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4 days into CPAP...is it helping? AHI way too high? 26 on day one, still at 13.79!
#21
It might not be optimal, but I think I would try the beginning pressure ~7 before moving up more. mainly in the interest of getting used to the therapy... 4 is clearly too low. (most of us feel smothered at 4 and cannot tolerate it) I would also decrease the max to 15 for now. first thing is to become accustomed to sleeping with the beast Smile

Welcome
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#22
Jen, you need to increase minimum pressure, and it might be more comfortable if you also use the Aflex at 2. This will reduce pressure during exhale. I had suggested a minimum pressure of 9, but in truth anything higher than 4 would do you a world of good. The clinical menu to access pressure settings is very easy to get at. Turn the control knob to show setup in the menu, then press the control knob and ramp buton at the same time. The machine will enter clinic menu. Just turn to Setup and scroll down to minimum pressure, press the knob then change the setting and select it by pressing the knob again. Aflex is a comfort setting, and you can change that from the clinician menu or the user setup menu.

Get the manual and take control of your therapy.
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#23
(06-18-2016, 12:45 PM)jen61 Wrote: Could the leakage be causing the high AHI?

The leakage will cause your airway to collapse and you'll experience obstructive apneas, just as if you weren't using a CPAP machine at all.

Look at the leak graph on SleepyHead. If you see extended periods of time where the leak rate is elevated those are likely the times that your mouth has fallen open. Since the chin strap is not working, call your equipment provider and request a full face mask. Likely your insurance will cover this. If your equipment provider won't cooperate call your insurance company and ask if a replacement mask is covered. It very likely is.

There are three numbers that ass up to your AHI. The obstructive apnea index (OA), the hypopnea index (H), and the central apnea index (CA). If the largest of the three is the CA that's a sign that the pressure may be too high.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#24
Sleeprider what exactly is the Aflex? I haven't heard that term before now. I'm not sure I've seen that setting on my machine. Some of the options are locked to me. Apparently the company I got it from is supposed to take care of settings etc. (I guess) She did say she would be downloading my data every night and be "behind the scenes"... but it's been several days and I haven't heard anything from her. I think I'll give her a call tomorrow to go over some things.
Sleepster, I do have 30 days to try the mask to see if it works. I tried on several others but I thought this one would be less cumbersome and awkward, but if it's not doing the job I may have to switch. I may try as someone suggested to put the chin strap over the mask and it may secure it better.
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#25
Respironics machines have two modes that reduce pressure when you start to exhale, A-Flex and C-Flex. Each has a setting from 1 (least) to 3 (most). Resmed machines have a somewhat similar mode called EPR.
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#26
Jen, A-Flex is Respironics version of exhale pressure relief. It makes it easier to exhale as it reduces pressure slightly as you exhale, then increases pressure as your inhale begins. Normally this feature is not locked out and is user-settable just like ramp. At the risk of being redundant, get the clinician manual and take control of your therapy. There is nearly no one here that does not do this.
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#27
Does using the aflex or cflex make the AHI ratings worse or better?
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#28
EPR, A-flex and C-flex are all considered comfort settings. For the most part, they don't make therapy better or worse, but more comfortable. That said, a lot of people seem to have increased clear apnea with changing inhale/exhale pressure. Usually not too serious, but it can happen. Also, it's possible, especially with Resmed EPR, to have more obstructive apnea when the exhale pressure (EPAP) becomes too low. For example, with a pressure of 7.0 and EPR at 3, the exhale pressure becomes 4.0 (5.0 with A-flex or C-flex). Sometimes that does not keep the airway open for the next inhale.

Lower EPAP than IPAP can feel great, but pressure has to stay high enough to prevent OA, and for some people, too much pressure support causes CA. So I guess the answer to your question is, it depends.
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#29
Thanks you sleeprider. I decided to turn off the c-flex and see what happens to my AHI. It's hard to say but last night AHI was slighly lower but not much. I have a Remstar auto but it's set for 12 right now. I may try to do the auto thing next.

Thank you!! Smile
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#30
Unless A-Flex is raising your clear-airway (CA) apnea index, the only reason to lower it is comfort. Most people find it more comfortable to raise it. Indeed, that is it's purpose. It lowers the pressure on exhale. C-Flex and Bi-Flex do essentially the same thing, but they differ in the way they affect the shape of the expiratory portion of the flow rate graph. This is, I think, largely a marketing scheme.

Don't worry about the difference between A-Flex, Bi-Flex, C-Flex, and C-Flex+. They all essentially do the same thing -- increase comfort by lowering the pressure when you exhale. If you find them comfortable and they don't raise your CA index, use them.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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