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DTjazz
Unread post  Post subject: Take a look please  |  Posted: Mon Sep 14, 2020 10:39 am

Joined: Sat Sep 05, 2020 9:26 am
Posts: 21
PAP Mask: Res Med air touch 20
PAP Machine: Res Med 10
Pressure Setting: 9-12

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DreamStation Go
Min5 and Max 16
No Ramp and Opt start is OFF

1. Trying to understand Clear Airways as they look similar to obstructive Apnea

2. Also trying to understand Flow Limitation

3. Also, why did the machine take me down in pressure when it was doing well at 12? (Or is that just the nature APAP vs CPAP?)

As I see this it looks like 12 is a good pressure. I would appreciate your thoughts.

I attached screenshots. If there is a better way to share the information please let me know.

Thank you!


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DeltaBravo3.8
Unread post  Post subject: Re: Take a look please  |  Posted: Mon Sep 14, 2020 4:57 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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As set, your PAP has authority to vary pressure between 5-16. DreamStations need fine tuned to a tighter pressure, one that is nearly on top of your ideal pressures. Your chart shows 10.8 as your Median pressure and the 95% is at 12.8 as seen in the pressure stat on the left. Your DreamStation needs to be in that area to treat your events better. The Achilles heel of Respironics is that they are slow to respond and need set very close to the 95%, but I would see what happens somewhere between 8 and 10 for your low number. And with high Clear Airway/Central Apnea events being your highest, try 0 or 1 Flex; when paired with the above pressure bump maybe CA is happier as these do not like pressure swings so much with CPAP/APAP.

Also to clean up the clutter on the chart, remove the VS2 events from the charts. Respironics picks up hose vibrations and flags these and other vibrations as snores.

Flow Limit is a partial hypopnea, hypopnea is a partial apnea. I think FL is 30-50% Hypopnea at 50-75% and apnea is 75-100% blocked. The numbers are probably somewhat off, but there is definitely a FL to Hypopnea to Apnea progression.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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DTjazz
Unread post  Post subject: Re: Take a look please UPDATED SLEEP REPORT  |  Posted: Tue Sep 15, 2020 9:51 am

Joined: Sat Sep 05, 2020 9:26 am
Posts: 21
PAP Mask: Res Med air touch 20
PAP Machine: Res Med 10
Pressure Setting: 9-12

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Improved night with a couple questions. I am still quite new.
My questions are on a oxygen dip at 1:36-1:37
Please note breathing at 1:35
Also the section of Periodic Breathing at 00:12-00:14
SpO2 also provided for this time.

Thank you.

Settings
APAP DreamStation Go with full Humidifier on Adjust mode
Min 9 Max 14
Ramp started at 9 BUT was set to start at 6 (I do not understand why)
Opti Start ON
SMART RAMP ON
I hope that is everything!


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DeltaBravo3.8
Unread post  Post subject: Re: Take a look please  |  Posted: Tue Sep 15, 2020 10:19 am
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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It's showing improvement. So how do you feel? Is there any improved comfort or rest? Of the 2 sessions, this being the opening post and this more recent, which felt better to you? The data seems better as in headed the right direction on optimizing according to charts, but always factor in comfort and feel.

And I try to mention it, so I will do so now, if you ever change any setting, and it feels bad or uncomfortable, fall back to whatever it was prior. Tell us about it here, and we can try to go another method.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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Pugsy
Unread post  Post subject: Re: Take a look please  |  Posted: Tue Sep 15, 2020 10:19 am
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Joined: Wed Aug 02, 2017 8:01 pm
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PAP Mask: Bleep/DreamPort nasal mask
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Did you push the button to start the ramp? You have to push the button even if in the setup menu it is turned on.

The O2 drop was very rapid and recovery also very rapid. I suspect a loss of contact artifact. Real desats don't happen that fast and recovery isn't that fast. The pulse ox loss contact...probably a bit of movement.

OptiStart isn't your best option. Not sure if it is responsible for wacky ramp or not. I would suggest turning it off and just using regular auto mode start.

_________________
I may have to rise but I refuse to shine.


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DTjazz
Unread post  Post subject: Re: Take a look please  |  Posted: Tue Sep 15, 2020 10:39 am

Joined: Sat Sep 05, 2020 9:26 am
Posts: 21
PAP Mask: Res Med air touch 20
PAP Machine: Res Med 10
Pressure Setting: 9-12

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Any concerns with the periodic breathing?

Definitely better this night.

I will turn off optó start.

It was nice to be good for 4 hours.


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DTjazz
Unread post  Post subject: Re: Take a look please DOUBLE CHECK  |  Posted: Tue Sep 15, 2020 10:53 am

Joined: Sat Sep 05, 2020 9:26 am
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PAP Mask: Res Med air touch 20
PAP Machine: Res Med 10
Pressure Setting: 9-12

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Do you see the shallow breathing @ 1:35-1:36 I don't know how to read charts but I highlighted the area which caught my eye.

I agree O2 readings can be off but it seems like there may be a correlation with the breathing?


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Pugsy
Unread post  Post subject: Re: Take a look please  |  Posted: Tue Sep 15, 2020 11:33 am
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PAP Mask: Bleep/DreamPort nasal mask
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Periodic Breathing is just a waxing and waning of the flow rate that lasts for 2 minutes. It isn't a problem unless it is packed full of central/CAs.
Even if it was....not enough of it to be a problem.

Hold your breath for 30 seconds with the pulse ox on...that's a much longer cessation of breathing than that very short lived shallow breathing time....
Watch it for 5 minutes....does the O2 level ever drop?

More likely what happened is the pulse ox came loose and caused a slight arousal and you sort of paused your breathing while maybe readjusting the pulse ox.

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DTjazz
Unread post  Post subject: Re: Take a look please  |  Posted: Wed Sep 16, 2020 6:51 am

Joined: Sat Sep 05, 2020 9:26 am
Posts: 21
PAP Mask: Res Med air touch 20
PAP Machine: Res Med 10
Pressure Setting: 9-12

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Looks much better but what is variable breathing?

I didn't even realize previous reports showing over 40% so I guess 22% is better but still a high number.

Dream Station Go
No ramp
Opti Start OFF
Min 9
Max 15

Much better night's sleep. 7+ hours which is best yet.


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Pugsy
Unread post  Post subject: Re: Take a look please  |  Posted: Wed Sep 16, 2020 7:18 am
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PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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Don't know what the variable breathing data point means.
Some machines seems to show it and some don't but I haven't seen an explanation. I don't think it means much one way or the other though.
I will poke around and see if I can find out anything but a quick search yielded nothing.

You may want to try a slightly higher minimum pressure still yet. There's still more clutter on your reports than I would want to see on mine.
It's just the algorithm not responding very quickly. Common for Respironics auto algorithms. 0.5 to 1.0 cm.

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Pugsy
Unread post  Post subject: Re: Take a look please  |  Posted: Wed Sep 16, 2020 7:58 am
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I can't find anything that explains the variable breathing data point.
I don't know that it means much one way or the other. Our breathing varies during the night under normal conditions and it may just point to that normal variation.

Usually with sounder sleep that will mean less variations since awake breathing is more irregular. Maybe less variable breathing just points to a better quality more sound sleep which is of course a good thing.

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DeltaBravo3.8
Unread post  Post subject: Re: Take a look please  |  Posted: Wed Sep 16, 2020 9:33 am
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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FWIW I am not aware of a definite definition on variable breathing within the OSCAR dev circle. It seems to indicate what you've mentioned there Pugsy. An obscure variable breathing datapoint that means breathing that varies. It's almost like the FL scale of 0-1 as maybe somewhat arbitrary, but at least we can point out higher, or grassy looking FL to disturbances to sleep and such. I personally do not think it points to any serious situation, far below the event flags of OA, CA, H, even FL. Just my opinion though.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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Pugsy
Unread post  Post subject: Re: Take a look please  |  Posted: Wed Sep 16, 2020 10:05 am
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Well...I am of the opinion that if I can't find information about it and I can't do anything about it even if I did....I don't worry about it.
There might be some relationship to sleep quality going on there but I have never had a machine or software show that data point and even on the Respironics website it isn't talked about. So maybe an OSCAR thing????
I have Encore Pro available but haven't seen it reported but then I don't have a Respironics machine now so I don't know if something changed in reporting data points or not.

I tend to think of it like I do VS2 snores...shrug my shoulders and move on.

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