I'd like to present myself and the clinical case. Uploading graphs in a few days.

[watino]

Firstly: thanks! to this forum because it pushed me to take care of my breathing and gave the resources and software to do it.

Background: progressing daytime tiredness that has left me in bed 95% of my free time the last >8 months. Otherwise healthy 36 yo male. I checked "everything else" with a number of specialists, so apnea is the working diagnosis. 

Scandinavia: I asked for a sleep study 11 months ago, it's done now and now I'm told I'd have to wait 5 months to go try a CPAP. As per my tiredness my family Dr has insisted on sick pay, which would cost the Healthcare system ca 37000 usd, to then give me a CPAP in 5 months. Instead of costing them ca 900 usd for giving me the device today. I refused.

Sleep study (at home, borrowed equipment):
ESS 22/24. BMI 25. Slept 7 hours of which 48% on my back. AHI 22/h. ODI 19/h. Snoring index 73% "very troublesome snoring".

Total events / of which when supine
Obstructive apneas: 78 / 76 
Mixed apneas: 0 / 0 
Central apneas: 4 / 2
Hypoapneas: 66 / 55

Longest apnea is 33 seconds. Average is 19 seconds. 
Average saturation 94%. Lowest saturation  83%. Average desaturation 5%.
Saturation under 90% was present 3% of the time. Saturation under 85% was present 0.7% of the time. 

I got the SlumberBump positional (on side) sleeping device with limited effect, decent quality tho, ymmv. 

So unable to get professional help, not even paying privately anywhere in this country, I found this forum (thanks again!) and obtained:

• Airsense 10 autoset with humidifier and heated tubing
• Clinician's manual (read it all) 
• AirFit F20 medium size
• SleepyHead (read all wiki) 
• ResScan (read all manual). 

It gets here tomorrow! I'm so glad.


So I was thinking of starting with Ramp auto, Temp auto, EPR 2, auto-CPAP mode with pressures min-max 4-10. Sounds reasonable? I know a titration study would be ideal but that'd be 5 months from now and they only let you lie down 1 hour anyway. I'll post screenshots here the next days, please assist, and will get my sleep lab to look at the readouts also in 5 months when they call me. (I know we can't base Min-max pressures on any data I've given so far) 

Was really miserable, hope is back. Made a small donation.

[dwd1249]

Sounds like you are on the right path. I did the same as you but the machine I started with was a Resmart, not the best. It did give me relief and let me keep my job driving a bus.
I now have the same machine as you and it should let you do self titration.
You might be better starting off at 6 - 15 pressure. Most people fine 4 too low .
Post some SleepyHead data and you'll get help here.

[PaulaO2]

I would aim for wide open for a few nights, since you are self-titrating. Set it at 6 to, say 18 or 20. Watch the data for several nights then adjust slightly. Watch, adjust.

You can also read this:
http://www.apneaboard.com/adjust-cpap-pr...re-on-cpap

[Sleeprider]

Watino, great that you have taken this matter into our own hands and obtained the new machine. I hope you will continue this thread and post your results when able. You will need 4 posts to attach an image or link to one. Please read the first two links in my signature that describe how to post that data. I'm sure with your determination you will have great success.

[watino]

Thank you! 

I'm really glad about this supportive community after all resistance from health care providers. 
I'm getting the device today, that's excellent.

[watino]

Yes! 

Pressures 7-15 have given me 2,2 AHI per hour (supine) as opposed to the previous 39.


Device and mask are of excellent quality, silent soft and with no extra leaks. However my question, maybe someone can say, concerns effort at expiration.

I find it really hard to breathe against the mask. Then during the night something changed and it was easy to exhale for some hours, now a lot of effort is required again. Why?

This was present even at pressure 4 with EPR 3, I feel it's the vents somehow. Is this normal?

[watino]

I'll clarify:

With the machine off, exhaling against the mask is easy. When pressure is coming from the machine at 3L there is a clicking sound from the vent/valve, it closes, and exhaling becomes hard. Exhaling at 3 is not noticeably harder than exhaling at 12.

Is this vent/valve functioning as intended?

[Sleeprider]

We don't know what mask you are using, but all full face masks have an anti-asphyxia valve. This valve is open when you inhale and the machine is off, ensuring you get air in the event of power failure. When the mask is pressurized, the valve should be closed. The anti-asphyxia valve is not an exhalation vent, that is typically a vent built into the connector, or mesh in the mask. The mask must maintain pressure through both inhale and exhale in order to provide treatment.

The EPR setting should make exhale easier, and for most of us, the pressure becomes unnoticeable after a week or two. It will be much easier to see what is going on if you will post a screenshot image of your therapy from #Sleepyhead.

[watino]

Here's the data


Night 1: kept waking up, i do that without a sleeping pill
https://imgur.com/a/EP0R8 

Night 2: was 5 hours off mask unfortunately, i fell asleep too quickly to take it on.
https://imgur.com/a/enNUb



What do you think?
7-15 feel comfortable and it never went over 14.5 anyways.

[Sleeprider]

I think this looks okay, and will improve once you get more continuous therapy. My recommendation is to turn off ramp or minimize it as much as possible. By suppressing the pressure at startup with ramp, you end up with huge sudden spikes when ramp transitions to therapy, and I think that is disrupting your sleep and therapy. Try doing without it.