New user introduction

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Rubicon
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Re: New user introduction

Post by Rubicon » Tue Dec 05, 2023 6:40 am

Pugsy wrote:
Tue Dec 05, 2023 6:32 am
Yeah...it probably would but my thought was give it a couple of weeks and let him get used to the new kind of mask and then go down the "let's zoom in up close" thing only if we really need to.
I was looking for a sneak preview as I'll be on hand-held devices for the holiday.

Specifically, with the inspiratory curves stable and the expiratory curves not, IMO deserves a look-see.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

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Re: New user introduction

Post by Pugsy » Tue Dec 05, 2023 6:46 am

Rubicon wrote:
Tue Dec 05, 2023 6:40 am
Pugsy wrote:
Tue Dec 05, 2023 6:32 am
Yeah...it probably would but my thought was give it a couple of weeks and let him get used to the new kind of mask and then go down the "let's zoom in up close" thing only if we really need to.
I was looking for a sneak preview as I'll be on hand-held devices for the holiday.

Specifically, with the inspiratory curves stable and the expiratory curves not, IMO deserves a look-see.
Okay.....since you volunteered :lol: :lol: :lol: go for it.
If there had been a lot more centrals going on....I probably would have suggested it sooner and not waited a couple of weeks......or if he had reported he felt like he was sleeping soundly with minimal wake ups.

_________________
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Curious_Steve
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Re: New user introduction

Post by Curious_Steve » Tue Dec 05, 2023 7:59 am

Pugsy wrote:
Tue Dec 05, 2023 6:46 am
Rubicon wrote:
Tue Dec 05, 2023 6:40 am
Pugsy wrote:
Tue Dec 05, 2023 6:32 am
Yeah...it probably would but my thought was give it a couple of weeks and let him get used to the new kind of mask and then go down the "let's zoom in up close" thing only if we really need to.
I was looking for a sneak preview as I'll be on hand-held devices for the holiday.

Specifically, with the inspiratory curves stable and the expiratory curves not, IMO deserves a look-see.
Okay.....since you volunteered :lol: :lol: :lol: go for it.
If there had been a lot more centrals going on....I probably would have suggested it sooner and not waited a couple of weeks......or if he had reported he felt like he was sleeping soundly with minimal wake ups.
Y'all are awesome. I'll get last night uploaded on my laptop in about 12 hrs. (This whole work thing, it just gets in the way, you know)

Curious_Steve
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Re: New user introduction

Post by Curious_Steve » Tue Dec 05, 2023 7:59 pm

I was able to get my LL numbers to 0.0 last night, and I'm really starting to like the new mask.
I might be changing too many variables at once, but I did swap my super firm pillow out for my somewhat softer backup pillow. On a side note, it was interesting waking up and actually being able to focus my vision on my phone's screen versus having to reach for my cheaters. For the past few years, my vision has been terrible upon waking. I'm tickling 50, so presbiopia (when your arms are too short to read the menu syndrome) has been slowly increasing.

I want to post an OSCAR screenshot, but with the caveat that much of the activity that began around the 0340 mark may have been from my wife getting out of bed, then coming back and cuddling up against me stirring me from a restful state. That rash of OA's I experienced I am aware of my cheeks puffing out (while wearing a full face mask) like a chipmunk. Even though I was comfortable, I was lying on my back, which isn't a good position for me.

screenshot-20231205-192839.png
screenshot-20231205-192839.png (215.66 KiB) Viewed 4289 times

Curious_Steve
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Re: New user introduction

Post by Curious_Steve » Tue Dec 05, 2023 8:00 pm

Rubicon wrote:
Tue Dec 05, 2023 6:40 am
Pugsy wrote:
Tue Dec 05, 2023 6:32 am
Yeah...it probably would but my thought was give it a couple of weeks and let him get used to the new kind of mask and then go down the "let's zoom in up close" thing only if we really need to.
I was looking for a sneak preview as I'll be on hand-held devices for the holiday.

Specifically, with the inspiratory curves stable and the expiratory curves not, IMO deserves a look-see.
Rubicon, I uploaded to SleepHQ, and would love to hear your thoughts when you get a moment.
https://sleephq.com/public/78ea2caa-896 ... 4ceec47c7f

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Rubicon
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Re: New user introduction

Post by Rubicon » Wed Dec 06, 2023 4:28 am

Preface: There are 5000 breaths/night so don't draw an all-encompassing conclusion if we look at a block of 20. Stuff changes with sleep stage, body position and a bunch of other things.

Before we look at expiratory phases, here's some inspiratory events (above the zero line) these are flow limitations that lead to arousals (breaks in sleep continuity). The machine is chasing them with pressure but not doing a particularly effective job:

Image
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Re: New user introduction

Post by Rubicon » Wed Dec 06, 2023 5:01 am

Image

Image

In the first image, you're undoubtedly awake. The waveforms are smooth and the inspiratory:expiratory ratio is ~1.0:1.5.

In the second image, where sleep has probably arrived, you got tons of little lumps and the I:E Ratio is now ~1.0:0.5.

Sleep apnea is generally considered to be a problem with inspiration. However, you seem to also have an issue with expiration (OK, it's still sleep-disordered breathing).

That said, little lumps on the breathing waveform may be caused by cardiac oscillations (CBA, cardioballistic artifact). Interesting phenomenon, but benign. However, because of the shortened expiratory time and the fact that you have CBA in the inspiratory waveform as well, IMO this is soft palate interference.

When you were first examined, did your medical guy take a look down your throat and comment about the structures down there?
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

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Rubicon
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Re: New user introduction

Post by Rubicon » Wed Dec 06, 2023 5:37 am

In this area, there's significant FL, but expiration looks much less impeded:

Image
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

Curious_Steve
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Re: New user introduction

Post by Curious_Steve » Wed Dec 06, 2023 6:26 am

Rubicon wrote:
Wed Dec 06, 2023 5:01 am
IMO this is soft palate interference.

When you were first examined, did your medical guy take a look down your throat and comment about the structures down there?
Thanks for looking this over.
The initial exam happened in 2007, so I'm not 100% sure, but that does sound familiar. In 09 I had a deviated septum as well as several other sinus related issues addressed in a surgery. This was a huge help.

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Re: New user introduction

Post by Rubicon » Thu Dec 07, 2023 4:45 am

Well that was a short thread.

IMO you have a lot of opportunity for DWing.

For instance, your machine is spending a lot of the night chasing events. If it's chasing events, then you're having events. The whole idea is to treat/prevent them from happening.

At low pressure your inspiratory waveform looks ferstunk:

Image

At 12 the waveform is improved (it's somewhat maintained at 10, this is probably due to a successful down-titration):

Image

Hey, 5000 breaths, remember? A lot of stuff happens over 8 hours...
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

Curious_Steve
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Re: New user introduction

Post by Curious_Steve » Thu Dec 07, 2023 2:27 pm

Rubicon wrote:
Thu Dec 07, 2023 4:45 am
Well that was a short thread.

IMO you have a lot of opportunity for DWing.

For instance, your machine is spending a lot of the night chasing events. If it's chasing events, then you're having events. The whole idea is to treat/prevent them from happening.

At low pressure your inspiratory waveform looks ferstunk:

Image

At 12 the waveform is improved (it's somewhat maintained at 10, this is probably due to a successful down-titration):

Image

Hey, 5000 breaths, remember? A lot of stuff happens over 8 hours...
As a self certified knob turner and button pusher, I love the idea of Dwing.

When I get home I can post links to the last couple of nights if you're still interested in looking at the data.

Also, I have an O2 ring coming in this afternoon. I'm not sure if that data will be helpful, but I'm certainly curious.

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Re: New user introduction

Post by Rubicon » Thu Dec 07, 2023 6:05 pm

Curious_Steve wrote:
Thu Dec 07, 2023 2:27 pm
Also, I have an O2 ring coming in this afternoon. I'm not sure if that data will be helpful...
Well, you don't know if you don't look.

Probably be some sub-clinical desats associated with the FLs. Them ain't an issue as much as the arousals the FLs cause.

But it's fun to look at squiggles.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

Curious_Steve
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Re: New user introduction

Post by Curious_Steve » Thu Dec 07, 2023 7:04 pm

Rubicon wrote:
Thu Dec 07, 2023 6:05 pm
Curious_Steve wrote:
Thu Dec 07, 2023 2:27 pm
Also, I have an O2 ring coming in this afternoon. I'm not sure if that data will be helpful...
Well, you don't know if you don't look.

Probably be some sub-clinical desats associated with the FLs. Them ain't an issue as much as the arousals the FLs cause.

But it's fun to look at squiggles.
Squiggles are fascinating. But really, I just want to see if I'm sleeping as good as I think I am.
Also, I'm going to deep dive on Flow Limits this evening to try and educate myself on what it is and what they mean.

Dec 5
https://sleephq.com/public/e8caf8fd-2a6 ... 952ee4e57b

Dec 6 (I may show to be restless last night, we got some family news that is weighing heavy at the moment.)
https://sleephq.com/public/90606cd7-5d4 ... f2416daf2f

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Re: New user introduction

Post by Rubicon » Fri Dec 08, 2023 4:27 am

Curious_Steve wrote:
Thu Dec 07, 2023 7:04 pm
But really, I just want to see if I'm sleeping as good as I think I am.
Depends on how good you think you're sleeping.

IMO it's not all that well (or, you could do quite a bit better). You're having tons of arousals which break sleep continuity.
Also, I'm going to deep dive on Flow Limits this evening to try and educate myself on what it is and what they mean.
There's a lot less of that palatal interference/CBA in those 2 nights, but the FL is still a big problem.

Let me find you an arousal...
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
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Re: New user introduction

Post by Rubicon » Fri Dec 08, 2023 5:00 am

So you're only looking at 2 squiggles-- flow and (soon) oximetry. There's a bunch more stuff being monitored during NPSG:

Image

Flow limitations often cause breaks in sleep continuity, which are seen in EEG. Looking a little closer:

Image

It's these arousals that make you tired.

Note the subtle change in breathing waveform that causes the arousal.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.