A-Flex - First Night

roster · Post by **roster** » Thu Sep 20, 2007 11:59 am

Night 1 - Sept 12
Pressure 4 - 10
A-Flex setting 2
Leak 30
90% pressure 10
AHI 25

Night 2 - Sept 13
Pressure 7 - 12
A-Flex setting 2
Leak 37
90% pressure 11
AHI 32

Night 3 - Sept 14
Pressure 10
Straight cpap setting
Leak 35
AHI 33

Night 4 - Sept 15
Pressure 8
Straight cpap setting
Leak 37
AHI 31

Night 5 - Sept 16
Pressure 7
Straight cpap setting
Leak 29
AHI 30

Night 6 - Sept 17
Tennis balls
AHI ?

Night 7 - Sept 18
Pressure range 10 - 15
No Flex
Leak 49
AHI 20

Night 8 - Sept 19
Pressure range 7 - 10
No Flex
Leak 38
AHI 20

I felt like I had a pretty good night and this morning I felt better than usual. There were six of us in a pretty boring technical meeting all morning and by 10:30 I was afraid of nodding off.

I also noticed that two of the considerably younger guys were having more problems than me staying awake. .

BTW, I don't know what the hell these numbers I am tracking signify. I have a strong suspicion that the docs are right about the "home" machines not accurately reporting AHI.

roster · Post by **roster** » Sun Sep 30, 2007 11:43 am

A quick update, my second titration study is scheduled for tomorrow night. I plan to come home early from work to get in about an hour of aerobics and maybe a little weightlifting. I want to eat early and shower before I go to the sleep lab. I hope to be fatigued enough to sleep deeply.

In the meantime, I installed Encore Pro 1.8.49 and Encore Pro Analyzer. I have been comparing the data in Encore Pro with the data on the A-Flex's data screen. The AHI numbers are identical. Average leak does not agree but is close.

I now have experimented on different nights with pressure ranges of 7-9, 8-10, 9-11, 10-12, 11-13, 13-15. The AHI is running 26 to 32 at these settings. It doesn't seem to matter about the pressure, I always get the same AHI and the 90% pressure is always the max pressure. Now even if I need a very high pressure, say 18 or 20, I would think the AHI would come down some by increasing the pressure ffrom 7-9 to 13-15, but it hasn't. ????

For a 7-hour night I am getting about 75 minutes total in apnea. Again, this stays the same as the pressure is varied. Most of the AHI is A and most nights there are zero nonresponsive events.

I was titrated 19 months ago at 10 and the doc said 7 took care of 90% of AHI but they bumped it to 10 to eliminate most of the snores.

Currently my VS is running high, i.e., in excess of 20 per hour.

Variable breathing is running 25 to 30%. What is that?

Average leak is running near mask specification level. High leak is showing zero.

I kept some notes about what happening during the night and how I felt next day (crappy, as usual). Two nights, I had AHI of 20 but I had usage of 7 hours and sleep of only about 5 hours. So if you divide the incidents by 5 hours instead of 7, my AHI was effectively over 30.

I would like to think the data reporting is inaccurate but it does correlate with how poorly I feel.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, Encore Pro, AHI

wabmorgan · Post by **wabmorgan** » Sun Sep 30, 2007 12:13 pm

Those AHI number are pretty HIGH. You might try a broader ranger say 6 to 14 and see what happens. (I was also given an RX of 10 but then I went back to sleep doc and ask for auto-pap, he actually gave Rx of 6 to 14.)

Judgeing from the numbers.... seems like it is pretty accutate considering how poorly you state you feel.

On the other end of scale, I also just installed Encore Pro and card reader and pulled the data from it. AHI running between 0 and 4.4:)

rested gal · Post by **rested gal** » Sun Sep 30, 2007 5:03 pm

rooster wrote:my second titration study is scheduled for tomorrow night.

rooster, it will be VERY interesting to see what pressure they come up with at your titration. And how well that pressure handles events.

I know I sound like a broken record, but I still think there's a strong possibility that GERD and/or vocal cord spasms are responsible for the extremely high AHI's you've been racking up.

Nov 05, 2005 subject: SUCCESS AT LAST-GERD,420E, PRILOSEC AND BENADRYL
viewtopic.php?t=5551
-SWS's thoughts on loonlvr's massive clusters of events and loonlvr's followup post.

roster · Post by **roster** » Sun Sep 30, 2007 7:01 pm

rested gal wrote:......

I know I sound like a broken record, but I still think there's a strong possibility that GERD and/or vocal cord spasms are responsible for the extremely high AHI's you've been racking up.
.............

Hmm, instead of exercise and a light early dinner, maybe I should loaf and have two large plates of meatballs with lots of heavy garlic tomato sauce just before I check into the lab.

Then they can see what the problem really is! .

RosemaryB · Post by **RosemaryB** » Sun Sep 30, 2007 8:38 pm

You already know this*, but a reminder: Remember to get the entire study with graphs and charts from them. I'd ask right after the titration if they can give it to you, and if not, find out exactly how you can get it and how quickly.

When I got mine, there were portions of the graph missing. I had them reprint it so everything was on there. This is in case your doctor doesn't seem able to figure out whats going on. You have the study and can ask others here and perhaps other doctors.

* If I were as sleep deprived as you are, I might not remember anything at all.

Careful, if you have spaghetti with too much garlic, it might throw off the equipment .

DreamStalker · Post by **DreamStalker** » Mon Oct 01, 2007 1:53 pm

Rooster -

I hope your titration goes well tonight.

One thing that has not occurred to anyone is that you may have gotten a defective machine. You may want to take it with you to the sleep lab and have them check it out with a mamometer and see if it actually cranks out the set pressure(s). My AFLEX machine does not whine at all ... it is as quiet or quieter than my tank model.

Again, best of luck!

Wulfman... · Post by **Wulfman...** » Mon Oct 01, 2007 2:19 pm

DreamStalker wrote:Rooster -

I hope your titration goes well tonight.

One thing that has not occurred to anyone is that you may have gotten a defective machine. You may want to take it with you to the sleep lab and have them check it out with a mamometer and see if it actually cranks out the set pressure(s). My AFLEX machine does not whine at all ... it is as quiet or quieter than my tank model.

Again, best of luck!

Crossed my mind at one point, but due to how badly rooster's been feeling, I didn't think about it TOO long.

I'd put more odds on something like GERD.

Den

roster · Post by **roster** » Tue Oct 02, 2007 7:34 am

Just got back from the sleep lab and want to post a quick word before I get involved in today's other challenges.

I was titrated last night at straight cpap 19 cm! You make remember my previous sleep lab had titrated me at 10 and when I kept having problems the doc lowered it to 7.

No doubts now about the accuracy of the A-Flex and Encore Pro! Thank goodness for them as they were the major impetus to get a second titration study.

Last night the technician started out at 5 and pretty quickly got to 14. At 15 the Hybrid mask was being blown off my face and we tried several adjustments and then switched to my F&P432. We could not get this to work until we clamped everything down tight with a Tiara chinstrap. The chinstrap stabilized the straps on the F&P mask and maybe more importantly held my mouth shut allowing the mask to stabilize.

At 16 cm the pressure would not break through and I was actually arousing each time to restart breathing. She tried bipap with no good results. Finally ended up at 19 straight and I slept well for about two hours.

I had a great techincian that talked to me for an hour before the titration and told me everything she could see when she came into the room to make adjustments. After I got up, she took me into the control room and ran through the graphics of the report pointing out lots of examples of what was happening. We could see lots of apneas over one minute at pressure of 16 and 17 and they were not at all responding to the therapy. At pressure 19 there was two hours of great looking sleep and the RLS ceased.

Well I will be looking for some advice on managing a pressure of 19 with my A-Flex and will start a separate post.

Thanks for all of the help.

ozij · Post by **ozij** » Tue Oct 02, 2007 7:55 am

Congratulations on having 2 hours of good sleep with lower RLS - that is extremely important.

Here's to hoping the Aflex will help you handle that 19 straight!

If you ever find out the reason(s) for the different results in those titrations - please let us know.

O.

roster · Post by **roster** » Tue Oct 02, 2007 10:05 am

ozij wrote:Congratulations on having 2 hours of good sleep with lower RLS - that is extremely important.

Here's to hoping the Aflex will help you handle that 19 straight!

If you ever find out the reason(s) for the different results in those titrations - please let us know.

O.

Something doesn't make good sense.

Snoredog mentioned getting an ENT to put an endoscope up my nose and look all through the airway. I want to pursue this with the sleep doc as soon as she calls me. She is actually in with an ENT practice so there are specialists there well familiar with apnea patients.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Titration

Snoredog · Post by **Snoredog** » Tue Oct 02, 2007 4:05 pm

rooster wrote:
ozij wrote:Congratulations on having 2 hours of good sleep with lower RLS - that is extremely important.

Here's to hoping the Aflex will help you handle that 19 straight!

If you ever find out the reason(s) for the different results in those titrations - please let us know.

O.
Something doesn't make good sense.

Snoredog mentioned getting an ENT to put an endoscope up my nose and look all through the airway. I want to pursue this with the sleep doc as soon as she calls me. She is actually in with an ENT practice so there are specialists there well familiar with apnea patients.

RosemaryB · Post by **RosemaryB** » Tue Oct 02, 2007 4:57 pm

I'm glad you had a good tech for your titration study and that you are starting to get the information you need to make this work for you! At least you are beginning to know the score on why it wasn't working.

If your sleep study shows that you have a big increase in apneas during REM, wearing a backpack stuffed with a pillow will keep you sleeping on your side. With a data capable machine and the software, you can see this. If I don't wear the backpack, I can see a different pattern, a string of apneas bunched together usually during the second part of the night. If I do wear it, I don't see that pattern.

I hope you get some good sleep tonight.

linuxgrl · Post by **linuxgrl** » Tue Oct 02, 2007 6:08 pm

Rosemary, that backpack idea is something I am definitely going to try tonight! I, like you, have a lot of REM apneas and the tennis ball trick never worked for me. Apparently when I'm asleep I don't mind a tennis ball poking me in the back.

Snoredog · Post by **Snoredog** » Tue Oct 02, 2007 6:18 pm

linuxgrl wrote:Rosemary, that backpack idea is something I am definitely going to try tonight! I, like you, have a lot of REM apneas and the tennis ball trick never worked for me. Apparently when I'm asleep I don't mind a tennis ball poking me in the back.

no no no, she sleeps with her laptop in the backpack

Mask

Additional Comments: Also use Pur-Sleep and love it! Other masks: Liberty & Swift II