DonMidwest

Thanks for the explanation of the blank interval as mask slipped.

I sleep most of the time on my back. Some nights I wake up on my back and assume been on my back all night.

I have attached my summary chart. Since I have started working with you my AHI has been less than 5. I noticed on your graph, the max is 5 while mine is 20!

Also it is clear when we switched to a constant pressure of 11 with the red bars

My big night was April 18 when I forgot the cervical collar! Really stands what a difference it has made. Note my total time in apnea was 1 hour! And that was the only night with a huge Large Link since we started. That graph is not attached.

Should I squeeze down the rows and move rows around so that they match the selection of rows you use for this summary page?

Some updates. I think that we are the longest, or second longest session here on MyApnea. Always thank you.

You suggested changing to a ResMed F40 mask. I am in the process of doing that. Medicare has a 6 month cycle that allows an entire change. I am putting things off to fit that cycle and change to F40 mask system. I was able to get the head gear but they sent 3 F30i cushions by mistake. They will send a mailing label, I will return the 3 cushions, and then they can send 3 F40 cushions.

I probably mentioned that I sent a message through My Chart to my "sleepy doctor" asking if F40 would be available on May 19 for my titration study. I did get a call back from the sub organization, related organization, or whatever's its connection is to the practice of the "sleepy doctor" and they will ensure that there will be a F40 mask for my titration. They mentioned that Ohio Health, the large system has not yet put F40 into their inventory. This probably explains why my "sleepy doctor" has not responded. I will let it rest.

I did look up Functional Medicine sleep doctors and will probably change after finishing the titration. I don't want to upset the various systems: US, Ohio Health, Medicare, Insurance and who knows what else.

When I go for the sleep study I will take my statistics and my memory card will be in my AirSense 10. Now that I am well below 5 I am not sure what they can do for me. I began this session with concern for Stage 3 and REM stages because they are important for the treatment of Alzheimer's disease. I hope to get that information from the sleep study since it is not available from OSCAR. In particular, OSCAR doesn't work with sensors of eye movement.

Well, I spent more time on OSCAR learning or reinforcing terms. I am sure Sierra knows about the two links from Apnea Board:

https://www.apneaboard.com/wiki/index.php?title=Soft_Cervical_Collar

https://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy#Positional_Apnea

Things were going so well last week that I started looking into the breaks where there is No flow, No Pressure and No Mask Pressure. These can be seen on the bottom graphic in the chart below as breaks in the Mask Pressure graphs. I think there are 4 of those before the longer bathroom break. Do you know what they mean? I zoomed in and couldn't see anything.

Last week. Sat April 20, 1.65, Sun 2.21 Mon 2.84 Tue 0.53 Wed 1.73 Thurs 1.66 Fri 1.53 Sat 3.41

Then there was last night. I spent 2 evenings at with my granddaughter whose mother was out of town. Friday night was OK - that is the new normal that I thought I was on. Then last night some strange things happened and the AHI jumped up to 3.41.

Some things that might have contributed: not in own bed, glass of wine about 9PM, later to bed than usual, snack food at the event after 9PM but didn't eat much. Can you make sense of what happened between 01:05 and about 01:40?

Started CPAP 13 years ago so it might have been 20 years of disturbed sleep. Early days of CPAP worked OK

Average of 7 hrs per day last week. Had not done that for years.

No naps in over a week.

As noted in the first post, I was beside myself because I could only see failure on the horizon. Sleeppy doctors did nothing.

Never consistently had AHI less than 5. Only occasionally.

Learned so much and need to learn more. Still not that good at understanding the graphs.

I will check back in a week if things go smoothly as we suspect,

If there is a breakdown I will contact you that day.

Another great night. I put in a screen shot with the device settings so you can see them. Are we at the point of going for a few days and check in only if something strange happens? Or, are there more fine tuning adjustments that you recommend.

Another very good night.

I washed off the cushion. It looks like we should stay on this course for a while longer to see if it stabilizes at these settings

Another good night. Slept almost 7 hours straight through. Should I stay the course for a while longer?

Some not so good news. Got up early and went with daughter in law for a robot competition her for my 12 year old granddaughter.

I had an aphasia, a speech TIA that lasted about 5 minutes. Before that I had a sense that something was not right and gave my daughter in law to be on the lookout. Fine now. Did not go to doctor. Had a head and neck scan a couple years ago and they found nothing.

It looks like I didn't restart the machine after I went to the bathroom. I thought that it would start automatically. That interval of machine off is over an hour. That meant that I was breathing into the mask for over an hour with no pressure assist. I was in a degraded breathing state.

The CSR happened when the machine realized that it needed to restart and did it automatically.

Is this a reasonable view? Even with this a very good night. Without the hour off it would have been a night over 8 hours and approaching 9 hours. I have not slept that long for years.

Interesting night. I need to write down data from the Airsense 10 window when I go to the bathroom. As I recall, I got up at elapsed time of something like 4.4 hours.

There is a gap in pressure and flow between 22:40 approximately and 00.12 approximately. I was asleep. You mentioned that might be a time when the mask was dislodged. I sleep on my back almost all the time and wake up on my back so something happened. Any more ideas? Should I tighten the mask straps? I must have been breathing during that time.

Or maybe I was sleep walking and got up and went to the bathroom. Going to the bathroom requires shutting down the CPAP machine and disconnecting the hose at the same time because of the automatic start.

I have included another graph of different variables.

After I wake up for the major bathroom break, I sometimes do breathing exercises to relax and go back to sleep. I know that CO2 is the gas that regulates breathing. Some of the authors I read say that there is a need to increase CO2 for health reasons. One exercise is breathing in a paper bag. Last night I used a modified 4 6 8 routine. Not sure about the magic numbers and didn't follow faithfully. But the strategy is to breath in quickly, 4, hold breath for a longer time, 6, and then exhale, 8, to maximize the CO2.

Does this explain the graphs for these variables? Title volume, Insp. time, Exp. time?

Here is how I can tell if I went to the bathroom in that first 15 minute break. I may have have mentioned that I have an artificial unitary sphincter to control leakage as a result of prostate cancer removal surgery. The nylon device is implanted. There is a bulb in my scrotum that when squeezed sends air pressure to open up the sphincter on the urethrae. It takes two hands to operate the device. Left hand to hold the top tube out of the bulb to stabilize the device and the right hand to squeeze the bulb. I have to stand up because if I sit down there is not enough gravity to empty my bladder and I leak on my PJs. I made an artificial urinal by cutting out a section of a 1 gallon plastic water jug. I use my pinkie (left smallest finger) on the left side of my hand, putting it in the handle of the jug, and the rest of the fingers on the left hand to hold the top tube, and then using the right hand to squeeze the bulb and aim. I can empty the the jug each time. So when I get up after say 5 hours, I can tell if I got up earlier and went to the bathroom earlier.

Given all the stuff around my head: cushion, frame and cervical collar, it might be sleepwalking.

Biggest score in a few days. Lots of CA and several OA. Suggestions?

I sent a MyChart message to my sleepy doctor to ask if the Mask Fitting had the new F40 masks. Have not heard back. The MD and sleep group are related and not related if you understand. A totally different company provides supplies. They don't carry F40 yet. Because of your help I could probably get by with my F30i, but the F40 looks better.

I heard back from Dr. A Wells. She thanked me for the information on OSCAR, she will look into OSCAR, glad that I am doing well, and she had heard about Lefty Lanky 27. My response was I was not particularly found of Lefty Lanky 27, but he is someone who works with OSCAR I found on the web. I suggested she look for someone else to work with. I wished her well on her CPAP Mask class that begins today. I did not sign up.

What? "pretty good." It is beyond anything I had hoped for. (joke + truth)

I am sure you don't know but I will ask. Is the Gaba helping? You can wait until tomorrow to respond.

For sure I am going to hold tight to the current settings.