Sleep Woes-Need help with Oscar results

The only thing I can think of is to switch back to the other mask, and see if the results change.

I will try the Dreamwear tonight then. It will give my nose a break as I was getting irritation from F20. Earlier you said to bump to 14 as I had been on 13 for longest time. Does this situation change your perspective? i had dropped my pressure back to 13 last night (with F20) thinking that might help with the ca but no joy.

cevetsky wrote: ↑

Mon Dec 23, 2019 11:01 am

I will try the Dreamwear tonight then. It will give my nose a break as I was getting irritation from F20. Earlier you said to bump to 14 as I had been on 13 for longest time. Does this situation change your perspective? i had dropped my pressure back to 13 last night (with F20) thinking that might help with the ca but no joy.

The problem is that you need more pressure to alleviate the obstructives... but then all these centrals appeared. either way, things aren't good. Let's see what happens tonight.

Will try 14 with Dreamwear then post tomorrow.

palerider wrote: ↑

Mon Dec 23, 2019 5:08 pm

The problem is that you need more pressure to alleviate the obstructives... but then all these centrals appeared. either way, things aren't good. Let's see what happens tonight.

Has he actually been struggling with obstructive apneas?

All his data has indicated clustered, consistently spaced apneas in a mixed form of central, obstructive and unknown. Earlier his data was all distorted due to massive amounts of leak which is also the reason for the high number of unknown apneas. Now he has the leak under control and his two nights of data have indicated similar results, CSR like breathing which probably agrees with his past data (he can look at his previous nights flow data in closer detail to see if this is the case, just look for a periodic style of breathing).

Going back to a nasal mask is just going to cause excessive leakage and poor quality data again but go ahead and try it for a night. Then can try to treat the CSR like breathing by turning off EPR to see if that helps.

Geer1 wrote: ↑

Mon Dec 23, 2019 8:02 pm

palerider wrote: ↑

Mon Dec 23, 2019 5:08 pm

The problem is that you need more pressure to alleviate the obstructives... but then all these centrals appeared. either way, things aren't good. Let's see what happens tonight.

noise.

Oh, and I HAD hoped that Morbius had chased you off. :sigh:

Well switched to Dreamwear and pap cap chin strap. Nubers are not good as seen in the attached file. Up for discussion.

cevetsky wrote: ↑

Tue Dec 24, 2019 9:41 am

Well switched to Dreamwear and pap cap chin strap. Nubers are not good as seen in the attached file. Up for discussion.

As expected you have extensive leaking again. You could try mouth tape to see if that stops the leaks but I would stay with using the full face mask as the Dreamwear mask is negatively affecting your treatment and large leaks makes your data tough to interpret.

What you need to do now is look at your flow data in more detail. You tried turning EPR off previously and were still having clustered apneas but from an overview level it isn't clear if those apneas were appearing in a periodic style as they now appear to be, that could be because of the data being affected by the leaks or it could be because EPR does make some difference. You can try to determine that by looking at your old data but it may be tough. If you turn EPR back off now with the FFM you will probably get much clearer data that will help determine if the EPR setting helps with periodic breathing.

Then if you post more detailed flow rate data (zoom in to ~10 mins of data during apnea cluster) we can help you determine how to proceed. You could do this for the couple good nights of data you had with the FFM to start with (one of the OA's, and one of the CA's).

You might be having CPAP treatment induced centrals or possibly positional obstructive apneas. Do you know if you have a tendency to tuck your chin or sleep with a large pillow or your head at the edge of pillow so head is tilted forward?

Well I do appreciate your input. I have been on cpap since year 2000 but all this is new to me. First off I am not sure how to "zoom in" to create the info you need. As far as your other question about sleeping and pillow concerns I do not do that, head never tucked in. I will go back to FFM and turn off EPR then repost when I get the chance. In the mean time maybe you can tell me how to zoom in on apnea cluster as you requested.

cevetsky wrote: ↑

Tue Dec 24, 2019 9:41 am

Well switched to Dreamwear and pap cap chin strap. Nubers are not good as seen in the attached file. Up for discussion.

screenshot-20191224-103407.png

Ok, for tonight, let's try setting the pressure to 13, but turn EPR off. For some people, perhaps you, the extra ventilation that EPR gives will cause central apnea.

cevetsky wrote: ↑

Tue Dec 24, 2019 12:45 pm

Well I do appreciate your input. I have been on cpap since year 2000 but all this is new to me. First off I am not sure how to "zoom in" to create the info you need. As far as your other question about sleeping and pillow concerns I do not do that, head never tucked in. I will go back to FFM and turn off EPR then repost when I get the chance. In the mean time maybe you can tell me how to zoom in on apnea cluster as you requested.

Double clicking on the chart data will zoom in. Right clicking will zoom out. You can also left click and hold it at a start point and then move cursor to an end point then release to zoom into a specific section. Once you are clicked into the chart area you can use the keypad arrows to move around chart as well. Play around with it for a bit and you will get the hang of it.

Duration of the zoomed in portion can be seen just above the flow chart.

palerider wrote: ↑

Tue Dec 24, 2019 12:51 pm

cevetsky wrote: ↑

Tue Dec 24, 2019 9:41 am

Well switched to Dreamwear and pap cap chin strap. Nubers are not good as seen in the attached file. Up for discussion.

screenshot-20191224-103407.png

Ok, for tonight, let's try setting the pressure to 13, but turn EPR off. For some people, perhaps you, the extra ventilation that EPR gives will cause central apnea.

Well I believe I have tried that set up. Posted on page 2 Sunday Dec 8 was with Dreamwear with EPR off, no joy.

cevetsky wrote: ↑

Tue Dec 24, 2019 1:10 pm

Well I believe I have tried that set up. Posted on page 2 Sunday Dec 8 was with Dreamwear with EPR off, no joy.

I imagine he means to do this with the FFM. Large leaks affect both your results and treatment so it is hard to draw any conclusions from that old data especially the ones with the smart start issue.

First step was to figure out why the machine was shutting off. Second step was to deal with the leaks. Now we have decent data and can try to diagnose the cause of apnea’s and try to improve them.

Well palerider is the one that suggested I go back to old mask (dreamwear) because of the CSR and CA. with FFM. He quoted me that I was switching to dreamwear for last night. It is starting to get confusing here.

I think you're going to need a different machine.

Why did you turn on EPR when you switched to 14?