AHi gone up five fold using Resmed F30 full face mask

[Sleeprider]

i see a couple things here. Your events are very clustered, and the comments by zzzZorro concerning a soft cervical collar may be something to consider. If the apnea arise from chin-tucking a collar can make a big difference. Your Elite CPAP is not capable of variable pressure, however it does have exhale pressure relief (EPR). Have you ever used it, and if so what were the results?

[Summer]

i see a couple things here. Your events are very clustered, and the comments by zzzZorro concerning a soft cervical collar may be something to consider. If the apnea arise from chin-tucking a collar can make a big difference.  Your Elite CPAP is not capable of variable pressure, however it does have exhale pressure relief (EPR).  Have you ever used it, and if so what were the results?

Thanks for your reply, I have been using the eliminator wedge neck support under my chin, unfortunately the latest variant has the chin part scooped out but I have packed it with foam. It has helped but I think need more packing, I do have a scrawny neck, as I have lost weight.

I seemed to suffer a lot of CAs, some I can see some are related to being awake and fidgety, I have installed an night camera to check. I did have EPR at 1 (the NHS clinic configured it that way), but I set it to off, as well as the ramp, thinking that would help reduce the number of CAs. My understanding that when starting off on CPAP, some individuals have problems with blowing off too much CO2.

My main complaints are:

1. AHI is too high and mentally I feel it, and physically as my adrenals are pumping all night.

2. CA / Central apneas are too high. Why?

3. Being awakened by apnea events were I hear the mask valve slam (I can test this slamming by blowing hard into the mask whilst the cpap is on). It could be caused strong hyperventilating. 

4. Leaks, these have improved, I do use a mask liner but have cut out the nose section of the liner.

5. I am now wondering if the F30 my have the nostril openings not correctly aligned.

My prescription was set to 8cmH2O, note the clinic did not titrate me, they just said see how you get on. 
I have slight increased a couple of day ago to 8.4cmH20. Should I increase further?

Thank you in advance !!

[Summer]

Summer - I have to ask, why aren't you using OSCAR's F12 key to take the screenshots instead of the photos?

Hi, I will now use F12. Thank you.

[Sleeprider]

Summer, I'd like you to try raising pressure to 9.0 and turn on EPR Full-time at 2. This will give some exhale pressure relief. The use of EPR will help us to eliminate CA as a primary problem and focus on the flow limitation that is evident on your statistics. If we see an increase in CA we may back off of EPR, but a trial is usually helpful in either finding a more comfortable setting, or learning whether you don't tolerate it.

[Summer]

Summer, I'd like you to try raising pressure to 9.0 and turn on EPR Full-time at 2.  This will give some exhale pressure relief.  The use of EPR will help us to eliminate CA as a primary problem and focus on the flow limitation that is evident on your statistics.  If we see an increase in CA we may back off of EPR, but a trial is usually helpful in either finding a more comfortable setting, or learning whether you don't tolerate it.

Hi Sleeprider, thank you !!  I have been trying to steer away from using EPR as I thought it would make CA worse due to blowing off too much CO2. I will now try using a pressure 9.0 and turn on EPR Full-time at 2. I am going to wait until Sunday to start CPAP again and in the meantime I will use my Aveo TSD (with the large spacer), its not ideal but I feel better.

I will let you how I will get on.

[Sleeprider]

It's possible it will make FL worse, or it may clear things up. The thing is, we won't know until it is tried. By all means feel free to revert to previous settings if you get uncomfortable.

[Summer]

It's possible it will make FL worse, or it may clear things up.  The thing is, we won't know until it is tried. By all means feel free to revert to previous settings if you get uncomfortable.

Hi Sleeprider, last night I slept with my cpap using the new settings; 9cmH2O, EPR Full time 2, F30 hybrid mask and chin support wedge.


I awoke a few times, but still had AHI 0f 22.32; OA 5.91, CA 14.11, H 2.30 for the period of 3 hours, didn't have any mask slamming though. The increase in pressure wasn't uncomfortable so that is good. Note that I am sleeping on my back all night, with head turned to either left or right on flat bed with a low tempur neck pillow. I think I need to further adjust the chin support wedge, which I will do tonight.

After 3 hours I stopped the machine and reverted back to my AVEO TSD and nasal dilator. I didn't use my pillow wedge that I sleep on to help with reflux. I noted on waking a few hours later (using the AVEO TSD period of sleep) that my chest was very tight, which I now know is caused by the amount of effort my chest muscles are having to use.

What do you think? thank you !



See attached Oscar screen shots.

[Summer]

Also I have looked at my night camera which I installed to help me see what is going on.  Interestingly, OSCAR reports a cluster of events at 1.25 am, I awake at 1.44 (camera detected movement) and check my face mask, so it seems that the previous OA's from 1.25 to 1.44 eventually wake me up. There are subsequent CA's come off the wake / transition.  Note my position as reported by my camera is on my back, head straight. I can do a screen shot of the position reported by my camera and post it.