Need Some Sugestions

Pugsy · Post by **Pugsy** » Wed Jan 15, 2020 2:10 pm

Actually I wouldn't go changing anything right now. There's no urgent need for one thing and I don't want to invite the aerophagia monster back just to maybe go killing 1 or 2 apnea events. Sometimes the cure is worse than the disease.

Besides...I really think that with time and as the body/brain adjusts to all this that you will sleep better and the AHI will likely drop a bit on its own. With lots of awake times there comes the risk of false positive flagging. There is a lot of truth to the "give it time" thing.

I have heard of that Oura ring thing. Supposedly fairly accurate but seems to be based on measuring movement more than anything else and movement doesn't always mean awake but of course could be.
I have owned a couple of FitBit devices...even the one that is newer and supposed to do heart rate and sleep stages. It's okay...but it told me once that I was sound asleep when I was up letting one of the dogs out to pee...so not perfect.
Anything that doesn't use actual EEG leads to measure sleep stages I sort of take with a grain of salt. Sometimes accurate and sometimes not but at least not a phone app laying on the nightstand telling you how well you slept.

Anyway...no I am not interested in investing any more money in those types of gadgets. Both Fitbits crapped out on me way earlier than they should have and I don't really need some device to tell me how well I slept or not. My body does a pretty good job of doing that all by itself without any gadgets.
But thank you anyway. Been there and done that and no urgent need to go there again.

Now if I could find a device that would let me sleep through my non sleep apnea related issues that mess with my sleep...I might sit up and take notice but I know I have problems that the cpap simply isn't designed to fix. Those I work on in other ways as best I can.

Dog Slobber · Post by **Dog Slobber** » Wed Jan 15, 2020 4:27 pm

I really like what I see on the newer graphs.

As Pugsy pointed out, OSCAR won't upload more data if here is already session information for that date. You can address it by deleting data for a known incomplete date, then all sessions will be uploaded. But the best way to address it is to avoid it. If you have a nap in the day, don't load it into OSCAR, wait till the next day and grab them both.

Regarding the Ramp. I think that might be another OSCAR bug. I think OSCAR interprets AutoRamp as 45 minutes.

Regarding your therapy. This is where I'm really pleased. Notice how moving your minimum to 9, it flattened your pressure line. The higher minimum pressure prevented airway collapse and therefore didn't need to use even higher to open collapsed airways. Another possible benefit of not going up as as high, is that might be keeping you under the threshold where you are bothered by aerophagia.

When your minimum was 9, the machine never needed to go higher than 12.36.
In your previous graphs, with a minimum of 5, your machine was routinely going above 14.

Let's keep it on 9 for a bit.

droo_d · Post by **droo_d** » Wed Jan 15, 2020 11:49 pm

Pugsy wrote: ↑
Wed Jan 15, 2020 2:10 pm
Actually I wouldn't go changing anything right now. There's no urgent need for one thing and I don't want to invite the aerophagia monster back just to maybe go killing 1 or 2 apnea events. Sometimes the cure is worse than the disease.

Besides...I really think that with time and as the body/brain adjusts to all this that you will sleep better and the AHI will likely drop a bit on its own. With lots of awake times there comes the risk of false positive flagging. There is a lot of truth to the "give it time" thing.

I have heard of that Oura ring thing. Supposedly fairly accurate but seems to be based on measuring movement more than anything else and movement doesn't always mean awake but of course could be.
I have owned a couple of FitBit devices...even the one that is newer and supposed to do heart rate and sleep stages. It's okay...but it told me once that I was sound asleep when I was up letting one of the dogs out to pee...so not perfect.
Anything that doesn't use actual EEG leads to measure sleep stages I sort of take with a grain of salt. Sometimes accurate and sometimes not but at least not a phone app laying on the nightstand telling you how well you slept.

Anyway...no I am not interested in investing any more money in those types of gadgets. Both Fitbits crapped out on me way earlier than they should have and I don't really need some device to tell me how well I slept or not. My body does a pretty good job of doing that all by itself without any gadgets.
But thank you anyway. Been there and done that and no urgent need to go there again.

Now if I could find a device that would let me sleep through my non sleep apnea related issues that mess with my sleep...I might sit up and take notice but I know I have problems that the cpap simply isn't designed to fix. Those I work on in other ways as best I can.

Hahaha seriously. If only there was a device that would help with non sleep apnea related issues.

I'll make sure to stick it out at min 9 while I let my body adjust and will continue to record data! As anxious and excited as I am to experience my first night of amazing "no events" kind of sleep, I need to give it some time as you've said. Thank you for the reminder

P.S. I also think the gaps on both 1-13 and 1-14 has to be from raining out so I'll bump up the hose temperature from 81 to 83 and maybe play around with Climate Control instead of leaving it on Auto. I have a faint memory of minimal condensation causing me to wake up.

Dog Slobber wrote: ↑
Wed Jan 15, 2020 4:27 pm
I really like what I see on the newer graphs.

As Pugsy pointed out, OSCAR won't upload more data if here is already session information for that date. You can address it by deleting data for a known incomplete date, then all sessions will be uploaded. But the best way to address it is to avoid it. If you have a nap in the day, don't load it into OSCAR, wait till the next day and grab them both.

Regarding the Ramp. I think that might be another OSCAR bug. I think OSCAR interprets AutoRamp as 45 minutes.

Regarding your therapy. This is where I'm really pleased. Notice how moving your minimum to 9, it flattened your pressure line. The higher minimum pressure prevented airway collapse and therefore didn't need to use even higher to open collapsed airways. Another possible benefit of not going up as as high, is that might be keeping you under the threshold where you are bothered by aerophagia.

When your minimum was 9, the machine never needed to go higher than 12.36.
In your previous graphs, with a minimum of 5, your machine was routinely going above 14.

Let's keep it on 9 for a bit.

All the specific changes you mentioned before was such great info! The excitement I had this morning seeing the AHI drop felt amazing and I'll continue to rock it at min: 9 while I let my body adapt. Couldn't have a better experience on CPAP Therapy without all the advice I've been reading. I also recovered the data from 1-13 and will include it here in case it may be helpful. I am noticing a strong trend of the AHI dropping down gradually while my body adjusts just as Pugsy had mentioned. I also notice my Clear Airway Events are much higher than my OAs as of now but I'm assuming as time goes by, those will also decrease. Will be back later!

droo_d · Post by **droo_d** » Wed Jan 22, 2020 1:06 pm

Its been a week since my last update. I'm on my work computer and Oscar is more "zoomed" in compared to how it is at home so I couldn't get the settings in the screenshot. Settings have remained the same over the week with the only difference being that last night I changed EPR from Ramp Only to Full Time.

From Jan 16 - Jan 20, I experienced Large Leaks (10%-40%) and difficulties breathing while using the F30 Padacheek so I need to 1) Cut larger nose holes and 2) Ensure no wrinkles when I decide to use it again. Awesome silky smooth product! Just need to properly use.

With the update on Oscar data, should I continue to run the same settings? I will be purchasing a Soft Cervical Collar to help keep my airway open as I'm a back-sleeper and I tend to tilt my head over to either side leading to these large leaks around my nose and frequent wake ups. I have an almost non-existent nose bridge

Note: I was using the F30 FFM the entire time but tried on the Dreamwear FFM last night

: Oscar 1-15.JPG (326.42 KiB) Viewed 3553 times

: Woke up and restarted machine due to a leak; Oscar 1-21.JPG (339.38 KiB) Viewed 3553 times

zonker · Post by **zonker** » Wed Jan 22, 2020 2:16 pm

droo_d wrote: ↑
Wed Jan 22, 2020 1:06 pm
Its been a week since my last update.

you're certainly heading in the right direction! look at you, getting that ahi down. good work!

so, i reckon it's time to raise that minimum pressure. from the charts, looks like it wants to get to 11 pretty quickly. up to you if you want to go straight from 9 to 11. be bold or be cautious.

how are you feeling upon waking up?

Jas_williams · Post by **Jas_williams** » Wed Jan 22, 2020 2:38 pm

I would not change anything as your pressure line is fairly flat your numbers are great how are you feeling. It’s now down to long term trends

droo_d · Post by **droo_d** » Wed Jan 22, 2020 3:06 pm

zonker wrote: ↑
Wed Jan 22, 2020 2:16 pm

droo_d wrote: ↑
Wed Jan 22, 2020 1:06 pm
Its been a week since my last update.

you're certainly heading in the right direction! look at you, getting that ahi down. good work!

so, i reckon it's time to raise that minimum pressure. from the charts, looks like it wants to get to 11 pretty quickly. up to you if you want to go straight from 9 to 11. be bold or be cautious.

how are you feeling upon waking up?

Thank you for the great recommendations in the first place! I can't quite examine how I feel besides tired since I'm still frequently waking up from these minor nasal leaks so the AHI has been much lower but the wake ups really disturb my overall sleep. Based on sleep tracking which way be super off or relatively accurate, I'm averaging 5.5 hours of sleep time and 2-3 hours of awake time daily for the past 3 weeks so my sleep debt is quite high.

Definitely wouldn't dare hop straight to 11 but I can inch towards it gradually since I've managed to remove all signs of aerophagia

droo_d · Post by **droo_d** » Wed Jan 22, 2020 3:08 pm

Jas_williams wrote: ↑
Wed Jan 22, 2020 2:38 pm
I would not change anything as your pressure line is fairly flat your numbers are great how are you feeling. It’s now down to long term trends

I definitely see a lot of truth in this! I will for sure consider holding out and seeing longer trends before making any adjustments. Finally got a night of low leak so I may see how the AHI trend changes

Pugsy · Post by **Pugsy** » Wed Jan 22, 2020 3:24 pm

You aren't having enough central apneas to worry about. Ignore them. A few here or there is normal anyway.
I am betting some of them are SWJ false positives anyway.

FWIW...I agree with Jas. I see no need to increase the pressure at this time. The reason we use apap mode is so the machine can auto adjust when it needs to.

droo_d · Post by **droo_d** » Wed Jan 22, 2020 4:44 pm

Pugsy wrote: ↑
Wed Jan 22, 2020 3:24 pm
You aren't having enough central apneas to worry about. Ignore them. A few here or there is normal anyway.
I am betting some of them are SWJ false positives anyway.

FWIW...I agree with Jas. I see no need to increase the pressure at this time. The reason we use apap mode is so the machine can auto adjust when it needs to.

Thanks for reassuring! Just got the soft cervical collar so I will continue to stick to the same settings to see if the nasal leaks are caused by me leaning the mask against the pillow as I'm asleep. I want to push for a night of 0 leak disturbances to really assess how I feel before drastically changing anything

droo_d · Post by **droo_d** » Mon Jan 27, 2020 1:36 pm

Update: Soft cervical collar is working amazing for leak prevention.

For the past week, I've kept EPR (Level 3) on Full Time instead of Ramp Only while keeping all other settings the same and I've noticed my AHI being higher at an average of 5. Keeping EPR on Full Time seems to increase the # of Central Apneas while leaving it on Ramp Only makes it really difficult to sleep once the exhale assist stops kicking in. I can usually tell when my FFM no longer moves during exhale.

Based on your experience with those who have increased Clear Airways because of EPR,
1. Would you recommend turning EPR off completely
2. Getting used to Ramp Only while leaving EPR on level 3
3. Keep it Full Time but lower EPR to either 1 or 2
4. Other option

I've been feeling sluggish and brain fogged so I'm continuously looking to improve based on weekly or monthly trends. Thanks in advance!

Attached Photo: I didn't fall asleep until 2:30am so events before that are false.

: I didn't actually fall asleep until 2:30am so events before are false; Oscar 1-26.JPG (351.26 KiB) Viewed 3460 times

Jas_williams · Post by **Jas_williams** » Mon Jan 27, 2020 2:14 pm

I suggest lowering the epr to 2 full time it is likely to halve your CA's

droo_d · Post by **droo_d** » Tue Jan 28, 2020 1:44 pm

Jas_williams wrote: ↑
Mon Jan 27, 2020 2:14 pm
I suggest lowering the epr to 2 full time it is likely to halve your CA's

Yep! That did the trick. Thank you!

Had a great night sleep last night and the lowest AHI I've had in over 2 weeks. I'll be sticking with the same settings and may experiment with EPR at 1 sometime later down the road.

Feeling much better with minimal leaks, no mask wake up disturbances, and no gaps in between the graphs for low AHI nights which was very common before.

: Oscar 1-27.JPG (323.92 KiB) Viewed 3434 times

zonker · Post by **zonker** » Tue Jan 28, 2020 3:02 pm

droo_d wrote: ↑
Tue Jan 28, 2020 1:44 pm

Jas_williams wrote: ↑
Mon Jan 27, 2020 2:14 pm
I suggest lowering the epr to 2 full time it is likely to halve your CA's
Yep! That did the trick. Thank you! Had a great night sleep last night and the lowest AHI I've had in over 2 weeks. I'll be sticking with the same settings and may experiment with EPR at 1 sometime later down the road.

Feeling much better with minimal leaks, no mask wake up disturbances, and no gaps in between the graphs for low AHI nights which was very common before.

Oscar 1-27.JPG

hoping this is a trend!

could you post the next two nights worth of data? i'd be curious to see how this is going.

very glad this is straightening out for you!!

droo_d · Post by **droo_d** » Mon Feb 10, 2020 12:47 pm

zonker wrote: ↑
Tue Jan 28, 2020 3:02 pm

droo_d wrote: ↑
Tue Jan 28, 2020 1:44 pm

Jas_williams wrote: ↑
Mon Jan 27, 2020 2:14 pm
I suggest lowering the epr to 2 full time it is likely to halve your CA's
Yep! That did the trick. Thank you! Had a great night sleep last night and the lowest AHI I've had in over 2 weeks. I'll be sticking with the same settings and may experiment with EPR at 1 sometime later down the road.

Feeling much better with minimal leaks, no mask wake up disturbances, and no gaps in between the graphs for low AHI nights which was very common before.

Oscar 1-27.JPG

hoping this is a trend!

could you post the next two nights worth of data? i'd be curious to see how this is going.

very glad this is straightening out for you!!

Had a little hiatus to give myself a chance to observe a two-week trend and I am averaging an AHI = 1.55. Occasionally, even with the soft cervical collar, I would get some leaks but definitely much better than without it and I know the main reason is because my mouth still tends to drop while asleep. Looking for some input on how I could improve and lower it some more. Thanks

Settings: 9 Min to 18 Max with EPR of 2. I've been testing only one change and that's Ramp Only vs Full Time for EPR.

If anyone has a soft cervical collar, are you supposed to strap it skin tight to your neck or leave an adequate amount of room?

: Oscar 2-1.JPG (318.75 KiB) Viewed 3371 times

: Oscar 2-2.JPG (336.64 KiB) Viewed 3371 times

: Oscar 2-3.JPG (336.91 KiB) Viewed 3371 times

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