Smargie’s Therapy Thread...in Need of ASV Advice

[zonker]

Thanks for your help, Dog Slobber, and I love your user name! I played around with the Snipping Tool and was able to capture what I needed from SH. But I could not figure out how to transfer it to a post on here. How do I do that?

when you compose a post, you'll see at the bottom of the text box two tabs, "Options" and "Attachments". use the attachment tab. it will open up a dialog box part which will be "Add files". hit that and then look for your chart picture. follow the directions and it will add the picture in with whatever text you wish to type.

sounds complex, but it's really fairly easy.

if you have any problems, just ask.

good luck!

[Jay Aitchsee]

addfile.JPG

[zonker]

addfile.JPG

oh, sure! make it easy for someone, why don't ya?



to the OP-yeah, just like he's shown you.

[Smargie]

Thank you for the hand holding, Jay and Zonker. It's impossible to make directions involving the computer too simple for me! OK, let's see if I did this right...well it looks like they are in the wrong order and that part of 2nd one's border got cut off in the transfer. Is this at least along the lines of what you need?

[zonker]

Thank you for the hand holding, Jay and Zonker. It's impossible to make directions involving the computer too simple for me! OK, let's see if I did this right...well it looks like they are in the wrong order and that part of 2nd one's border got cut off in the transfer. Is this at least along the lines of what you need?

ohhh, you are just so close!

let me see if i can find an example for you of what a screenshot should look like....okay, here's one-

screenshot-10-31-18.png

but, you get a gold star for taking the screenshot, finding it and posting it here.

[Miss Emerita]

(Psst, Zonker, no pie charts, or so they say!)

[zonker]

(Psst, Zonker, no pie charts, or so they say!)

i'm the exception that proves the rule!!

[palerider]

(Psst, Zonker, no pie charts, or so they say!)

The problem with the pie chart is for shorter, lower resolution screens where the pie chart causes the statistics on the left to get pushed down off the edge of the page.

If all the stats are showing, with the pie chart, then the pie chart is ok

[zonker]

(Psst, Zonker, no pie charts, or so they say!)

The problem with the pie chart is for shorter, lower resolution screens where the pie chart causes the statistics on the left to get pushed down off the edge of the page.

If all the stats are showing, with the pie chart, then the pie chart is ok

see? i said i was the exception.

[Pugsy]

I am with Palerider about the pie chart...I don't care if it is there as long as what I need or want to see below it is available to be seen.

Though my own personal opinion of the pie chart is that it is a rather useless feature and confuses some people.
It's a pie chart folks...a percentage of the pie...which that percentage happens to also show up in the AHI bar graphs. I don't need a slice of the pie to know how big of a percentage so and so event happened...I got real percent numbers right in front of me to evaluate. I don't have to evaluate the size of the slice of pie.

If a person has one central apnea all night long...the pie chart will show all central apnea color coding.
If a person has 100 centrals apneas all night long and nothing else....the pie chart will still show all central apnea color coding.
It's a whole pie of centrals that visually looks the same but means something totally different.

If a person has one central apnea and one obstructive apnea all night long....the pie chart will be split in half with the 2 color codes
If a person has 100 apneas...50 central and 50 obstructive all night long...the pie chart will be split in half with the 2 color codes.
They will both look like identical pies but mean something totally different.

[Smargie]

Thanks for giving me credit for my previous effort, Zonker...that was nice of you. I did it that way because I read somewhere on this site to not scrunch up the graphs and make them too hard to read. I guess the more important issue is to have them lined up properly. I hope this one passes!

Snips of SleepyHead #4.PNG (136.52 KiB) Viewed 2954 times

[zonker]

Thanks for giving me credit for my previous effort, Zonker...that was nice of you. I did it that way because I read somewhere on this site to not scrunch up the graphs and make them too hard to read. I guess the more important issue is to have them lined up properly. I hope this one passes!




Snips of SleepyHead #4.PNG

that's looking better, though they won't need the snore graph. at this point, though, i think we are getting bogged down a bit.

we need palerider or pugsy to come in to give you some sterling advice, of which i'm fresh out!

[Jay Aitchsee]

Doin' good on the chart work Marge. Now, how about zooming in and showing us a section of the Flow rate chart about 5 minutes in duration to include a couple of those CA? Do you have another mask? How do you feel about taping your lips? It doesn't look to me as if your leak rate is too high, although I'm not real good at reading DreamStation charts.


If indeed, these CA are being caused by air being forced out of your mouth, which I'm not certain they are, then tape or a full face mask might help.


In any event, see if you can zoom in on a section so we can see what it looks like.

[Pugsy]

Holy crap. I just saw this last report.
Leaks aren't the issue at all...be it mouth breathing or whatever...your leak graphs are well within what is quite normal for your mask and your machine...actually minimal excess leaks are occurring.

Central Sleep Apnea brought on by the addition of cpap pressure used to treat Obstructive Sleep Apnea gives us that nice Complex Sleep Apnea diagnosis.
And while yes...sometimes it will fade away on it's own I don't see that happening in your case because it is so pronounced...so I have my doubts as to how much "give it time" will actually help you.
Watch this video...it explains a bit what and why some people develop centrals with cpap pressure.
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

You don't have much choice in the matter though...your doctor is in the driver's seat here.

I don't see this being related to mouth leaks or tape or not taping or anything but being plain old complex sleep apnea popping up.
Using Flex might make it worse but I don't even think turning Flex off (which you wouldn't like anyway) would help all that much.
And you aren't limited to centrals caused by high pressures...you are getting just about as many at the lower pressures of 8 ish as you are getting when the machine goes higher.

While miracles can happen and with time those centrals might stop happening....even if it did I suspect a very long time and you are having way to many centrals to just let slide by.
Light a fire under your doctor's butt...he said a couple of weeks...don't let him stretch it out for very long.
I predict a different machine in your future is going to be needed and sooner is better than later.

[Smargie]

Thanks for your feedback, Pugsy, even though it's pretty disconcerting. I watched the video and there are some important things I learned from it that don't fit my situation. They said that Complex Sleep Apnea begins when OSA has disappeared or is managed. During my sleep study (non-titrated) I had 3 CAs, 95 Hypops and 0 OAs. My AHI was 18. I know that a sleep study only represents one night during bizarre sleeping circumstances, but I'm pretty sure I wasn't having many OAs before the study. I was referred for the study because I had high CO2 readings for 2 blood labs in a row. I didn't snore much and my husband says he's never heard me stop breathing and then gasp for air, and we've been married for 21 years. According to the video, a person may have a few CAs during their study, but the distinguishing feature of CSA is the persistence or emergence of CAs and Hypops with CPAP therapy, and that although OAs are reduced, the AHI remains high because of the increased CAs and Hs.

So, I started out with no OAs, and now I have a lot of them, and the Hs and CAs have increased too. I also snore more now and have RERAs and periodic breathing. I'm including this just to show how quickly this happened (sorry it's no massive!):

Snips of SleepyHead #5.PNG (37.96 KiB) Viewed 2904 times

You are right that my doctor is in the driver's seat, and I know that CSA is NOT that common, and I agree with you that it doesn't seem like it's likely to disappear. I feel like the CPAP has actually harmed me and I don't think I should keep using this particular set-up. Unfortunately I can't say that my pal Pugsy from CPAPtalk disagrees with her based on my data from SleepyHead. In my experience docs don't like it much when their patients do medical research on the net. I wonder how I'll convince her to see me before my appointment on May 2nd, which is how she left it. I guess I'll just tell her I'm feeling increasing shitty and can't tolerate this amount of sleepiness (which is true).

Jay, thank you also for your feedback. I'll work on getting a screenshot of those 5 minutes.