Stuck in the Middle East, no proper doctor available

[learflyer]

Tonight was great!
For about an hour I was semi awake and could not get back to sleep and thats where most of the events where. Apart from that, I also had a camera record my sleeping positions and found out that on my back and left side the less events occurred. When I was sleeping on the right, I had quite a higher number.

Also, the Hypopnoes don't look too bad. Is that a mismarking by the device? Will get my SpO meter by Sunday, so hope to get more realistic data on that one, too.

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[Pugsy]

When it comes to hyponeas we can't always see what the machine is sensing. I know that sometimes I might look at a flagged event and sit here scratching my head why myself.
You have to remember that a hyponea flag is for a flow reduction that is at least 40% up to 79% that lasts at least 10 seconds.
We can easily see flow reductions up near that 79% mark (at 80% or more you get an OA flag) but we can't really see maybe a 50% reduction in air flow all that much. No real flat line to see or a near flat line.
I suspect that is probably what happened with the hyponea flag in this situation. The air flow reduction probably was just barely enough to get the machine to flag it. We can't see it but the machine can sense it.

As you get used to the mask and machine your sleep quality will improve and there will be less of those awake/semi awake SWJ (sleep/wake/junk) flagged events to muddy up your reports. Less time in the middle of the night where you woke up and couldn't get back to sleep.

Don't forget REM stage sleep as a potential culprit too. We have no way to evaluate sleep stages with these machines so we just have to wing it a bit. Google "sleep stages" and look at when REM normally occurs and you will get an idea how REM fluctuates. Normally first REM is about 90 minutes after sleep onset and is fairly brief but as the night goes on the REM happens more frequently and lasts longer with the greatest amount of REM happening in the wee hours of the morning.
It is also common for us to wake up at the end of a REM cycle. Most of the time we go right back to sleep and don't remember it but sometimes we wake up more and it takes a while to get back to sleep. This might have been what happened in your middle of the night awakening.

[ChicagoGranny]

we lack doctors with a standard that I am used to from where I come from (Europe)

As you may have figured out by now, Auto machine + Sleepyhead + cpaptalk is better than most doctors for a simple OSA case.

[jnk...]

we lack doctors with a standard that I am used to from where I come from (Europe)

As you may have figured out by now, Auto machine + Sleepyhead + cpaptalk is better than most doctors for a simple OSA case.

Heck. Any ONE of those things is better than most doctors for a simple OSA case!

Just to stress your point.

[learflyer]

Well, what can I say other than THANK YOU. As you see in the screenshot below, your recommendations are really working! Yeah!

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[JimW159]

I don't know where in the Middle East you are located, but if you are in one of the UAE states, there are several sleep medicine facilities there. For example: Dubai has the London Sleep Centre (affiliated with a private consultancy on Harley Street in London) plus a rather large multi-clinic/hospital group called Mediclinic. In addition there is also a substantial sleep medicine practice at the German Neuroscience Center. Abu Dhabi has a branch of the Cleveland Clinic with a department of sleep medicine - Cleveland Clinic is frequently cited as one of the top hospitals in the United States. Cornell University in Ithaca NY USA has a campus of their Weill Medical School in Doha, Qatar which includes a sleep medicine program. Hamad Medical Corporation has several centers throughout the region many of which, I understand, have active sleep medicine practices. One person connected with Hamad in Doha is Dr. Aisha Hussain who specializes in sleep medicine. (she graduated from a program at Weill and serves as an Assistant Professor at Weill - Qatar.)
In addition to these, there has been much development of advanced medical facilities in Bahrain, Kuwait, Oman (particularly Muscat) and Saudi Arabia in several cities. As well Lebanon has come back substantially in this regard. It has been many years since I lived there (Beirut, Dubai, and Muscat primarily) but while medical services were quite a bit scarcer than today, they could be found even if it meant traveling a fair distance.

[learflyer]

Well, if you lived here you know its best for me not to disclose the country publicly. Anyway - yes I agree. Lots of options here, and all nice names and all. But inside the quality is just not there. Too many incompetent actors. Most people I know don't trust doctors to handle more than a cold. And I know a few that have had very basic procedures gone terribly wrong or misdiagnosed. As my GP says - "unless its an emergency, you board a plane and fly to Europe."

By the way -thanks to this group I feel awesome, and my AHI is really coming down. What I am wondering though is why my Dream Station is showing strange pressure spikes for (I think) no reason. Is she trying to wake me up, annoy me, needs more attention?

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[Jas_williams]

The pressure spikes are a good thing. Part of the Philips algorithm is to try higher pressure to see if you do better there it finds you don’t and drops back down then repeats.... Nothing you can do about it but it shows your at the optimum pressure. Your numbers look very good the CA events look like sleep wake junk and can be ignored (Nothing your machine can do about them anyway)


Glad your feeling great

[Pugsy]

Those saw tooth looking pressure spikes are normal functioning of the machine. They are called test pressure probes.
Should be explained in the clinical manual...did you ever get one and read it?
If you didn't you can request it here.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

[palerider]

By the way -thanks to this group I feel awesome, and my AHI is really coming down. What I am wondering though is why my Dream Station is showing strange pressure spikes for (I think) no reason. Is she trying to wake me up, annoy me, needs more attention?

To expand on what the others said about the pressure 'spikes'... If you look at enough resprionics charts, you'll see that when the breathing is very smooth and regular, it's almost as if the machine gets restless and says "well, let's see what we can do to make this better!)" (even though it's already great)... and it starts those regular pressure probes... but as soon as breathing is *irregular*... where there IS room for improvement.. the machine ... DOES NOTHING!. It makes no sense to me, none at all.. when breathing is irregular, that's when I'd raise the pressure a little and see if it got better.... You can see it in your chart, where the flow line is very even and regular, there are probe spikes, and where the flow line is irregular... nothing

It's like there's some test in the software that's backwards... but it's been like that for years, and through (at least) three different model lines.

The long and the short of it, the more spiky pressure probes you see, the better.