Encore Pro Daily Charts - 08-2007

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Nodzy
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Encore Pro Daily Charts - 08-2007

Post by Nodzy » Sat Aug 25, 2007 10:36 am

Some of the sleep-disorder knowledgeable people on the board have asked to see my charts in order to offer suggestions. I'll post one at a time. Older daily charts can be viewed at links before the current chart.

A Hybrid mask was used during this period. Its large passive exhalation vent rate surely isn't the best situation. But, a FF mask was a necessary attempt by me to remedy mouth breathing and mouth venting problems.

Some people suggest that my recent change to very low event numbers likely are not reliable due to the large leak rates. I counter that with the very obvious improvements in how I feel on most mornings, and thoughout each day since making the changes to the M-series A-FLEX, the Hybrid mask and Pur-Sleep aroma therapy. I beleive the event numbers have been right. And, the quality of my sleep feels better overall -- I have more periods of nights and whole nights wherein I don't even remember sleeping.

Of course, I also have some very rough nights too.




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Older charts can be found at links below:

September 2007

http://www.b419.net/cpap/sd2007.09.12.jpg ---- http://www.b419.net/cpap/NMweekly2007-0 ... -09-06.pdf

http://www.b419.net/cpap/sd2007.09.11.jpg

http://www.b419.net/cpap/sd2007.09.06.jpg

http://www.b419.net/cpap/sd2007.09.05.jpg

http://www.b419.net/cpap/sd2007.09.04.jpg

http://www.b419.net/cpap/sd2007.09.03.jpg

http://www.b419.net/cpap/sd2007.09.02.jpg

http://www.b419.net/cpap/sd2007.09.01.jpg

August 2007

http://www.b419.net/cpap/sd2007.08.31.jpg ---- http://www.b419.net/cpap/sd2007.08.25.jpg

http://www.b419.net/cpap/sd2007.08.30.jpg ---- http://www.b419.net/cpap/sd2007.08.24.jpg

http://www.b419.net/cpap/sd2007.08.29.jpg ---- http://www.b419.net/cpap/sd2007.08.21.jpg

http://www.b419.net/cpap/sd2007.08.28.jpg ---- http://www.b419.net/cpap/sd2007.08.20.jpg

http://www.b419.net/cpap/sd2007.08.27.jpg ---- http://www.b419.net/cpap/sd2007.08.14.jpg

http://www.b419.net/cpap/sd2007.08.26a.jpg ---- http://www.b419.net/cpap/sd2007.08.13.jpg

http://www.b419.net/cpap/sd2007.08.26b.jpg ---- http://www.b419.net/cpap/sd2007.08.10.jpg
Last edited by Nodzy on Fri Sep 14, 2007 8:05 am, edited 40 times in total.
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HumanBean
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Post by HumanBean » Sat Aug 25, 2007 3:39 pm

Nodzy,

Can you explain "Some people suggest that my recent change to very low event numbers likely are not reliable due to the large leak rates. " ?

Your leaks don't look large given the expected leak rates for the hybrid. I didn't realize the data could be unreliable.

Your info re the old hybrid has been very helpful to me. I can see from the data that the old version of my hybrid mask does not work well with my apap machine. I have many more events and the pressures have gone as high as 15 cms to try to manage them. When I use my swift my pressure never goes higher than 11 and the data indicate I'm having few if any events. Last night I had 0.0 ahis.

I'm going to stick to the swift for the next week and see how this goes. I really want to like the hybrid, but without the adaptive flow technology, I might as well not use cpap at all.

Thanks for all the info.


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Nodzy
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Post by Nodzy » Sat Aug 25, 2007 7:01 pm

HumanBean,

I'll try to answer… although I do not know the technical aspects of the M-series modes and adaptive algorithms. Keep in mind: I'm a novice despite being in therapy for over 5-years. This board is my OSA enlightenment. The med pro's wanted me to be a "mushroom" forever.

High leak rate periods, but below Large Leak flag periods (75-LPM and above), are considered to render therapy less effective to ineffective. Because, depending on type and mode of unit, pressure settings, mask style, mouth breathing, mouth venting and other factors the sufferer does not get effective response, pressure and / or volume from the unit. Many variables play into that. That is what I have read and been told.

While I do not doubt the validity of the possibilities, I do not believe that the scenario is a constant with defined limits that apply to every hardware pairing and patient.

I was on a straight CPAP for years, and then finally got the doctors to agree to upgrade my machine in 2006. Instead of an Auto, which I needed and pleaded for, they gave me a C-FLEX unit. It was an improvement, but it far fell short of what I needed. About two months ago I bought my own M-Series Auto A-Flex and am thrilled that I started getting some actual routine benefit from therapy. Recently adding a Hybrid mask and aroma therapy increased the comfort and benefit.

The current high (46 to 60-LPM) leak rate numbers I have nightly do not in any manner appear to negatively affect my treatment. The numbers were higher with nasal interface masks, than with the Hybrid.

I hope that helps.

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Post by Nodzy » Mon Sep 03, 2007 6:38 am

New charts are posted.
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Wulfman...

Post by Wulfman... » Mon Sep 03, 2007 9:20 am

I don't know what you did on the night of the 30th, but you might try to do more of it......

I would suggest trying a fixed pressure of about 11 and see what a constant pressure shows for that mask.
If it's tossing and turning that's causing the massive leaks, you're either going to need a different mask or different sleeping position.

Good luck.

Den

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Post by Goofproof » Mon Sep 03, 2007 10:09 am

Like Den says those last two don't look bad, considering the mask. It would never work for me due to the leak rate but it seems that you are able to get by on it. If you feel OK, you seem to be doing well. On those last two I don't think the data is corrupted, now the one before with the 60 rate it is. Jim
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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Post by Snoredog » Mon Sep 03, 2007 10:19 am

I wouldn't change anything, looks fine to me, with that mask you are going to have some leaks, just try and avoid those periods of leak where it gets at or above 75L/m, you can see the solid black tics above, when that is present, the machine stops responding to events.
someday science will catch up to what I'm saying...

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Post by Nodzy » Mon Sep 03, 2007 5:00 pm

Wulfman... wrote:I don't know what you did on the night of the 30th, but you might try to do more of it......

I would suggest trying a fixed pressure of about 11 and see what a constant pressure shows for that mask.
If it's tossing and turning that's causing the massive leaks, you're either going to need a different mask or different sleeping position.
Wulfman,

Thanks for the input. I can't figure out what created such a smooth night for me. A fluke, I think. I'm trying to stay away from straight pressure. I bought the A-FLEX to get away from it -- the medical overseers had me in straight CPAP and for a short period on CPAP C-FLEX for about 5-years and my routine results were abysmal. I felt like crap every day and rarely managed to keep any mask on for more than 3-hours – in short coma sleeps I would peel a mask off and not know it.

Neuropathy pain is a prime cause of the body movement, and I refuse to take drugs for it, considering my often shallow breathing. If I can stay this balanced and keep getting effective theapy with better O2 saturation I may again consider medications for the pain.

This is the first real therapy I’ve had, thanks primarily to the knowledge I gained from this board. Best wishes for you too….

Nodzy

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Post by Nodzy » Mon Sep 03, 2007 5:12 pm

Goofproof wrote:Like Den says those last two don't look bad, considering the mask. It would never work for me due to the leak rate but it seems that you are able to get by on it. If you feel OK, you seem to be doing well. On those last two I don't think the data is corrupted, now the one before with the 60 rate it is. Jim
Jim,

I was so bad off due to COPD on top of all else that imperfect therapy for a straight 4 to 5-hours a night is a blessing. More than that is pure bliss.

The relief I'm getting is amazing even with the higher leak rates. Too, claustrophibia is a contributor in my despising masks on my face. But Pur-Sleep and a switch to the Hybrid and resulting better therapy is easing much of the urge to yank the mask off multiple times per night.

Even on the nights yielding those recent worst charts I felt good in the mornings considering what I used to feel like on every morning and through every day. Yes, far from perfect, but good -- probably a 30-percent improvment. A small gain as most people would view it, but to me that's a major improvement in reduction of physical misery.

Nodzy
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Wulfman...

Post by Wulfman... » Mon Sep 03, 2007 5:16 pm

Nodzy wrote:
Wulfman... wrote:I don't know what you did on the night of the 30th, but you might try to do more of it......

I would suggest trying a fixed pressure of about 11 and see what a constant pressure shows for that mask.
If it's tossing and turning that's causing the massive leaks, you're either going to need a different mask or different sleeping position.
Wulfman,

Thanks for the input. I can't figure out what created such a smooth night for me. A fluke, I think. I'm trying to stay away from straight pressure. I bought the A-FLEX to get away from it -- the medical overseers had me in straight CPAP and for a short period on CPAP C-FLEX for about 5-years and my routine results were abysmal. I felt like crap every day and rarely managed to keep any mask on for more than 3-hours – in short coma sleeps I would peel a mask off and not know it.

Neuropathy pain is a prime cause of the body movement, and I refuse to take drugs for it, considering my often shallow breathing. If I can stay this balanced and keep getting effective theapy with better O2 saturation I may again consider medications for the pain.

This is the first real therapy I’ve had, thanks primarily to the knowledge I gained from this board. Best wishes for you too….

Nodzy
Well, in lieu of a single pressure, and still being able to use A-Flex, you could narrow your range down to like 11 - 12. That might give you the best of both worlds. From what I can remember, your 90% pressure seemed to end up on 11 on many nights. Also, my thought with regard to setting your bottom pressure at 11 is the little pressure "bumps" on the bottom line seem to indicate a need for a little higher pressure.

Good luck.

Den


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Post by Nodzy » Mon Sep 03, 2007 5:22 pm

Snoredog wrote:I wouldn't change anything, looks fine to me, with that mask you are going to have some leaks, just try and avoid those periods of leak where it gets at or above 75L/m, you can see the solid black tics above, when that is present, the machine stops responding to events.

Yep, Snoredog...

I lowered the bottom pressure the other night from 10cmH2O to 9cmH2O. I'm trying to find a balance that keeps me at good O2 saturation, low flag event numbers and low AHI. But which can still compensate for my worst events and worst nights.

Hopefully, I'll be able to get my medical records soon, and demand the overdue PSG... and have a better doctor and better polysonographer this time around. Due to COPD I'm still considering buying an oximeter, because I know they won't prescribe one for my use. I'll keep posting.

Thanks again,

Nodzy

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Post by Nodzy » Tue Sep 04, 2007 12:48 pm

Den wrote:Well, in lieu of a single pressure, and still being able to use A-Flex, you could narrow your range down to like 11 - 12. That might give you the best of both worlds. From what I can remember, your 90% pressure seemed to end up on 11 on many nights. Also, my thought with regard to setting your bottom pressure at 11 is the little pressure "bumps" on the bottom line seem to indicate a need for a little higher pressure.
Den,

Good point. Before getting the Encore Pro, and shortly later switching to the Hybrid and adding Pur-Sleep aroma therapy, I had tried higher pressures and for a period at a tight range. I'm now achieving some stability in therapy, slowly getting accustomed to the face-grasp of the Hybrid mask, at a 9 to 14cmH2O range. I dropped the low set point 1cmH2O last week in order to see what the reaction would be. Thus far it isn’t bad at all.

I’m thinking more along the “go lower” line of reasoning, trying to lower my bottom pressure gradually to see what the threshold of good results is there. With the COPD, which was in part, brought on by decades of untreated OSA I’m trying to stay at a good O2 saturation during sleep, but without becoming absolutely dependant on a higher pressure for that oxygenation if I can avoid it.

The alternative is to add oxygen to PAP therapy and I’m certain I can avoid that if I get the right pressure balance on the PAP unit. The answer I got today about another polysomnogram… “Sure, you’re overdue for one, but we’re behind and it could take months to get you in.”

I want to know my in-sleep saturation levels now, or very soon. While I feel much better overall since getting real therapy, I believe that my O2 levels are at times still dipping into unsafe ranges during sleep. I’m going on feel, how the body talks to me now that my brain is awake enough to listen.

Too, I’m still considering buying a wrist-style oximeter with software so that I can monitor myself on multiple successive nights, during day and evening activities… and whenever I feel that it is necessary.

Thanks for the input, and I will keep posting.

Nodzy

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Wulfman...

Post by Wulfman... » Tue Sep 04, 2007 1:02 pm

I understand. I guess in my earlier readings of your posts, I overlooked your other medical "issues" and was focused on your charts and readings.

Have you done any other overnight pulse-oximetry tests? They should be free from your DME if your doctor writes a prescription for them. That may answer some of those questions while you're trying to find a device of your own.

Best wishes,

Den


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Post by Nodzy » Tue Sep 04, 2007 1:12 pm

Den.

No... not yet. But in truth I do not at this point trust the medical professionals very much. I want to know for myself what the ranges are before they get a chance to minimize anything else, or fail to diagnose or prescribe properly for me. Sad, but my experiences haven't been thrilling with the medical profession on most points.

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Post by Nodzy » Fri Sep 07, 2007 7:16 am

New charts are posted.

I'm starting to post weekly charts so that data can be easily compared - which may prove useful for newer members of the board. I’ll switch to posting calendar weeks, Sunday to Saturday, at the end of this week.

The weekly .pdf files are optimized, but are still about 2-MB's large. People with dialup service will not get a fast display of the weekly charts.

Posting weekly charts may also encourage more people to obtain and use the software for their respective brand and models of flow generators -- especially if they are having trouble achieving consistently beneficial therapy.

Nodzy
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