last few nights have sucked :(

Yep. I'm on it! Going by their office on Monday and hopefully they will have it ready for me (like they said they would)

pandatx wrote:Since all he does, though, is look at the AHI number (seriously, that's it), maybe some of you guys here can help me make up a list of questions to ask him when I go?

Screenshots of all the current FLs may be helpful. Ask about the report where it says "many of the arousals appeared to be spontaneous", and if we can take some screenshots of the "spontaneous" arousals that have severe FL associated with them, we may respectfully inquire "HTF CAN AN AROUSAL BE SPONTANEOUS IF THE WAVEFORM UP TO THAT POINT IS FLATTER THAN A BEER THAT'S BEEN SITTIN' OUT ON THE PATIO ALL NIGHT!? I MEAN, DID YOU AT LEAST TRY AND SEE IF THEY WOULD RESPOND TO PRESSURE INCREASE? HUH!?

pandatx wrote:Today was another good day. Two in a row!

Can you upload the ResMed card data again? The last day I have is 4.11.2013.

Speaking of which, and as previously noted, there were a number of positives in that night (although utilization was down a bit).

At first glimpse, the AHI (which was composed entirely of "A"s) looked worrisome at 5.7. However, none of them were of any consequence, as many of them occurred during periods of SWJ (which would make them artifactual) while others may be dismissed as normal phenomena.

For instance, these two, identified as obstructive, are more likely post-arousal centrals:




In the first, there is a big breath taken, then a ventilatory pause. That's what the body always does.

Similar for the second, but if you want to dismiss that as something buried in SWJ, I won't argue.

You're so funny thinking I know what SWJ means. But yes, I will upload the data card again in a little while. I have a little energy this morning (yay) so I'm going to try to get some yoga done

pandatx wrote:You're so funny thinking I know what SWJ means.

I assumed SWJ meant "Spider Web Junk".

SWJ Sleep Wake Junk
The machine just records what it senses and doesn't have any way of knowing if we are awake, asleep or semi awake.
When awake or semi awake we don't have the same nice normal breathing pattern as we do when asleep.
Sometimes the machine flags events during an awake or semi awake time that wouldn't be flagged in a sleep lab setting because the sleep lab tech would have immediate access to the EEG brain wave data and could see that the person wasn't technically asleep.
Sometimes it is really easy for us to see that the flow rate irregularities are likely awake flow irregularities.
Sometime it is difficult to see the minor change that points to SWJ.

Ah...thank you!

Mollette, do you need all the files or just the "Data" and "Settings" folders again?

Wow, just wanted to say thanks for posting this thread and for all the analysis Mollete. I am in a similar situation, dealing with artifacted sleep possibly from FL and having someone actually explain the concept of reading Flow Rates and Flow Limitations is truly appreciated.

Keep Fighting the good fight.

This has got me intrigued and I want to be able to help haha

mollete wrote:

pandatx wrote:Today was another good day. Two in a row!

At first glimpse, the AHI (which was composed entirely of "A"s) looked worrisome at 5.7. However, none of them were of any consequence, as many of them occurred during periods of SWJ (which would make them artifactual) while others may be dismissed as normal phenomena.

For instance, these two, identified as obstructive, are more likely post-arousal centrals:




In the first, there is a big breath taken, then a ventilatory pause. That's what the body always does.

Similar for the second, but if you want to dismiss that as something buried in SWJ, I won't argue.

Mollete, A big THANK YOU! This graph looks a lot like some of Mike's "bad nights" that makes me so anxious and wondering what I'm doing wrong! I hope I can remember your words when he has another bad night like this!

Mollete, Many thanks. Much of what you have graciously expressed here resonates with me. It seems my sleep issue may be similar with Amy. My sleep study showed an AHI of 1.8 with RDI of 40.1. There were something like 207 RERAs scored. Doc didn't do a titration study but gave me an APAP with 5-15cm range. I had a thread about a month ago where I was speculating many of the points you have made here. I did observe that when my pressure went above 7 and to 8 or 9 that FL was greatly reduced and my flow rate curve was much more rounded. Speculating that my RERAs were responsive to higher pressure I bumped my min to 7cm. I have experience more energy as a result. I believe I could go higher on the minimum, but I have my follow up in a few weeks and decided to do as you suggest to Amy and get the doc on board with "helping" me make this decision. At least I have data to justify why I made the change.

I am only polluting Amy's thread here to point out that UARS can be treated with pressure as it seems to be working for me. But I also appreciate Mollete's thoroughness in suggesting that we really need to understand what is the root cause of Amy's sleep issues. I am looking forward to hearing more from the sleep study raw data.

Panda:

I'm wondering if a full-face might not be the answer for you. I tried a nasal and it was horrible. If you do go F-F, ask for the Quattro FX AND fabricate that little chin strap (mentioned by a gal on another thread here) that'll link the lower left and right straps. I've had enormous fortune with it since beginning on March 3. 50 days on CPAP and at least 46 have been sterling.

As several good folks have stated, don't quit! I only wish I'd had CPAP years ago but am grateful for being able to spend the rest of my life with it.

Thank you

I asked about full face last time I was there but he didn't even want to let me try it b/c they didn't test me with it during the titration study. Although I'm sure if I mention going someplace else they'd give it to me in a heartbeat.

I am trying to keep my positivity about this but, man, its really so much harder than I'd anticipated and I can totally see why people give up.