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A couple of newbie questions
#31
(12-19-2017, 08:50 PM)paulag1955 Wrote: Interestingly enough, I read that the way you intended. And thank you for sharing your experience with me. My goal is to be able to sleep with EPR turned off, but I think I'll have to do it gradually.Hi paulag1955,
It's fine to go gradually, CPAP therapy is very much a trial-and-error thing, 'till you find what works for you.
Keep up the good work.
trish6hundred
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#32
If it was my chart, I'd have min 10 max 15 ( because of the CA y and the 95% is under 13) and see where the pressure settled. I think the two rises in pressure and the OA clusters are from chin tucking or back sleeping, see how they go, some people need to use a soft foam cervical collar to keep the airway straight
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#33
Paula, better results! as promised, the CA event rate was cut in half. I agree you can limit maximum pressure, but that's all You have made good progress with this change in EPR, and if you want to limit the maximum pressure to 13 that is a good idea. We can also just observe what another night brings. I think the strong cluster of obstructive apnea was probably a positional issue that might respond to a cervical collar, but I really don't want to push too much at you all at once...this was a success! Congrats.
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#34
The cervical collar is OUT until I get used to sleeping with the mask. I'm pretty sure that's all my claustrophobia can handle right now. I generally sleep on my stomach or my side. If I had to guess, I'd say I was on my side at the time of the first cluster (that's how I fell asleep) and on my stomach at the time of the second. Can anyone make sense of that? 

P.S. I very rarely sleep on my back, especially now that I'm having to sleep with a ponytail to keep the lower strap in place, so I doubt back sleeping is the cause.
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#35
Quote.........I slept with the mask for 8 hours last night, then took it off and slept for almost 3 more. I still wouldn't say I feel particularly rested this morning..........Unquote

Paulag1955 - omitted to say that your data is really good for having just started this month and also for sleeping for 8 hours!!!!!! Well done! Also as SR noted EPR reduced from 3 to 2 saw a 50% reduction in clear airway apneas. I also noted that a bunch happened when you must have fallen asleep and a cluster happened when the pressure was still low. If you feel confident enough, you might find that increasing the minimum to 6 will get rid of those. AS EPR is on 2, you will still be getting a pressure of 6-2= 4 cm H2O pressure.

It is understandable that you feel you need to sleep without the mask & machine as you feel the sleep was not sufficient with the mask on. Let me assure you, your sleep as shown by your chart is fabulous and would be much much better with the mask. Only time will prove to you that actually, APAP is giving you your wakeful hours back. Quite a few of us did so too.

Indeed you are doing so well but it is still early days. Think the 'elders' are advising more as a result of the good results but only you can decide the pace of change. This journey is indeed personal and I remember SR and others giving advice which looking back took me months to arrive at the same position as they had advised. I just was not confident enough to carry out the changes quickly.

But I got there finally..............
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#36
Last night was...not good. Put the mask on around 10:45 and slept fitfully until 12:55. Almost cried when I saw that I'd only slept for two hours, because it felt like five or six. Did cry when I turned the machine off and saw that my AHI was 23. Took a quick bathroom break and put the mask back on. I was having a really hard time exhaling, but I did doze off a couple of times. Both times I startled awake due to an air bubble trapped in my throat. Then I couldn't go back to sleep at all. Took the mask off and read in bed. Worked some crossword puzzles, read some more. Finally gave up for good and got up a few minutes ago. Still have not heard back from the sleep clinic.
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#37
[Image: NczTrv4.jpg]
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#38
Paulag, I think you might need to put a lower limit on maximum pressure. Notice that at higher pressure you have significant clusters of events. I think your pressure range would be more comfortable and effective at 6 minimum and 10 maximum. It's up to you. Hopefully these mixed apnea events will subside, but I want to assure you that if they don't go away on their own, there are comfortable and effective PAP therapy options that can help. Meanwhile, the best we can do is help you adapt and feel more comfortable and and rested. Limiting maximum pressure to 10 should be a big help.
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#39
So are you saying that the events are a response to the high pressure rather than the high pressure being a response to the events?

I'm going to contact the sleep clinic again today. I want to hear what they have to say.
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#40
The machine detected obstructive apnea and raised pressure. This in turn triggered CA. Since your apnea are mixed, it is a little complicated and what is reported as OA, may or may not actually be accurate, and could be a pressure-induced apnea. That pattern is something we see from time to time, and hopefully some of the other members that have been coached to reduce maximum pressure, and achieved better results will also post. With some people, higher pressure seems to shut down the airway like over-packing a suitcase.
Your lungs can only hold so much and if you're not exhaling, the machine reads obstruction, event though it is a form of central. If we looked much closer at those events we might see exactly what happened.

I think it's a great idea to contact the clinic, but be sure to point out your events are mixed obstructive and central apnea, and that they are more numerous at higher pressure and fewer when pressure is less than about 7-cm.
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