing to take away from that video is that a min of 4 is a bad idea, for the vast majority of people... the max is irrelevant for most people, unless they have something like aerophagia and then have to balance trying to get their AHI down, without being painfully bloated.

Some few people are fine with 4, but they're way out on the edge of the bell curve.

It just irks me that after having a couple sleep studies this past year, and going to two different doctors, that they don't individualize the machine settings more. It's what I'm paying them for, to "fix" my apneas by adjusting my machine to whatever they find. They are the ones that have doctorate and pulmonology degrees.

Which is why we're a *self help* group, the members of which, overwhelmingly adjust their machines themselves, without forking over buckets of money to disinterested doctors.

If I have issues at any time during tonight, I'll increase the settings. But like Jason suggests in his video, a full range of 4-20 is a bad idea in the long term.

4-20 is fine.. for *one night* to get a better idea of what the min pressure should be.

Just use it to figure out where you need to be.

Jason tends to prefer fixed pressure... I disagree, because I see data from people *all night long* as opposed to primarily a few hours, and sleep varies from hour to hour. Your needs are different throughout the night.

Just ask Pugsy about her 'prescribed' vs 'needed' pressures.

Take charge of your own therapy, nobody else will care as much as you should.

[WarpedTrekker]

Thanks Palerider. I guess from here on out, the only thing I'll need from my doctor is supplies. Masks, etc. Otherwise it seems they are a "set-it-and-forget" doctor.

Here are the results from last night. Actually slept great, and surprised I didn't have more centrals on PS 4. Only thing I don't understand, is why the pressure chart doesn't show the lowest line, when it is at EPAP 4 ? The first hour of sleep, it shows no EPAP. When I restarted the machine at 6:30am, same thing. I never saw that when I had EPAP set higher like to 5 or 6.

I'm still concerned, due to my past history of blood clots, etc, that such a minimum number may not keep my oxygen high enough, but last night seemed okay. I guess what I can do is run it like this for two weeks to appease them, and if things go wrong, they said I should contact them. Then maybe, just maybe, they will see their mistakes. The doctors need to be held accountable. Maybe an online review to go along with some other bad ones is in order for this doctor. Maybe I can also report them to a certain agency as well. This all depends how the next few nights go. I just definitely dont want my heart going into AFIB or other ryhthm again and have to call 911 due to their stupid mistakes.