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[CPAP] New to all this, trying to make sense and better my treatment
#1
Question 
New to all this, trying to make sense and better my treatment
Thank you for your help in advance.

Short background, was diagnosed back in 2016, and used my CPAP quite a bit then it began making a noise like it was dying so I stopped using it about a 1.5 years ago. I didnt notice much in terms of energy etc. so I just stayed off it. Recently been dealing with Attrial Fibbrillation and they have told me they want me to get back on my CPAP. I have ordered a new motor for my Resmed AS10 and installed it and have been back on it for about a week and a half.  just curious if there are any tweaks I can or should be making to my machine based on the information below. I have some PDF'd reports as well as screenshots at the link below I also (dont know if it helps) uploaded a couple of days of "datalog" files.

Only complaint I have is some nights I will turn and my mask hose will slip out of the heated hose end which may lead so some of the large leaks.

Thank in advance for any suggestions or comments.


"shorturl.at/noXZ9"


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#2
RE: New to all this, trying to make sense and better my treatment
Hi SleeplessNeattle,

Can you include Flow limitation graphs. I want to see if the pressure increase are increasing because of leaks or flow limitations.
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#3
RE: New to all this, trying to make sense and better my treatment
Yes, please include the Flow Limitation graph.  On one chart, the 95% FL is reading .11, we like to see it at .10 or lower.  

I always look at this as the chicken or the egg... which came first.  

My guess is that the few leaks you experienced caused the flow limitation.  You can see the narrowing of the flow rate during the leaks.  In turn, Flow Limitation will cause the pressure to rise.  This can cause unnecessary arousals.  

Are you aware if you mouth breathe?  Or you may have just turned over in your sleep and moved your mask.  Although the leaks are not too bad and won't affect your therapy, just try to be aware of the mask fit because leaks are important to solve.

Other than that, your AHI is very good.  In time, you may want to consider a slightly higher minimum pressure, maybe around 8cm.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#4
RE: New to all this, trying to make sense and better my treatment
I am attaching some screenshots from last nights sleep. 

I do sometimes need ot adjust my mask at night but the big thing is that my mask hose end very easily falls out of the heated hose end. Maybe I should look at taping it together or something. 

I have uploaded 3 screenshots below from last nights data. 

How soon do you feel I should change my setting up to 8?

Alternatively, I have uploaded PDF reports and full data logs to my google drive at the link below

shorturl.at/noXZ9


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#5
RE: New to all this, trying to make sense and better my treatment
When my heated hose got too loose to grip, I wrapped a rubber band around it a couple of times. Not too tight, so you can still pull the two parts apart.

Or maybe get a new one, if you have spare cash... Big Grin
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#6
RE: New to all this, trying to make sense and better my treatment
Oh wow the rubber band is a great idea, though I might need to use a hair tie.

Money is definitely tight here. As it isnI am getting hand Me down cpap masks and hoses from my dad since they replace his stuff on schedule for free (he's a veteran).

So back to the raising the minimum to 8.. just hoping to understand what the reasoning or purpose of that is like if the pressure autosets is is there a benefit to cutting off the lowest pressure it will go to?
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#7
RE: New to all this, trying to make sense and better my treatment
If you start your therapy too low, the machine has to detect a few events before it starts raising the pressure. Once it's up, if there are no new events, it will drop back down, and the cycle repeats.

The machine seems to give the best results if you start off with the minimum about 1 cm H2O below the median pressure shown in the Statistics panel. Moving the minimum up will, of course, raise the median, so it's sort of a moving target for a while. But it will settle to a steady value.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#8
RE: New to all this, trying to make sense and better my treatment
Is there ever a reason to lower the minimum back down?

Is this something like the goal is to eventually have as minimal pressure as possible to where your ready to get off the machine?

I will go ahead and raise the minimum to 8 tonight.
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#9
RE: New to all this, trying to make sense and better my treatment
It won't hurt to move the Min pressure to 8. My thought is that it might even out some of the pressure swings that are probably caused from the flow limitation. Since you're already using EPR 3, which helps with FL, the only other thing to try is raising the Min pressure.

I'm always for using the lowest pressure that gives decent therapy. If it doesn't make a difference or you're not comfortable with it, you can change it back.

I've never had a problem with the mask hose coming loose from the tubing, but the rubber band trick seems a good idea.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#10
RE: New to all this, trying to make sense and better my treatment
Your pressure increases are almost entirely due to flow limitations and your total number of apneas is low. At least until the flow limitations are under control you probably should run at fixed pressure somewhere in the range of 8-9, with epr = 3. You should slowly vary the pressure to minimise the flow limitations. This is a tedious time consuming exercise but should result improved "comfort" and reduced leaks.
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