Jonathan's ongoing list of questions, comments, concerns...

Bandaid or Moleskin will help the bruse overtime your nose will learn to toughen up. Jim

jonathan, here's what they want to see-
you're doing better on getting graphs posted. took me FOR-ever to get it right.

i'm no expert so i have nothing to add in interpreting your graph. besides, you already have two of our best people commenting!

Thanks, everybody. I'll try to get moleskin. I already tried a bandaid in my first week and the resulting leak was horrific.

Anyway, my doc weighed in and she recommended me contacting the sleep center -- which isn't happening. I'll have to sneakernet the card, wait a week for them to have time to look at the data, and arrive at the same conclusions. So tonight I go 14/10 and see what the data looks like tomorrow.

zonker wrote: ↑

Mon Nov 12, 2018 3:04 pm

jonathan, here's what they want to see-

screenshot-11-9-18.png

you're doing better on getting graphs posted. took me FOR-ever to get it right.

i'm no expert so i have nothing to add in interpreting your graph. besides, you already have two of our best people commenting!

Thank you for saying so. I build websites for a living, and have been using BBSes since the days when we had to dial into them with Procomm Plus, so was starting to feel like I was losing my mind with each incorrect posting. lol.

JonathanZK wrote: ↑

Mon Nov 12, 2018 4:48 pm

Thank you for saying so. I build websites for a living, and have been using BBSes since the days when we had to dial into them with Procomm Plus, so was starting to feel like I was losing my mind with each incorrect posting. lol.

OMG! BBS!! and you had to pay the long distance charges. i well remember i had a one month bill of close to four hundred bucks.

these kids today don't know how good they have it!

zonker wrote: ↑

Mon Nov 12, 2018 5:45 pm

JonathanZK wrote: ↑

Mon Nov 12, 2018 4:48 pm

Thank you for saying so. I build websites for a living, and have been using BBSes since the days when we had to dial into them with Procomm Plus, so was starting to feel like I was losing my mind with each incorrect posting. lol.

OMG! BBS!! and you had to pay the long distance charges. i well remember i had a one month bill of close to four hundred bucks.

these kids today don't know how good they have it!

No kidding... Makes you wonder what they'll say about their kids' tech.

JonathanZK wrote: ↑

Mon Nov 12, 2018 4:48 pm

starting to feel like I was losing my mind

That's an entirely separate issue, the results of which remain to be seen

Well, I had a pretty rough night... I adjusted the settings +1 from 13/9 to 14/10 and the results are not positive.



And for comparison, here's last night:



And also for comparison, here's my best night:



If the increases in OAs and Periodic Breathing are any indication, raising the pressure to 14/10 was a mistake. And snoring was largely unaffected.

No large leaks were detected, but I'm becoming convinced there's something going on. Toward the end of my night, I felt nothing in terms of pressure. No cheeks being blown up, nothing. Just total relaxation -- but I noticed if I press the mask harder against my face, pressure increases. There are no leaking sounds from the sides. I can't feel any blowing in the eyes. If I move fingers around the edge, I detect nothing. But if I push on the mask, there's increased pressure. Same if I move; when I sat up, the sudden increase in pressure nearly knocked me back down. Is it my imagination? I see the leak rate is a bit higher from 1:20-2:30am, but I dunno. I asked the other day if this could be just getting used to the pressure. But it doesn't seem like that...

Any advice for the next adjustment(s) would be appreciated.

It’s starting to look like you have positional apnoea and will require a BiLevel with more pressure for when your on your back. The Bipap pro is basically a fixed pressure machine and cannot provide what you need

Jas_williams wrote: ↑

Tue Nov 13, 2018 11:55 am

It’s starting to look like you have positional apnoea and will require a BiLevel with more pressure for when your on your back. The Bipap pro is basically a fixed pressure machine and cannot provide what you need

Thanks for your reply, Jas... If I may, I have a couple follow up questions...

First, what is leading you to the positional apnea conclusion? I'm not trying to be challenging, but rather would like to understand what parts of my description or data are pointing in that direction -- both for my own education, and to help deliver my doctor (an arrogant SOB assigned to me by my HMO) to a productive outcome.

Second, when I raised my IPAP, I also raised my EPAP by the same amount. My original sleep studies showed an intolerance for CPAP because I couldn't breathe against it. Would it be useful to experiment further, do you think with higher IPAP values and lower EPAP? (

Third, assuming I have to return the machine -- and I think it likely that that's the case -- with what should it be replaced? I don't have a ton of money to spend, especially if the sleep center gives me a hard time and I'm not able to get my $1400 copay back.

Thanks again.

JonathanZK wrote: ↑

Tue Nov 13, 2018 4:34 am

If the increases in OAs and Periodic Breathing are any indication, raising the pressure to 14/10 was a mistake. And snoring was largely unaffected.

Well, it's pretty much unheard of that *more* pressure results in *more* obstructives. But, sleep does vary from night to night, and you may just have had a bad night.

JonathanZK wrote: ↑

Tue Nov 13, 2018 4:34 am

No large leaks were detected, but I'm becoming convinced there's something going on. Toward the end of my night, I felt nothing in terms of pressure. No cheeks being blown up, nothing. Just total relaxation -- but I noticed if I press the mask harder against my face, pressure increases. There are no leaking sounds from the sides. I can't feel any blowing in the eyes. If I move fingers around the edge, I detect nothing. But if I push on the mask, there's increased pressure. Same if I move; when I sat up, the sudden increase in pressure nearly knocked me back down. Is it my imagination? I see the leak rate is a bit higher from 1:20-2:30am, but I dunno. I asked the other day if this could be just getting used to the pressure. But it doesn't seem like that...

Any advice for the next adjustment(s) would be appreciated.

Either it's your imagination, or your machine is faulty.

You could make a home-made manometer, or buy a digital one on ebay (under 30$ last I checked), and check the pressure yourself.

palerider wrote: ↑

Tue Nov 13, 2018 2:36 pm

Well, it's pretty much unheard of that *more* pressure results in *more* obstructives. But, sleep does vary from night to night, and you may just have had a bad night.

hmm...

palerider wrote: ↑

Tue Nov 13, 2018 2:36 pm

Either it's your imagination, or your machine is faulty.

Or the mask. Pity I can't just go down to the local market and take a few of them to a dressing room.

palerider wrote: ↑

Tue Nov 13, 2018 2:36 pm

You could make a home-made manometer, or buy a digital one on ebay (under 30$ last I checked), and check the pressure yourself.

I like this idea. I wonder how I can hook it up to keep track throughout the night so I can look at it at 3am...

JonathanZK wrote: ↑

Tue Nov 13, 2018 3:18 pm

palerider wrote: ↑

Tue Nov 13, 2018 2:36 pm

You could make a home-made manometer, or buy a digital one on ebay (under 30$ last I checked), and check the pressure yourself.

I like this idea. I wonder how I can hook it up to keep track throughout the night so I can look at it at 3am...

I use one of the oxygen adapters. like this: https://smile.amazon.com/Oxygen-Enrichm ... B071GW7DFN

Any inexpensive manometer won't record, but you can hook one up to look at when you wake up and think there's lessened pressure.

So I'm adjusting settings for tonight. Leaving IPAP at 14, putting EPAP back to 9... then I was perusing the menu and saw a section for Bi Flex set to 2. I looked in the manual, and I Googled a bit, but can't seem to get a good plain English description of this "comfort" feature. Could this be the source of my observed pressure variances?

JonathanZK wrote: ↑

Tue Nov 13, 2018 8:11 pm

So I'm adjusting settings for tonight. Leaving IPAP at 14, putting EPAP back to 9... then I was perusing the menu and saw a section for Bi Flex set to 2. I looked in the manual, and I Googled a bit, but can't seem to get a good plain English description of this "comfort" feature. Could this be the source of my observed pressure variances?

I've never figured out the point of biflex, I mean, it's a pressure relief on exhale... but, that's what bilevel is all about... seems kinda redumbdant to me, but respiroinics is really proud of their 'flex' tech... so I guess they stuck with it. though, like I said, I have no idea why, just making stupid guesses.

palerider wrote: ↑

Tue Nov 13, 2018 8:20 pm

JonathanZK wrote: ↑

Tue Nov 13, 2018 8:11 pm

So I'm adjusting settings for tonight. Leaving IPAP at 14, putting EPAP back to 9... then I was perusing the menu and saw a section for Bi Flex set to 2. I looked in the manual, and I Googled a bit, but can't seem to get a good plain English description of this "comfort" feature. Could this be the source of my observed pressure variances?

I've never figured out the point of biflex, I mean, it's a pressure relief on exhale... but, that's what bilevel is all about... seems kinda redumbdant to me, but respiroinics is really proud of their 'flex' tech... so I guess they stuck with it. though, like I said, I have no idea why, just making stupid guesses.

Well, I'm going to turn it off and see how it goes...