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Have brand new CPAP but now think I made not need
#11
RE: Have brand new CPAP but now think I made not need
(06-25-2016, 07:26 PM)green wings Wrote: Hm, your sleep study may not have been scored in such a way as to know whether the spontaneous arousals that you had were RERA/UARS events or not.

Since you have your APAP machine plus SleepyHead, though, that gives you a very good tool for finding out if you are having RERA events and flow limitation, which is what you will be interested in from a UARS point-of-view.

from the SleepyHead Sleep Disorder Glossary: "RERA Detection in the Respironics System One data..Respiratory effort-related arousal..defined as an arousal from sleep that follows a 10 second or longer sequence of breaths that are characterized by increasing respiratory effort, but which does not meet criteria for an apnea or hypopnea. Snoring, though usually associated with this condition need not be present. The RERA algorithm monitors for a sequence of breaths that exhibit both a subtle reduction in airflow and progressive flow limitation. If this breath sequence is terminated by a sudden increase in airflow along with the absence of flow limitation, and the event does not meet the conditions for an apnea or hypopnea, a RERA is indicated."

Interesting!

Going to try to post the screenshots.

[Image: eec1b4d51a.jpg]

[Image: eec1db22d6.jpg]

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#12
RE: Have brand new CPAP but now think I made not need
I don't have too much to offer as I'm new to graph interpretation, myself, but I did notice your mask leak events. I use the same mask, and I recall how you mentioned you were a strict side sleeper. I've noticed that sleeping with the side of my head on a pillow is tricky with this mask unless I place it onto the pillow from just the right angle to avoid torquing the mask & breaking the seal on my nose. I try to raise my head a bit and then start leaning against the pillow so that it grips the mask and keeps it tight against my nose as my head sinks down to normal position. Friction keeps the mask a little higher than my head wants to go, keeping that seal intact. Otherwise, if the pillow is pushing the mask off of your nose a bit, that will likely generate air flow noise & possibly blow air onto your face, likely disturbing your sleep for a moment.

Also, because the mask itself is a sort of squishy tube, sleeping with the side of your head against a pillow seems to compress that side of the mask tubing mostly shut. I've yet to determine a solid impact from the mask squishing, but it's something to keep in mind.

It doesn't look like a very prevalent issue here, but I just figured I'd mention it since I noticed. You could maybe experiment with the angle your face hits the pillow, and maybe experiment with the firmness of your pillow.
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#13
RE: Have brand new CPAP but now think I made not need
cpap4uars,
Your leak rate is a bit high. Not sure, but due to removing mask or trying to adjust mask??
There are breaks in the flow rate at the same time that a leak shows on the graph.

Try to adjust your mask with pressure on. There is a mask fit check on your Apap. Don't make the straps too tight. They should be loose enough for comfort, but tight enough to stop leaks.

I hard a hard time with the dreamware mask too, I am pretty much a side sleeper and couldn't keep it in place. A lot of folk like it though.

You do have RERAs and flow limitation scoring on both graphs. A simple explanation for RERAs are baby apneas that haven't grown up. They may not be scored as an apnea event, but are just as disruptive to your sleep. A slightly higher minimum pressure will help with RERAs, and FL.

When I first started therapy, I had high RERAs and FL, it took me awhile to find the right pressure to elimate most of them.

Don't give up, it takes some of us longer to adapt. Afterall, who really wants an
alien strapped to their face and be tethered to a hose?

But believe it or not, most of us here look forward to going to bed and using our PAP machines.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
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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#14
RE: Have brand new CPAP but now think I made not need
LOL @ the alien reference!

I think the leakage is from me waking up a few times in the night to turn over and then I fiddle with it to get my head/neck situated just right so I'm comfortable but I don't feel air leaking out the sides.

I did the mask fit test and got 100%, so that's why I think it's me fiddling w/it. I do disconnect it once or twice to get up for the bathroom, I am not sure if the machine counts that as a leak.
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#15
RE: Have brand new CPAP but now think I made not need
I think you're right with waking and trying to adjust your mask, or turning over. I don't think it's anything to worry about. If you had leaks all through the night, then that could be a problem.

Also, when you wake to use bathroom, just turn machine off, and then unhook mask.

OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
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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#16
RE: Have brand new CPAP but now think I made not need
(06-25-2016, 09:01 PM)OpalRose Wrote: I think you're right with waking and trying to adjust your mask, or turning over. I don't think it's anything to worry about. If you had leaks all through the night, then that could be a problem.

Also, when you wake to use bathroom, just turn machine off, and then unhook mask.

I have it set to Auto On & Auto Off. The tube at the top of my mask allows me to do a quick disconnect while leaving mask on. Is that ok?
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#17
RE: Have brand new CPAP but now think I made not need
Hi cpap4uars,
WELCOME! to the forum.!
I want to encourage you to stick with CPAP therapy, I know it can take time to get used to but you haven't been at it that long, so don't give up.
You may need to try several different masks 'till you find what works for you, this is the hardest part of this whole thing.
Hang in there for more responses to your post and much success to you on your CPAP journey.
trish6hundred
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#18
RE: Have brand new CPAP but now think I made not need
(06-25-2016, 09:07 PM)cpap4uars Wrote:
(06-25-2016, 09:01 PM)OpalRose Wrote: I think you're right with waking and trying to adjust your mask, or turning over. I don't think it's anything to worry about. If you had leaks all through the night, then that could be a problem.

Also, when you wake to use bathroom, just turn machine off, and then unhook mask.

I have it set to Auto On & Auto Off. The tube at the top of my mask allows me to do a quick disconnect while leaving mask on. Is that ok?


Yes, that works. Forgot about that auto on/off setting. Sleep-well
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
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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#19
RE: Have brand new CPAP but now think I made not need
(06-25-2016, 09:26 PM)trish6hundred Wrote: Hi cpap4uars,
WELCOME! to the forum.!
I want to encourage you to stick with CPAP therapy, I know it can take time to get used to but you haven't been at it that long, so don't give up.
You may need to try several different masks 'till you find what works for you, this is the hardest part of this whole thing.
Hang in there for more responses to your post and much success to you on your CPAP journey.

Thank you trish! This is a really friendly and welcoming board. I'm glad I found it. So you agree with everyone else, even though we don't know for sure I have UARS, but based on the machine data I have something going on during sleep that isn't kosher per se?

(06-25-2016, 09:40 PM)OpalRose Wrote: Yes, that works. Forgot about that auto on/off setting. Sleep-well

Oh good, ok Smile

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#20
RE: Have brand new CPAP but now think I made not need
(06-25-2016, 07:21 PM)cpap4uars Wrote: I have it on the highest Flex setting (3). Seems to be good to me.

Hi cpap4uars,

When we first start using CPAP it often helps to use the max A-Flex (3). But after a couple weeks our breathing muscles will get stronger and we may not need as much exhalation pressure relief.

An A-Flex setting of 3 gives the max exhalation pressure relief, but during inhalation (which is when we have the Flow Limitations which can cause RERAs) the pressure also drops earlier (while we are still trying to finish inhaling) if using an A-Flex of 3.

After the first couple weeks of CPAP use, if we have UARS it may be more comfortable to have the high inhalation pressure last longer, which it will do if we are using an A-Flex setting of 1.

ResMed EPR doesn't act the same; with ResMed the high inhalation pressure lasts until we start breathing out.

But on Philips Respironics machines the high inhalation pressure starts dropping the earliest with max A-Flex, before we have completely finished inhaling, and the inhalation pressure starts dropping the latest (after we are nearly finished inhaling) when using an A-Flex of 1.

Take care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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