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David Clark - Therapy Thread
#51
RE: David Clark - Therapy Thread
Try turning the Smart Start off and see if that doesn't correct your problem. Like George Jetson, you will now have to press the button. (Ahh, memories!)
Crimson Nape
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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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#52
RE: David Clark - Therapy Thread
I've been having a fair amount of CA's which my sleep study did not show. I was thinking the highish pressure 20 then I turned it down to 18 but still had them was causing it. Two days ago I turned the pressure down to 12 and I'm not showing many CA's now. The same two days ago I started using a DreamWear nasal cushion mask so I'm getting some leaking because I'm not keeping my mouth shut. I was also hoping the lower pressure might not force my mouth open but I guess not. I may have to resort to a chin strap. Are there any adjustments to pressures you see that I might need to make? 
Thanks
Dave
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#53
RE: David Clark - Therapy Thread
I got a little tired of fighting with mouth leaks so last night I gave the Dreamwear nasal a break and tried out my 
F&P Vitera. Overall it doesn't look like it was a bad night but I have no idea what was going on for that hour.
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#54
RE: David Clark - Therapy Thread
Looks like for about 1/2-hour your mask was ajar and leaked near the large leak threshold. Flow limits during that leak are not necessarily accurate. On the whole, the night looks pretty good.
Sleeprider
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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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#55
RE: David Clark - Therapy Thread
Overall it doesn't look too bad I don't think. Are there any setting suggestions you have that would help with the flow limitations? 
Thanks 
Dave
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#56
RE: David Clark - Therapy Thread
If you want to try getting after the flow limitations, increase IPAP by 1-2 cm and increase PS from 5 to 6. You are already using a relatively high pressure support, and you should consider this move to be somewhat experimental to see if it makes a difference. We want to evaluate for effectiveness and comfort, and may decide to reduce PS to a more comfortable level. I don't know the source of your FL but it may be anywhere in the upper airway from nasal to near the soft palate or pharyngeal. Some people get lower flow limits with direct pressure to the nose using nasal pillows, but tolerance for nasal therapy is an individual thing.
Sleeprider
Apnea Board Moderator
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____________________________________________
Download OSCAR Software
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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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#57
RE: David Clark - Therapy Thread
Thank you. I'll try the setting adjustments and see how it goes tonight. I have Dreamwear pillows and well as nasal cushion. I like them both but when I use them the mouth leak comes into play. The chin strap I have doesn't really work that well unless it's uncomfortably tight. There's probably better straps out there. The last two graphs I've posted where the AHI was lower and leaks were low are after I switched to the Vitera.
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#58
RE: David Clark - Therapy Thread
Be aware that many chin-straps pull the jaw back and can directely increase flow limitation. The Knightsbridge dual strap pulls upward and seems to be a bit less of a problem, but is a full head cover. I actually prefer to see people try soft cervical collars to support the jaw from below and behind, than to use a chin-strap that wraps the chin or jaw and pulls toward the crown of the head.
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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#59
RE: David Clark - Therapy Thread
I did buy this one but I haven't tried it yet. I think maybe I saw it mentioned here somewhere.
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#60
RE: David Clark - Therapy Thread
Good choice! Especially when the summer months arrive. The material is a lot cooler than the normal covering material used.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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