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2 Years of CPAP & Still Somewhat Tired
#11
RE: 2 Years of CPAP & Still Somewhat Tired
I see you are hitting your max pressure quite often. I would have set it to about 12 initially and see what happens. You may need to go even higher. Personally I would say a min of 8 and a max of 12 with EPR at still 2 if you feel more comfortable with it but try 1 to see if you are ok with it. Sleeprider and the others may have different insights, though.
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#12
RE: 2 Years of CPAP & Still Somewhat Tired
(09-18-2017, 09:12 PM)Sleeprider Wrote: ozO2, this is a great opportunity to really dial in your pressures and get really comfortable with the machine. Your first chart shows that with variable pressure from 4-8  you pegged the meter quite a bit of the night but had great results.  What I'd like you to try is is EPR, exhale pressure relief.  It can make pressure so much more comfortable.  My suggested strategy will be to use your original pressure, but add in EPR and see if you find it more or less comfortable.  There are so many variables with the Autoset For Her with 3 different auto algorithms.  Your results are great as-is, at 1 AHI.  What we want to do is experiment to find settings that are the most comfortable.  That goes beyond the numbers.

My suggestion would be a minimum pressure of 7 with EPR on Full time at 2.  This will give you a starting pressure of 7/5 (inhale/exhale). This should feel really good.  To ensure you avoid obstructive apnea and hypopnea, set the maximum pressure to 11.0.  The pressure will only go as high as needed.  You can use the Autoset standard, soft or For Her algorithm.  Should not matter much.  Give this a try and let's see where you can go for results and comfort.  The only issue I see for now is you have some moderate mask leaks.  We can deal with that separately if needed.
7-
If you find you really like the Autoset, I bet you can get it since your supplier is so cooperative.  I nothing else, you can buy it on Amazon for about $440.

My recommendation has not changed, other than you now own the machine.  Try EPR as it may reduce hypopnea, however, given that you are at 7-10 pressure, please increase minimum pressure to 8, and maximum pressure at 12 with EPR 2.   As long as it does not increase CA events, I think you will find the therapy more comfortable, and may improve your AHI results.
Sleeprider
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#13
RE: 2 Years of CPAP & Still Somewhat Tired
I'd raise the max to 20cm and leave it there until you figure out how much pressure you actually need. I doubt it goes all the way to 20cm.
It would be quicker than to continue bumping it up.
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#14
RE: 2 Years of CPAP & Still Somewhat Tired
Took me 10 years to start sleeping better. I am on my third cpap machine and this one for what ever reason is doing it for me. Never give up. Just keep trying.

Took me 10 years to start sleeping better. I am on my third cpap machine and this one for what ever reason is doing it for me. Never give up. Just keep trying.
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#15
RE: 2 Years of CPAP & Still Somewhat Tired
Thanks all for the quick responses. I will try sleeping tonight with min pressure at 8 and max at 20, with EPR set to 2 and see how it goes.

PS @Sleeprider: I don't yet own an Autoset, I just have a very patient DME  Rolleyes
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#16
RE: 2 Years of CPAP & Still Somewhat Tired
So I've now gone a couple of nights with the higher pressure settings and EPR at 2, and I seem to be getting better results (see below for last night's charts). Can I optimize any further?

Also, do I need to get the Autoset, or can I translate these settings into my CPAP machine (lets say by setting the pressure to 11 or 12 and EPR at 2)? Here in Canada it would cost me close to $1000 to buy another machine (unless I can somehow get insurance to pay something...).
[attachment=3989]
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#17
RE: 2 Years of CPAP & Still Somewhat Tired
If that isn't mask leak, to me it looks like mouthbreathing. I'd swap to a full face mask, or you can try all the stuff to get mouthbreathing under control.

Auto is just easier. With that chart, I guess you would have a fixed pressure of 13. (95%+1cm) As long as what you get has a SD card, you can tweak the pressure as you go along. You can get secondhand or new. The S9 resmed elite is a good fixed pressure machine, they have been superseded with the 10, so there should be some discount. They should last for years. The real cost of cpap is mask replacement. That is where the money is spent over the years, the machine is generally the lesser cost.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#18
RE: 2 Years of CPAP & Still Somewhat Tired
oz02, you don't mention which province you are in. Ontario's Assistive Devices Program pays $860 towards CPAP devices and $1020 towards APAP devices. There should not be $1000 difference anywhere in Canada. Shop around and check our Suppliers List at the top of the page. I gather some of them will ship machines to Canada.. And there are Canadian suppliers that are not on the list because nobody has reported back; check them out, too.

I think an APAP is worth the extra money. Talk it over with your prescribing doctor.

Edit: CPAP is $860, APAP is $1020, and BiLevel is $1120 -
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#19
RE: 2 Years of CPAP & Still Somewhat Tired
(11-12-2017, 05:31 PM)pholynyk Wrote: And there are Canadian suppliers that are not on the list because nobody has reported back; check them out, too.

I reported on a Canadian supplier last month I've had a good experience with. I don't know what the criteria are for making it on the list.

http://www.apneaboard.com/forums/Thread-Ontario-Suppliers?pid=226292#pid226292
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#20
RE: 2 Years of CPAP & Still Somewhat Tired
To tell the truth, I'm not sure what the criteria are, either. I will take it up with the Advisory Board and Staff.

Thanks for reminding me.
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