what else can I do???

[palerider]

Yup, and formatting the chart the right way gives us all we need in almost all cases, and it's a single, easy to do screenshot for you.

You really didn't do it the way the other user requested, if you go back and look.

Anyway, please follow that how to page, and you'll make it easier for us to help you.

This is what she asked: “Turn off the pie chart. (File, Preferences, Appearance, uncheck pie box.)

Next, stack your charts like this:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

Be sure to fit them all into one screenshot. You can squish them a little by grabbing the gray horizontal bar that separates them and moving it up.”

As far as I can tell, that’s what I did. If you think it’s a misinterpretation, then please let me know what I did wrong. As I said, I’m new to this board and am pretty desperate for help. Just telling me my screenshot is useless is frustrating.

You turned off the whole left panel, which removes a lot of data, and you had extra charts that squished things too much.

It doesn't look anything like the example.

[Miss Emerita]

Hello, Susan. Somehow the whole left panel disappeared. It has a lot of important information in it so get it back into your screenshots (but with that pie chart turned off).

This fiddling with format is a pain, but once you get it set up, people can really give you better suggestions. (I think the wonderful people working on Oscar have a plan to make all of that format stuff easier for us.)

[Susancpv1]

Screen Shot 2020-01-19 at 12.17.05 AM.png (608.08 KiB) Viewed 1730 times

Thank you, Miss Emerita! I get it now. I am attaching the screen shot again. Hope this provides the right information! Thanks in advance for your help!

Susan

[Julie]

Not sure you need the snore graph, but in any case why have you kept your max. pressure so low - most have it much higher, i.e. at 20, so if the machine needs to go higher than whatever it's been capped at, it can, without a problem, and if not, it won't matter if it doesn't reach it... the low pressure is the one that does the work and needs to start higher (than 4) so it can 'catch up' with events that occur at a higher place.

[palerider]

It's the mask pressure line that's not needed, please remove that, and resize the six requested graphs.

Min 8, max 20 on pressure.

[Becksta]

Ok just re-read about not piggy backing on someone else’s thread, so I’m going to make my own.

Do you want their help, or help for YOU? Would you like someone else distracting people from helping you?

lighten up, francis. she just made her own post!

Yeah, it's just the eyeroll that ticked me off.

The eye roll was directed at ME!! Like, read the instructions why not?!

[Susancpv1]

Okay, so last night I set the min pressure to 9 and the max to 20. I'm not as dead-to-the-world as I was yesterday, but still tired and having dyspnea. I'm sure these changes take a few days (weeks? months?) to adjust to. But please tell me what I should be looking for on the pressure graph. I've seen others' graphs where their pressure is a flat(ish) line while mine jumps all over. I reckon my goal is to have a flatter pressure reading, correct?

[Pugsy]

I reckon my goal is to have a flatter pressure reading, correct?

Attachments

Well....yeah kinda....sort of. Kinda all depends on when in is fluctuating and why.
Is it going all over the place with wide changes all night long?
Is it maybe doing a lot of changing just when REM is probably happening?
Is it going all over the place because the FLs/Snores are wild and all over the place?

Do you happen to know if your OSA is worse in REM or not? If it is (it's very common) it is possible that some of the increases are because of REM increased pressure needs and to try to smooth things out just for REM related pressure needs could well mean you are using a lot more pressure all night long just to deal with the 20% of the night you are normally in REM.

My OSA is worse in REM and I might need 6 to 8 cm more pressure only during REM...To smooth out my pressure line would require me to use 10 to 12 minimum some nights.....I suppose I could do it but I get by just fine with 7 cm minimum the other 80% of the night.
I choose to just let the machine increase as needed and let the machine spike upwards. I sleep through it and never know it happens and feel about as well as I am going to feel anyway.

Your minimum is 9 cm....the maximum it went to 11 cm. A 2 cm range that looks more ragged from the scale than it really is.

I wouldn't change anything else for a week or so until I got a better idea what the trend was doing.
Your snores and the FL graph aren't horrible looking....I see no urgent need to increase the minimum IMHO.
I see no reason to smooth things out any further either...but I will leave that choice up to you.
The 2 most common causes of needing more pressure....REM stage sleep and sleeping on one's back.

If you smooth things out too much you might as well end up using fixed cpap mode.

[Susancpv1]

Thank you, Pugsy. I do have more events during REM. Is there a reason to not crank it up high? You said you get by with a lower pressure setting. Is there a harmful effect to cranking it up?

[Pugsy]

Is there a harmful effect to cranking it up?

Not really. Aerophagia is probably the worst thing that will happen and that's not guaranteed.

Is there a reason to not crank it up high?

No, not really. I just wanted to point out that if you keep smoothing out the pressure graph that you are fast approaching what fixed pressure more does.

If your pressures were really going wildly all over the place AND it was happening not just in REM...then I would be more on board for maybe smoothing things out a bit but if someone just wants to smooth things out just because of REM pressure needs....might as well use fixed pressures.

Maybe I am kinda funny but I don't see a minimum of 9 and the machine not going over 11 (which means a 2 cm range) equal to a lot of variations and I would leave it alone assuming I was sleeping decently and feeling decent.
Meaning I don't see the need to smooth that 2 cm range out any more.

Like I said....it all depends on why the machine wants to go up and back down and when and how a person is sleeping and feeling.

But it hurts nothing to probably be using more minimum than might be technically needed for the bulk of the night.

I have been down that experiment road myself some years ago. At the time I was using a Respironics machine so needed a little more minimum pressure to break up the REM clusters. I had come to the 10 cm minimum and 20 cm maximum (and would often see 16 cm and sometimes 18 cm during probable REM)...and AHI was ranging 1 to 3. Back then we didn't have centrals flagged separately and no flow rate to maybe discount SWJ flagged events.

So I decided to increase the minimum in 0.5 cm increments over a period of time to see what difference, if any, it made in my AHI or sleep quality or how I felt. I spent 1 week at each new minimum...0.5 cm increase each week up until I spent a week at 13 minimum...so took me 6 weeks.
Nothing changed with the increases...absolutely nothing. AHI didn't change...sleep quality didn't change nor how I felt.
More minimum and less variations in the pressure did nothing for me. I see no sense in using more pressure if it doesn't change anything.
Now it didn't hurt me but it wasn't real comfortable using 13 and I thought there wasn't much sense it doing it since nothing really changed except the pressure line smoothed out.

I see no sense in using more pressure during the entire night for REM related stuff when the machine can easily reach where it needs to go to with an optimal minimum setting. Supine sleeping for me never made any real difference in pressure needs. If it had I might have done something different.

You can do what you want to and it won't hurt you to use more all night....but YMMV and you may be like me and it simply not make any big difference in anything.
Or you might be like some of the others who notice that smoothing out the pressure line means they feel better and sleep better.

Everything regarding to cpap comes with a big YMMV sticker.

[TropicalDiver]

In your shoes, I would be concerned about continued dyspnea. I would be visiting a good pulmonologist (not a RT) with the goal of sorting through the potential causes. By all means, please continue working the apnea issue. That is important but it is possible that you are experiencing an unrelated pulmonary issue. In other words, address both issues.

Working the dyspnea, it sounds like you need a ground up effort -- starting with history and physical exam. I assume you had a chest x-ray as part of the cardiac workup (that would help rule out a pneumo or pneumonia although not a PE). While I am not in the medical field, I would also want complete blood work (looking for things like low RBCs, anemia, thyroid, clotting, etc.) Pulmonary function test would also be on my list. Do you know how your oxygen saturation has been? (You can obtain a pulse oximeter for around $20, Does it stay in the mid to upper 90s, including with activity? Does anything improve it?)

I assume the cardiac workup included much more than a stress test? Is there anything that seems to trigger the dyspnea -- stress, meals, exercise, positional, time of day, etc.? Does it come and go or is it constant? All things a good doc will likely ask.

[chunkyfrog]

Cute baby.
Sorry for the sidetrack, but I just can't resist looking.

[Julie]

Baby goats are the cutest!

[Susancpv1]

I will make an appoint today to see my GP to get a referral to see a pulmonologist. My husband said my breathing was at about 2.5 times the rate of his ( that was at one point during the night when he was awake). My pressure settings were set at 20/9 for the second night. I have the dyspnea all day no matter what my exertion. At the gym, I can still work out but have to pause every once in a while to get a deep breath. This may sounds weird, but this is a problem that has been happening since I’ve started using the CPAP. It started about a month after starting treatment. Stopped when I discontinued CPAP treatment for a few months and it came back when I restarted treatment this past November.

And, yeah, that goat was a total sweetheart!

[harrywr2]

"My husband said my breathing was at about 2.5 times the rate of his"

Your respiration rate data is in the OSCAR charts.