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omg_drd4_bbq
Unread post  Post subject: [Serious] DIY Titration study  |  Posted: Tue Jul 25, 2017 10:50 am

Joined: Tue Jul 25, 2017 8:50 am
Posts: 4
PAP Mask: Wisp Nasal Mask
PAP Machine: DreamStation Auto CPAP DSX500T11
Humidifier: 3
Pressure Setting: Auto 8-14cm, A-flex=3

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Background:

Hi all! Ok first things first, I know exactly what you're thinking and let's get this out of the way right off the bat: "You shouldn't be doing things without a doctor!" That's all well and good, but I've been tinkering with myself for well over a decade. Neurofeedback, tDCS, bazillions of supplements, 'afinils, greynet meds, you name it, I've tried it. Big into biohacking and transhumanist stuff. I have a BS in neuro so I'd like to think I have some idea what I'm talking about when it comes to meat-computers :P.

I have dealt with fatigue, brain fog, and daytime sleepiness for over five years, on top of DSPD, SAD, depression/anxiety and a lifetime of ADHD, which have always been barely controlled at best. But my main focus right now is the tiredness. It's hard to baseline subjective experience, but I just feel like I'm tired way more frequently what most people ought to be. Pretty consistently get 7.5 h sleep, try really hard to maintain good sleep hygeine, use orange goggles and avoid screens at night, etc. Still feel like it's not cutting it. I will get 7.5 h of what appears to be pristine, uninterrupted sleep, and still be a zombie the next day.

It was getting so bad at my last job that I had to take daily naps, and it was still a trudge to get through every day (this is on top of welbutrin, modafinil, and adderall in various combinations). Had to go on FMLA twice and put on PPI for a bit. I've had the battery of every fatigue-related bloodwork panel you can think of, and basically nothing out of spec. Went for the sleep study with PSG, and was told they didn't find anything (still need to get the med records from them, they have weird hours).

Sleepiness persisted, and I've suspected something to do with my breathing for a long time, since I've had sinus issues my whole life. Insurance is like, "you got your sleep study and found nothing, you aren't getting another." When I found out I could buy a PAP off amazon for under $500, I was like heck yes. Acquired a DreamStation Auto CPAP w/ A-flex, Wisp nasal mask, and Quattro full face mask, and I've been using that for about 2 months now. Initially, I felt like things improved, but then it seemed like good results were not really reliable.

The main issue I'm at right now is that because this whole thing is Wild West style, I don't actually have a prescription pressure or titration. I initially set the start pressure to 4 cm, but I found that just before dozing off, I would suddenly feel starved for air and rip the mask off. This can be caused by insufficient airflow / CO2 rebreathing, so I upped the pressure to 6 and then 8, and 8 seemed comfortable and avoided the air starvation issue. Auto is allowed to go up to 14, but it rarely goes above 10. I have A-flex set to 3, which gives me a ~2 cm drop on exhale. AHI starts low, but then creeps up past 10 towards sleep cycles 3-5 (more charts here). Predominantly hypopneas (50% of events on average), OSA pretty low, only about ~15% of flagged events are OSA.

/background

I'd like to be as legit as possible (as legit as someone playing DIY Sleep Tech can be ;)) so that I can collect some good data and go back to the sleep doc and be like, "Respectfully, I think you missed something. Can you take another look at this?" Or, thoroughly rule out sleep-disordered breathing as the cause of my sleepiness. That means getting a pressure and A-flex dialed in properly, so I'd like to conduct some sort of ersatz titration study.

I have at my disposal the following tech and skills:

* DreamStation DSX500T11
* OpenBCI 8-channel and 4-channel EEG boards
* Arduinos and RasPIs galore
* Python signal analysis skills, Fourier and wavelet, machine learning
* Girlfriend who is already quasi-nocturnal and would be able to adjust the machine at night
* Planning on constructing chest stretch breathing sensor, nasal canula transducer, nighttime video recording setup

What do I need to do to find optimal pressure and A-flex setting?

Thanks,


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diamaunt
Unread post  Post subject: Re: [Serious] DIY Titration study  |  Posted: Tue Jul 25, 2017 11:48 am
User avatar

Joined: Wed Mar 02, 2016 2:26 am
Posts: 2403
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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omg_drd4_bbq wrote:
Background:

Hi all! Ok first things first, I know exactly what you're thinking and let's get this out of the way right off the bat: "You shouldn't be doing things without a doctor!" I have at my disposal the following tech and skills:

You'd be wrong about that.

omg_drd4_bbq wrote:
* DreamStation DSX500T11
* OpenBCI 8-channel and 4-channel EEG boards
* Arduinos and RasPIs galore
* Python signal analysis skills, Fourier and wavelet, machine learning
* Girlfriend who is already quasi-nocturnal and would be able to adjust the machine at night
* Planning on constructing chest stretch breathing sensor, nasal canula transducer, nighttime video recording setup

What do I need to do to find optimal pressure and A-flex setting?

Thanks,


Set the machine to 6-20, sleep. read data into sleepyhead, look at the results. post a graph here, (instructions in my sig).

I did it myself, eight years ago, with nothing more than a non-auto machine with less data... and persistence, no nocturnal girlfriend, eeg's, arduinos, raspis, or breathing sensor.

Now, if you really want to play, I've got a Resmed S9 VPAP Tx that I'm not using at the moment... (that's a lab machine) you can build a sleeplab around it.

_________________
Sleepyhead Info
How to format your charts


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omg_drd4_bbq
Unread post  Post subject: Re: [Serious] DIY Titration study  |  Posted: Wed Jul 26, 2017 11:23 am

Joined: Tue Jul 25, 2017 8:50 am
Posts: 4
PAP Mask: Wisp Nasal Mask
PAP Machine: DreamStation Auto CPAP DSX500T11
Humidifier: 3
Pressure Setting: Auto 8-14cm, A-flex=3

Offline
Ohai, diamunt!

I mean, if I don't HAVE to do all the complicated stuff, then I would rather not :P just extra hassle.

I'll set the start pressure to 6 for the next few nights and report back once I get some more data.

Thanks,


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diamaunt
Unread post  Post subject: Re: [Serious] DIY Titration study  |  Posted: Wed Jul 26, 2017 5:38 pm
User avatar

Joined: Wed Mar 02, 2016 2:26 am
Posts: 2403
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

Offline
one night is enough to get the first idea, to see if you're even close to being in the ballpark with the 6 minimum pressure.

_________________
Sleepyhead Info
How to format your charts


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omg_drd4_bbq
Unread post  Post subject: Re: [Serious] DIY Titration study  |  Posted: Fri Jul 28, 2017 6:59 am

Joined: Tue Jul 25, 2017 8:50 am
Posts: 4
PAP Mask: Wisp Nasal Mask
PAP Machine: DreamStation Auto CPAP DSX500T11
Humidifier: 3
Pressure Setting: Auto 8-14cm, A-flex=3

Offline
Ok, here is data from last night, starting at 6 cm. The first two hours are cut off, I wasn't asleep for any of that, in a rare bout of insomnia.


Attachments:
Screenshot from 2017-07-28 10-00-51.png
Screenshot from 2017-07-28 10-00-51.png [ 111.51 KiB | Viewed 2995 times ]
Screenshot from 2017-07-28 09-56-19.png
Screenshot from 2017-07-28 09-56-19.png [ 233.26 KiB | Viewed 2995 times ]
Screenshot from 2017-07-28 09-57-10.png
Screenshot from 2017-07-28 09-57-10.png [ 307.3 KiB | Viewed 2995 times ]
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diamaunt
Unread post  Post subject: Re: [Serious] DIY Titration study  |  Posted: Fri Jul 28, 2017 8:49 pm
User avatar

Joined: Wed Mar 02, 2016 2:26 am
Posts: 2403
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

Offline
I'd suggest raising the minimum to 8.

And next time, please do the post like the examples in my sig, it's easier for you to post (only one screenshot needed) and easier to see what's useful.

_________________
Sleepyhead Info
How to format your charts


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omg_drd4_bbq
Unread post  Post subject: Re: [Serious] DIY Titration study  |  Posted: Wed Aug 02, 2017 9:03 am

Joined: Tue Jul 25, 2017 8:50 am
Posts: 4
PAP Mask: Wisp Nasal Mask
PAP Machine: DreamStation Auto CPAP DSX500T11
Humidifier: 3
Pressure Setting: Auto 8-14cm, A-flex=3

Offline
Ok, thanks for the input. It pretty much confirms that 8 is a good minimum, which is where I had it.


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