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Need help please! High events per hour
#51
RE: Need help please! High events per hour
My take is let's beat the clusters of obstructive events, then, we can take a look at what's left and apply som EPR/PS to handle the remaining flow limits and obstructive events, then, if you are willing and wish, consider EERS at that time to handle the Centrals and allow the higher EPR I just talked about. But let's get these clusters handled. Yes I know you are working on it.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#52
RE: Need help please! High events per hour
I hesitate to say this, in fear of putting a wrench things. But in case the OP is experiencing this, I want to mention a potential factor for the mouth-breathing.

With the P10, some people (myself included) have experienced a lack of adequate venting of the exhale air. This can result in not feeling rested, and often the body forcing mouth-breathing (in order to get fresh air as opposed to re-breathed air).

I experienced this, and now approach the P10 with some apprehension and trepidation. I used P10 for over a year, until I experieced this issue. (Admittedly, I wasn't cleaning my masks often, so perhaps it was my fault the mesh of the P10s potentially became clogged.) I switched to the F20 AirTouch (the only FFM I can keep sealed all night long without being cranked tightly against my face). But recently I'm trying the P10 again (because it's the best mask I ever used), and am hoping it works out.

So... mask choice is certainly a large factor in success with xPAP. And sometimes mask choice isn't as simple and straightforward as one might think.
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#53
RE: Need help please! High events per hour
I've used the same p10 frame and headgear for the better part of 3 years. I started out cleaning every 3 days. now about once in 4 - 6 weeks. I do think Hydrangea's comment is important info for all p10 users. in time I start to notice waking up feeling shaky inside, usually after a short nap. then I notice moisture on my mustache even though I use passive or no humidification. after nearly 3 years I should probably interpret these symptoms as a sign it's time to buy a new frame but so far blasting the exhalation port mesh with a water flosser every couple months does the trick.
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#54
RE: Need help please! High events per hour
I'm now trying out a different mask, but I used the P10 for almost a year without incident. Once a week, I would soak it in warm water and hypoallergenic dish soap for maybe 5 minutes, then lightly brush both surfaces of the vents with a toothbrush dedicated to that purpose, rinse, and then let it all dry out. I also liked to get a new mask every four months or so.
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#55
RE: Need help please! High events per hour
Hello everyone! A very Happy Thanksgiving to all forum members and their families. I am so pleased to be part of this superbly helpful, supportive and friendly virtual family of people all over the USA and other countries!

In order to maintain continuity, I am attaching the OSCAR results from last night. I decided to use My Airfit F20 full face mask and it seemed to bring my numbers down a bit to 6.6 - I was however aware of air leaking out from the sides of the mask. It felt like little pockets of air were forming inside the mask and trying to ooze out the sides. I found myself waking up on at least 3 occasions to tighten the straps holding the magnets to prevent air leaking. The result was that the mask was very tight on my face. Anyone know of a solution for this?

It would be so nice if someone could interpret last night's results for me in easy to understand language! Fred Bonjour kindly provided some input yesterday, but I must confess - I do not exactly follow what he is saying. This community seems to have a language of it's own! I'll get to know the lingo at some point - that I know!

Thank you to those members who have come forward to provide advice and input so far. Again, Happy Turkey Day and thank you all for your guidance!


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#56
RE: Need help please! High events per hour
Happy Thanksgiving to you, too, Arnold! I think the basic advice you're getting is to stick with your current settings and collar use for a while (maybe a couple of weeks, unless something weird happens).

There are two reasons. One is that sleep is highly variable from night to night quite naturally. Trends are usually more significant than what happens in just a night or two.

The other is that your CAs may be occurring in part as a reaction to the pressures you need to reduce the OAs and Hs. You get more O2, and that can wash out some of the CO2 that triggers your impulse to inhale. This is "treatment-emergent" CA, and it usually settles down with time. And I have to say, CAs are just quite inconsistent -- consistently inconsistent, as some have put it.

Do you sleep on your back much? If you do, you might want to try sleeping on your side if you can manage it. If that isn't possible, you might consider a contour pillow that would support your neck and let your head drop back. This would help you to avoid chin-tucking.

If you're a side-sleeper, do you think your mask gets knocked around by your pillow? There are specialty pillows for CPAP users that have cut-outs on the side. Out of curiosity I just ordered one to see if it helps me with a different problem (vented air bouncing off the pillow and bugging me).
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#57
RE: Need help please! High events per hour
(11-27-2019, 04:48 PM)bonjour Wrote: My take is let's beat the clusters of obstructive events, then, we can take a look at what's left and apply som EPR/PS to handle the remaining flow limits and obstructive events, then, if you are willing and wish, consider EERS at that time to handle the Centrals and allow the higher EPR I just talked about.  But let's get these clusters handled.  Yes I know you are working on it.
1. You have consistent clusters (events grouped close together) of obstructive events, Apneas, and hypopneas
2. This means you are mechanically blocking your airway at night by 'tucking your chin, think a fetal position.
3. to correct this 'chin tucking' you are using a collar and working on getting it adjusted.
4. This will fix a multitude of issues, possibly even some centrals 

5. You will likely have flow limitations and likely some residual obstructive events after the above,  Re-evaluate at this time
6. These residual obstructive events will likely require additional EPR to resolve BUT this will likely cause an increase in your centrals, 
7. therefore the use of a new technique called EERS might be able to lower the centrals.  Thus the need for the re-evaluation.

does that help?
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#58
RE: Need help please! High events per hour
Fred - thank you for clarifying. I do understand this a bit better now!
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#59
RE: Need help please! High events per hour
Hello again everyone on this busy Black Friday. I am definitely on a roller coaster ride and every night seems to be like a box of chocolates - you never know what you're gonna get, as Forest Gump said! I do not know until the next morning what my AHI numbers will look like!

Last night I was at 14.55. It was 6.60 the night before. I used the same mask, the same settings, the same cervical collar. 

Is it possible for someone to please interpret for me what happened last night, based on the readings from the OSCAR charts?

Thank you very much again!


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#60
RE: Need help please! High events per hour
We continue to see clusters of obstructive and mixed apnea that suggest positional apnea. The events are not related to pressure, and I doubt that increasing pressure will make much difference. Your results have evolved over the course of this thread from AHI near 20 with more obstructive content to lower AHI, but still a high level of sleep disruption and apnea. I have no idea what to suggest other than you must get the positional issues and leaks under control before we can ever hope to optimize settings.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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