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[CPAP] How am I doing? New here
#11
RE: How am I doing? New here
staceyburke, I agree that raising the maximum is worth trying, to see whether that can take care of some of those obstructive apneas. Possibly it will help; that would be great. But TimelyComics has to sleep on his back for now, so possibly it won't help.

I disagree about the EPR, though. The periodic breathing segment presented a bunch of OAs and Hs. If they'd been CAs, the reduction in EPR would make sense, but since they apparently weren't, I think there is value in continuing the EPR at 2 and even raising it to 3, given the severity of the flow limitations. (I say "apparently," because Hs could be central in nature. But given how few CAs we're seeing, I doubt whether that's the case here.)

TimelyComics, the soft cervical collar that Sleeprider recommends may be the same kind of collar you're using now. Could you check to make sure your chin can't tuck down inside the collar? Also, if you're using a high pillow, or several pillows, you might try switching to a single, fairly firm and flat pillow.
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#12
RE: How am I doing? New here
(03-02-2021, 12:57 PM)Dormeo Wrote: staceyburke, I agree that raising the maximum is worth trying, to see whether that can take care of some of those obstructive apneas.  Possibly it will help; that would be great.  But TimelyComics has to sleep on his back for now, so possibly it won't help.

I disagree about the EPR, though.  The periodic breathing segment presented a bunch of OAs and Hs.  If they'd been CAs, the reduction in EPR would make sense, but since they apparently weren't, I think there is value in continuing the EPR at 2 and even raising it to 3, given the severity of the flow limitations.  (I say "apparently," because Hs could be central in nature.  But given how few CAs we're seeing, I doubt whether that's the case here.)

TimelyComics, the soft cervical collar that Sleeprider recommends may be the same kind of collar you're using now.  Could you check to make sure your chin can't tuck down inside the collar?  Also, if you're using a high pillow, or several pillows, you might try switching to a single, fairly firm and flat pillow.
Thank you for taking the time to reply.
I've had a tough two nights and ended up foregoing cpap therapy due to excessive leaks and neck pain with the f30i. More than likely out of frustration, I ended up over tightening. Felt worse or back to how I originally felt before therapy.

Cpap therapy really does make a difference! 

So far the only change I've made is bumping up the max to 14 and purchased a Resmed N30i along with a Bleep kit. Trying the N30i tonight. If I'm able to get my leaks under control, I will transition to EPR.

Oh with regards to the collar, I currently don't own one yet. I've been using a cervical neck pillow and noticed since changing pillows, I'm able to keep my mouth closed. Sounds like it was just too tall. Might have explained why I was so prone to chipmunk cheeks.
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#13
RE: How am I doing? New here
Ah, cervical PILLOW, got it. Good to hear a lower pillow is helping you.

As a bleep user, I'll offer a couple of tips.

Be sure to clean the skin the ports stick to. You can use the bleep wipes, or you can use ordinary alcohol wipes (in the diabetes care section of a large drug store. My skin is dry, but it was still too oily for the adhesive to stick.

When you fasten the dreamway to the ports, listen for clicks. There are a total of four, but sometimes several of them occur simultaneously. I'd recommend practicing first with a port that is not stuck to your nose. When you think you've got it, block the short hose with your hand and test. You should not hear any leakage, and you should be basically unable to move any air.

Did you get the new bleep that comes with a little black unit that holds on diffuser pieces over the vents? If not, I recommend getting the black unit and diffuser pieces, which are available separately e.g. from Amazon.
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#14
RE: How am I doing? New here
(03-03-2021, 11:38 AM)Dormeo Wrote: Ah, cervical PILLOW, got it.  Good to hear a lower pillow is helping you.  

As a bleep user, I'll offer a couple of tips.  

Be sure to clean the skin the ports stick to.  You can use the bleep wipes, or you can use ordinary alcohol wipes (in the diabetes care section of a large drug store.  My skin is dry, but it was still too oily for the adhesive to stick.

When you fasten the dreamway to the ports, listen for clicks.  There are a total of four, but sometimes several of them occur simultaneously.  I'd recommend practicing first with a port that is not stuck to your nose.  When you think you've got it, block the short hose with your hand and test.  You should not hear any leakage, and you should be basically unable to move any air.

Did you get the new bleep that comes with a little black unit that holds on diffuser pieces over the vents?  If not, I recommend getting the black unit and diffuser pieces, which are available separately e.g. from Amazon.

I picked up the Bleep starter kit which should include those items.
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#15
RE: How am I doing? New here
(02-28-2021, 05:27 PM)staceyburke Wrote: You have 3 things that could be better. 1st - you have some large leaks that caused problems. There is a mask primer on the site you could read and another place is YouTube. Search for the exact mask you use and watch a couple, they may give you some ideas on how to limit leaks. 

2nd- you max out your upper pressure of 14, I would raise it by one. 

3rd - you did not handle the EPR as well as I hoped. You had some periodic breathing so until you get use to the therapy make EPR 1.

Now normally I don’t like to make more than one change at a time so you can see what helps and what does not. 

Back to the large leaks they really need to be fixed. Any time you have a flagged large leak you therapy is just not happening.

Hi Stacey

Apparently I don't know how to read OSCAR graphs... Where does it show large leaks? I see 0%
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#16
RE: How am I doing? New here
This was my 1st attempt with the resmed n30i. I used sonmifix sleep strips to seal my mouth as the chin strap just wasn't working for me (painful to use). At some point I woke up to find the strip was removed and was resting on the floor  Dont-know should explain the high leak rate.


n30i
EPR 2
max 15



Wasn't able to get a lot of sleep, but the data seems promising. Should I try bumping EPR to 3?


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#17
RE: How am I doing? New here
Yes, I think EPR of 3 would be a good idea. Your flow limitations are a lot better! Notice that with that improvement, your pressures aren't being driven up so high.

And actually, if you were sleeping through those leaks, you shouldn't worry about them too much. Leaks are bad when they (a) are large enough to impair the ability of the machine to treat you, (b) wake you up, or © make your mouth horribly dry. For your machine, leaks would have to be at 24 to impair treatment.

You'll probably get used to the Somnifix strips naturally, but if you keep taking them off, you might wear socks on your hands for a few nights to break the habit.

I'll be curious how things go with EPR of 3.
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#18
RE: How am I doing? New here
I would suggest you look at when your leaks are high, your pressures go up. I attached a screen shot of just your pressure over your leaks from Oscar. The trend is clearly there. Your avg. pressure was below 12 with an AHI under 2. Some of those events tagged for AHI could just be fake and not real events. Particularly anything that’s tagged CA for clear airway. Oscar has no real ability to know if it is true central apnea versus sleep onset centrals from having your sleep fragmented. If you’re having leaks and you are having arousals related to them, then Sleep Onset Centrals after an arousal are probably present and those aren’t real Central’s and perfectly normal (the majority of your events are CA). But they can contribute to your AHI going up because your leak is fragmenting your sleep, and the Software tracking this can’t tell the difference. In all honesty, I’ll go against the grain and suggest you probably should come down on MAX pressure. I think you’re getting too much pressure. Put forth a lot of effort into learning how to mouth tape and fixing the mouth leak so that you aren’t getting leak from there. CPAP auto algorithms are horrible for detecting apnea when leaks are intrusive throughout the night. The auto algorithms can’t differentiate between leaks and real apnea events and will drive up pressures for no reason.


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#19
RE: How am I doing? New here
Because the pressures are being driven up by flow limitations and not by the need to head off obstructive events, I agree that capping the pressure is not a bad idea if the leaks are bothersome. But I'd suggest making one change at a time so the results can be attributed where they should be.
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#20
RE: How am I doing? New here
Here's last night's. Only thing different was dropping MAX to 14. I wanted to see some consistency before making any further changes. 
Still trying to figure out the tape thing and mouth exhales woke me up. Looks like the pressure is spiking again due to flow limits.


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