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eorozco
Unread post  Post subject: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Tue Jul 28, 2020 3:02 pm

Joined: Thu Mar 07, 2019 11:25 am
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OK ... here are some OSCAR examples ... please enlighten me !!

any comment would be greatly appreciated

Regards

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Enrique


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DeltaBravo3.8
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Tue Jul 28, 2020 6:33 pm
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Location: Greencastle, Pennsylvania, USA
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OK the PAP is giving good therapy according to the chart data. How do you feel after a sleep session? Give a reasonably detailed and critical answer. Any area that you think could be better on the therapy is what we're fishing for.

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eorozco
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 7:57 am

Joined: Thu Mar 07, 2019 11:25 am
Posts: 34
PAP Mask: DreamWear by Philips
PAP Machine: Philips Respironics Dreamstation AutoCPAP
Humidifier: Respironics Dreamstation Humidifier
Pressure Setting: 8 - 20 cm H2O ... 9 average reported most

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I feel like TIRED every morning ... always feel like I need to sleep more ... even sometimes I feel as if my lungs are tired for using the machine during the night .... this is something that I'm beginning to experiment more with time .. I donĀ“t know why if my "therapy" is working, why am I feeling worse? ... I remember to feel with more energy months ago which is weird, because it is supposed to be better with the CPAP usage ... and in the afternoon sometimes I just want to sleep, which is something I never want before !! ...and I do not take ANY drugs or medications

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Pugsy
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 8:15 am
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Do you find that you are awakening much during the night?
Toss and turn a lot maybe?

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eorozco
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 8:24 am

Joined: Thu Mar 07, 2019 11:25 am
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PAP Machine: Philips Respironics Dreamstation AutoCPAP
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Pressure Setting: 8 - 20 cm H2O ... 9 average reported most

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No ... just one time to bathroom ... but sometimes, as soon as I put my mask on, it is very hard to go to sleep again !!

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Pugsy
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 8:42 am
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How old are you? Is the bathroom break common for you as in you are of an age where the prostate creates this common problem?
How long does it take you to go to sleep do you think?

On paper...your report looks good.

Now I happen to know first hand that on paper doesn't always translate in to feeling like super woman the next day but it has nothing to do with the actual sleep apnea therapy. The cold hard fact of life is sometimes other stuff messes with our sleep quality and how we feel during the day.

It's frustrating I know to see good numbers on paper and not feel them.

Would you say your daytime symptoms are better or worse on cpap than not on cpap? I assume you had some symptoms that were unwanted that earned you the sleep study and the diagnosis of OSA and got you on cpap.
What were those symptoms?.

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eorozco
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 9:09 am

Joined: Thu Mar 07, 2019 11:25 am
Posts: 34
PAP Mask: DreamWear by Philips
PAP Machine: Philips Respironics Dreamstation AutoCPAP
Humidifier: Respironics Dreamstation Humidifier
Pressure Setting: 8 - 20 cm H2O ... 9 average reported most

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Thank you ... I'm 57 and a couple of years ago I had surgery for my prostate because of benign prostate growth diagnosis (yes... I had very hard times in the night going to the bathroom) ... but now that is a thing of the past ... I was diagnosed with OSA because I felt bad during the day and have gasps and suffocations symptoms during the night ...my snoring was very BAD. Now I have to admit that the gasps and snoring are GONE and a few months ago, I even use my therapy motivated because really I feel good .... but it is in a couple of months that I'm beginning to feel frustrated and restless ... attached you'll find the original sleep study that takes me to the CPAP ... and the search for adjustments, mask (which I think I found the best for me), etc.

Regards


Attachments:
Estudio Apnea EOR Ago18-2016.PDF [557.7 KiB]
Downloaded 11 times

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DeltaBravo3.8
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 9:39 am
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Location: Greencastle, Pennsylvania, USA
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I think a possible consideration is to bump pressure up a bit from 8 to address the hypopnea and obstructives that show up. I don't remember what the fractional settings are for the Respironics DreamStations, but I'd consider the lowest bump up and try that at least 2 days. See if it lowers the events and if it helps the therapy feel better. We'd likely do this again if the results call for it. Just be aware there were quite a bit of CA on the attached file you'd posted, if I read it correctly. I'm not great at languages other than American English, but it appeared to indicate 33 CA on the right about half way through the chart displayed. This can be a real issue depending on the circumstances that caused the Central Events. Note that we may have to play the AVOID game with these CA as that's all we can do on any machine other than an ASV.

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Pugsy
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 9:44 am
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My Spanish sucks but I get the gist of the home sleep study as I am familiar with the ApneaLink home study report. To be honest if anything I think the home studies sometimes underestimate the severity of OSA but in your situation...it's pretty clear. It's not like you were borderline in terms of diagnosis.

I don't know why you aren't feeling as good as you would like to feel.
Or maybe as good as you felt initially. I know it seems to happen with a lot of people. We call it the honeymoon period. Initially feel remarkable improvement and then settle in to something less than they initially felt and they are disappointed.

How much of it is age related (let's face it as we get older our sleep gets more fragile) or is it something else.

Now in terms of your cpap therapy. On paper it looks good but maybe with a little more minimum pressure you would feel better.
I have seen it happen. People use a little more minimum than the machine wants to give or maybe technically is needed if just by going with the on paper report and they report they feel better and sleep better and are happier. Seems to happen a lot with Respironics machines users.

Your choice...but might be worth considering doing just to see if it helps how you feel or not.

Do bear in mind that sleep quality is affected by a lot of things.
When we wake up for anything during the night it will mess with how the overall sleep architecture functions. When we have trouble going back to sleep...that also messes with things not to mention the overall hours of sleep thing.

You might take the time to learn to spot arousal breathing in your flow rate.
http://freecpapadvice.com/sleepyhead-free-software
arousal breathing that disturbs the sleep architecture doesn't always end up with a flagged event of some sort. While the above link talks mainly about central apneas and such just bypass that part and learn to spot arousal breathing. You might be having a lot of arousals from something (and it doesn't have to be airway related) that is impacting your overall sleep quality and thus how you feel during the day.

I wish all arousals were airway related because we can fix those fairly easily with cpap but unfortunately we can have spontaneous arousals which are unrelated to the airway and cpap can't fix those and they are hard to pin down the cause. Hard to fix a problem when we don't know the cause of a problem.

So.....I would try a little more minimum pressure as first experiment...and I see DeltaBravo thinks along the same line.
Respironics machines...0.5 cm increments.
Worth trying but watch the CAs/centrals...if you see very many for sure go in and look to see if they look like arousal centrals and they don't count or for sure asleep centrals and they would be a potential problem. Either way...you need to do some homework and learn to look for arousal breathing.

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eorozco
Unread post  Post subject: Re: CPAP ... or CRAP therapy ...? (2) OSCAR slides  |  Posted: Wed Jul 29, 2020 10:56 am

Joined: Thu Mar 07, 2019 11:25 am
Posts: 34
PAP Mask: DreamWear by Philips
PAP Machine: Philips Respironics Dreamstation AutoCPAP
Humidifier: Respironics Dreamstation Humidifier
Pressure Setting: 8 - 20 cm H2O ... 9 average reported most

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Thank you both DeltaBravo and Pugsy ... no easy solution for my case ... I'll try the little pressure increments ...

Kind Regards

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Enrique


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