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[CPAP] UARS/Mild OSA New To CPAP. Please Help!
#11
RE: UARS/Mild OSA New To CPAP. Please Help!
New update. Still using the MAD, mouth taping, and min pressure at 9.

I feel the same, which is totally exhausted. I'm still waking up suddenly multiple times per night, often in the middle of a dream (REM sleep).

I've attached my OSCAR report from last night. Any insights would be appreciated! 

I have an appointment with my sleep physician next week. Should I push for a Bipap/ASV per Krakow's general advice?

   
   
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#12
RE: UARS/Mild OSA New To CPAP. Please Help!
A "shelf" ahead of inspiration is normal and is the slowing or cessation of expiratory flow. The duration of this null flow can vary from person to person. Flow rates look to be normal, however the flow rate chart could have much more detail by changing the Y-axis from Auto to a range of -100 to +100 (up to 120 is okay). Oscar automatically scales the chart to fit your largest flow, but this really reduces the resolution when you have occasional flow spikes.

A change to bilevel can make a huge difference for some people. It can be very difficult to make the case for medical necessity, especially, as in your case, when events are very low and there is no evidence of flow limitations or abnormal respiration. Forget about ASV, you don't have any form of central apnea, and if you got bilevel, you would be focused on pressure support with spontaneous breathing.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#13
RE: UARS/Mild OSA New To CPAP. Please Help!
Hi Sleeprider,

I appreciate the info!

One other question. I wake up often during the night, usually while I'm dreaming. I wonder if this may cause my fatigue and if the awakenings are caused by mouth leaking. 

Please see the graph below. 

1) Does this look like mouth leakage??
2) If so, is mouth leakage known to cause awakenings?

I should also note that I have aerophagia. I'm not sure if that correlates to mouth breathing.

Thanks again in advance! You all are amazing!



   
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#14
RE: UARS/Mild OSA New To CPAP. Please Help!
i forgot to mention I switched to an n20 last night.
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#15
RE: UARS/Mild OSA New To CPAP. Please Help!
long flat leaks are usually mouth leaks, and will result in a dry mouth. Happens to all of us, and these leaks are not into the large leak realm. Leaking through the mouth is not the same as mouth breathing. It may just be a relaxation of the jaw and air escaping, but it may include some oral inspiration. Aerophagia is just air passing into the gut past the upper and lower esophageal sphincter. People have different tolerance for pressure. When it becomes a problem, we often compromise between therapy efficacy and lower maximum pressure to improve comfort. That is always an option when event rates are as low as yours.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#16
RE: UARS/Mild OSA New To CPAP. Please Help!
Hello,

I have held at 9/6 pressure for over a month. I'm still feeling crummy. 

Two questions:

1) Every night, after about two hours of sleep, I fully wake up, and then I am in/out of sleep for the rest of the night. I hit the on/off button on occasion when I wake up. I have noticed that I often wake up after the APAP increases pressure (see graphs below ). I would assume this is due to three potential issues: 
     A) The APAP is not adequately treating flow restrictions, causing an arousal. The pressure before awakening is usually around 10. Would this indicate I should increase my minimum pressure? 
     B) The pressure itself somehow wakes me up.
     C) Aerophagia is causing me to wake up.

Any thoughts?

2) Looking at the flow rates, I have random large spikes. When I look at "healthy" flow rates that other people post, I don't see these black spikes. What causes these spikes in my flow rate? 

Thanks again in advance!

   
   
   

More graphs.

   
   
   
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#17
RE: UARS/Mild OSA New To CPAP. Please Help!
My doctor just prescribed me a Resmed Aircurve 10 Vauto BIPAP.

Based on my numerous posts above, can someone recommend the settings I should start on? I'm guessing inspiratory pressure of 10?

Thak you!
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#18
RE: UARS/Mild OSA New To CPAP. Please Help!
6-16 with PS=3
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#19
RE: UARS/Mild OSA New To CPAP. Please Help!
(09-02-2022, 07:30 PM)alwaystiredpleasehelp Wrote: My doctor just prescribed me a Resmed Aircurve 10 Vauto BIPAP.

Based on my numerous posts above, can someone recommend the settings I should start on? I'm guessing inspiratory pressure of 10?

Thak you!

I’m curious how the conversation to switch your machine was structured? Did you show them some data and request a change, or did they propose that change after looking at what they can see from your machine?
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#20
RE: UARS/Mild OSA New To CPAP. Please Help!
Agree with fishfinder. I did not think the doc would have prescribed VAuto machine. How did that go down -- your request or their decision?

Did your new prescription not include settings?

Please note the nomenclature for VAuto is different than traditional CPAP machines. Gideon has suggested 6-16 with PS=3. In the context of the AS 11 AutoSet, such a group of numbers would mean minimum inhale pressure 6, maximum inhale pressure 16, defining a band of INHALE pressures, with EPR of 5. In the context of the VAuto, as I understand it, the same numbers means minimum EXHALE pressure of 6, maximum INLH+HALE pressure PAP of 16, and Pressure support of 3. I encourage you to verity this with an expert like Gideon or Sleeprider. Of course, I'm not saying 6-16-3 is wrong or bad, just that the parameters are different.
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