Dalemazkour - Therapy Help

[Dalemazkour]

Thanks for the info I just ordered the arbors medium mask and headgear. One thing I have noticed is that having magnets the f20 come off at times during the night. Maybe the clip system will be better in keeping it on. Also just got the pillow and collar. That collar is going to take some getting use to for sure. lol

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I meant the P&K mask you recommended. Darn spell check

[Dalemazkour]

I ordered the wrong mask holder to go with the P&K mask. So mad I didn’t realize as Amazon groups all this stuff together like buy these together. lol
I had 30 AHI with the new settings so I am going back to 4-27 settings until I get the new mask head gear. It said I averaged in 3.4 episodes an hour on that date. Also my mask seal was good last night for the 2.5 hours I could tolerate but the exhale was a struggle or shall I say uncomfortable.

[PeaceLoveAndPizza]

Baby steps. It takes time to get the apnoea beastie under some reasonable level of control…

I have ordered the wrong equipment many times. Returned what I could, donated what I could not.

[Dalemazkour]

So I am still waiting on my new mask to arrive but have been trying to play with the settings and one day I will be at 45 AHI and then last night switched the settings again and was less than 10.  I tried ro organize and shrink the Oscar data tables to fit in a screenshot but having a hard time with the left side not sure how to consolidate that side to reduce so you can see all of it on one image.  Let me know if you would change anything based on last night.

[PeaceLoveAndPizza]

I cannot help with the technical side of formatting. It took me weeks to get it right. Maybe someone more technical can help.

With the leaks and flow limitations, it is difficult to manage the apnoea’s. You need to get those under control before things will improve.

There is not much we can do for the leaks short of mouth tape and/or soft cervical collar. For the flow limitations we can either wait for you to get the leaks under control or try something like the following:

EPAP min 6
IPAP max 25
PS 8

I am hoping that the new mask and use of a flatter pillow with mouth tape and/or SCC will help resolve the leaks and FL’s. If they do not help a visit to an ENT may be of value to see if there is something going on physically causing the FL’s.

Thanks for the patience and willingness to try things out. I know how frustrating this can be.

[Crimson Nape]

Dalemazkour - If you stretch the let side to be wide enough so each parameter fits on one line, you will get more lines displayed.  This will shorten the graphs a little, but not of any significance.

- Red

[Dalemazkour]

Went to sleep doctor on Wednesday and he said that anything under 13 AHI is fine given what I was at prior. He said my oxygen saturation levels are extremely low so I added a T Tube with an o2 concentrator set at 2 liters.  I was curious if you guys find this data better and also been trying to tighten the mask a little more for leaks.  I did try the other mask recommended from Vitera and wasn't a big fan so this data is with the medium resmed F20 mask. Let me know your thoughts if you would change anything. I am waking up with extremely dry mouth but AHI is better than earlier this week.

[PeaceLoveAndPizza]

I am very glad you saw the sleep doctor and that he found your O2 issues. Hopefully that helps you feel a bit better. Note that an AHI of 13 is still unacceptable. We want it 5 or less and preferably less than 2.

I go back to my recommendation a few posts back.

Mode VPAPauto
EPAP min 6
IPAP max 25
PS 8

Even with pressure 6-16 with PS 4 or 6 you still are having significant OA and H events, flow limitations, and snoring. You need more pressure. With more pressure support it should hopefully be more comfortable, which is why I suggest trying PS 8.

You may be a candidate for an ASV, but we need those more knowledgeable in that space to chime in their advice. 

[Dalemazkour]

Thank you for the information I will try tonight. Also, I was told on the ASV that you have to have central sleep apnea for insurance to approve it. I’ve asked the doctor a couple times now about it. Maybe there’s a second opinion I can get from another Doctor Who would order it.

[SarcasticDave94]

I'm not seeing what the ASV can help with here. Others might find something. CA don't look too terribly bad. The absence of all timing controls hinders the ASV more.

Leaks however are a big issue.

I used the F20 for almost a year, never getting leaks under control. And bad news, is you're likely going tighter to fix and actually making leaks worse. It's going to crush and flatten the cushion. Besides it'll make it very uncomfortable or painful to wear.

The Fisher and Paykel Vitera you mentioned was my best mask while using an ASV. It needs worn loose, and if an F20 medium fits, you'll maybe need large on the Vitera. Pay attention to the lower lip seal and the nasal bridge on the Vitera.