Kate's Therapy

[katestyles]

As predicted, family doctor is reluctant to undermine specialist, but agrees with my campaign of persistent, polite, pleading.

Latest issue is another breakout of dermatitis in a rectangle on my face - about the shape and size of my mouth taping. But it could be the alcohol wipes.

And I am still getting mouth breathing. Mostly after 5am.

[babydinosnoreless]

I would be looking for a new sleep doctor and a new gp and I would have told her so of she didn't write me a prescription I needed for bilevel. I am lucky now living in a large metro area where there is a lot of competition for medical dollars.

I had a neurologist that said I couldn't switch to their other office, one closer to where I lived. I told them i would find a different neurology practice. They said you can't do that. Its illegal to doctor hop. I said I don't take any pain pills or restricted drugs so effing watch me.

I called my gp had her recommend a new neurologist called them up and made an appointment the next day and then went down to the old office with a request for medical records. They were just flabbergasted that I could and did fire them. Freaking god complex some of these places have.

My husband did the same with one of his doctors that he just couldn't stand because there was always long waits. They too were amazed that he would dare switch doctors. I look at it like any other service. If they don't provide decent service I won't go back.

[palerider]

I look at it like any other service. If they don't provide decent service I won't go back.

Spot on!

[katestyles]

I have noticed a change in my sleep.
I am seeing a clump of events around 90 minutes into the night, and I am guessing that my sleep architecture is improving.
In my latest sleep test I had REM latency of 300 minutes.

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I have also solved most of my leak issues - I am back on the chinstrap, which seems to control the mouth breathing early in the night, and when I wake in the middle of the night, I add a piece of mouth tape, which seems to control the early morning mouth breathing.
I am definitely sleeping better, and so is hubby.

I'm still working on a Bilevel - LSAT has promised me his next available, and in the meantime I am still trying to educate my sleep clinic lady.

[Pugsy]

I have always seen that burst of activity 90 minutes after sleep onset...varying levels of course but it almost always there.
Goes along with my OSA diagnosis...worse in REM sleep than in non REM sleep.
I just called it my "witching hour".
Funny thing about it though....while REM is actually happening longer and more frequently in those wee hours of the morning it was always that first 90 minute witching hour that showed the most activity.

[djams]

I have noticed a change in my sleep.
I am seeing a clump of events around 90 minutes into the night, and I am guessing that my sleep architecture is improving.

I've been noticing a change in your sleep (as evidenced by your flow rate chart) for a while now. You're getting periods of the nice smooth flows. Zoom in on an hour, and pan across the night, they really jump out at you.

Sleep architecture - I can recommend the SleepTracker smart bed if you're interested in getting a better idea about this. Two sensor pads that go under your mattress, one for you and one for hubbyhead. Nothing to wear, nothing to charge, just get into bed like usual. The company behind Sleeptracker maintains a fully operational sleep lab (full PSG), and they offer free sleep studies so they can constantly monitor the accuracy of sleeptracker vs PSG. They state 95% accuracy.

Here's a snip of mine from last night - just to give you an idea. There's lots more info- this just shows the sleep stages.

[katestyles]

I have noticed a change in my sleep.
I am seeing a clump of events around 90 minutes into the night, and I am guessing that my sleep architecture is improving.

I've been noticing a change in your sleep (as evidenced by your flow rate chart) for a while now. You're getting periods of the nice smooth flows. Zoom in on an hour, and pan across the night, they really jump out at you.

Sleep architecture - I can recommend the SleepTracker smart bed if you're interested in getting a better idea about this. Two sensor pads that go under your mattress, one for you and one for hubbyhead. Nothing to wear, nothing to charge, just get into bed like usual. The company behind Sleeptracker maintains a fully operational sleep lab (full PSG), and they offer free sleep studies so they can constantly monitor the accuracy of sleeptracker vs PSG. They state 95% accuracy.

Here's a snip of mine from last night - just to give you an idea. There's lots more info- this just shows the sleep stages.

I had looked at that system - I am interested, but you always have to be sure your dollars are not going
to waste.

Where is their sleeplab?

[djams]

Santa Cruz, CA
https://www.fullpower.com/studies/sleep

$120 for two people. It's a bargain. (EDIT: to clarify that I'm talking about SleepTracker cost here. The sleep study is free)

Browse around that fullpower website. It's impressive what they do.

[katestyles]

From my sleep clinic person:
I am not reluctant to prescribe a Bilevel. I am happy to place an order for this it's just that insurance will not approve it unless we can prove through a sleep study that you need it. You can purchase one out of pocket with a prescription.

Alleluia!

[babydinosnoreless]

From my sleep clinic person:
I am not reluctant to prescribe a Bilevel. I am happy to place an order for this it's just that insurance will not approve it unless we can prove through a sleep study that you need it. You can purchase one out of pocket with a prescription.

Alleluia!

Yay!!!

[Dog Slobber]

From my sleep clinic person:
I am not reluctant to prescribe a Bilevel. I am happy to place an order for this it's just that insurance will not approve it unless we can prove through a sleep study that you need it. You can purchase one out of pocket with a prescription.

Alleluia!

I'm thrilled for you.

About fricken time!

[zonker]

From my sleep clinic person:
I am not reluctant to prescribe a Bilevel. I am happy to place an order for this it's just that insurance will not approve it unless we can prove through a sleep study that you need it. You can purchase one out of pocket with a prescription.

Alleluia!

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soooo....how long until you get the new machine?

[katestyles]

So - trying hard not to be overexcited, but thanks to LSAT, I have a tracking number that says I will be the proud owner of a Resmed Vauto tommorrow by 8pm!!

I am planning to start at comparable settings to my current APAP which is running at min 20, max 20, EPR 3.
Can someone check my math please?

1) Should I be putting Epap 17, Ipap 20?

2) All the titration protocols say PS should be at 4. Is 3 OK?

3) Should I be doing any other kind of settings?

4) What is the next change to make? I'm trying to limit FL.

[zonker]

So - trying hard not to be overexcited, but thanks to LSAT, I have a tracking number that says I will be the proud owner of a Resmed Vauto tommorrow by 8pm!!

I am planning to start at comparable settings to my current APAP which is running at min 20, max 20, EPR 3.
Can someone check my math please?

1) Should I be putting Epap 17, Ipap 20?

2) All the titration protocols say PS should be at 4. Is 3 OK?

3) Should I be doing any other kind of settings?

4) What is the next change to make? I'm trying to limit FL.

oh, goodness. this makes me wish desperately that i knew something useful to tell you!

i think friend palerider will be in shortly to give you the info you need.

good luck.

[Pugsy]

PS of 4 is what the labs commonly start out with and most people come out of a bilevel titration with PS of 4 or 5.
On a rare occasion a little more for some reason or other.

My suggestion is start with PS of 4
use auto mode...
Minimum EPAP 17
PS of 4
Maximum IPAP 25

See how much a little more IPAP helps with those FLs before adding more EPAP....might help out just enough.