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Need help tweaking settings
#1
I've been using my CPAP for 6 months now. My problem is that I still snore like a bear! Will someone please look at my Sleepyhead screen and give me some tips to get a better nights sleep? (or at least a better nights sleep for my better half)
Here is a screenshot:[img][Image: sleephead.png][/img]
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#2
It is my humble, amateur opinion that you need a full face mask.
The P10 pillows mask has a difficult time sealing at higher pressures (like 18.)
And, I suspect you are opening your mouth.

(You could try a chin strap.)

I don't think there's a tweak for the machine settings that would be of benefit.
[Image: TGgs30I.jpg]
"Since this country was founded, each generation of Americans has been summoned to give testimony to its national loyalty. The graves of young Americans who answered the call to service surround the globe."  JFK Jan 20, 1961
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#3
I agree with Mongo. You need to tame those leaks. Getting the right mask is the hardest part of getting this therapy to work properly.
Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
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#4
I only see two instances of leaks that "might" be a problem. Your leak data looks pretty good to me and I disagree the mask is your problem. People that use Resmed machines are not accustomed to seeing the two leak lines and total leak in particular.

Your machine is recording obstructive events: snoring, flow limitation, and hypopnea. This suggests the minimum pressure may be too low. My recommendation is to change your AFlex to 1. You will get the same pressure relief, but the timing changes to give you a faster increase from exhale to inhale. That should help. Increase APAP Min by 1 to 11.0, and lets see where it goes.

You have a fair amount of RERA in your results, and increased CPAP pressure may not resolve that, but we should see improvements in CA, H and FL.

When you post a Sleepyhead image, it helps if you minimize the calendar by clicking that triangle next to the date at the top left.
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#5
Hard to improve CA when it's zero.
Sorry, I couldn't help saying that.

Sleeprider... Think you have a point about raising min pressure.
The machine has to increase quite a bit in response to FL and HA.

I wonder if she can tolerate higher pressure as it appears she shut the machine off twice when pressure reached about 16.
Also, I get how PR machines report leak rate. At both shutdowns, the lower leak rate line is up quite a bit -- I wonder if that is disturbing her sleep.
[Image: TGgs30I.jpg]
"Since this country was founded, each generation of Americans has been summoned to give testimony to its national loyalty. The graves of young Americans who answered the call to service surround the globe."  JFK Jan 20, 1961
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#6
JM, I think starting from a slightly higher pressure and preventing flow limitations, might avoid some of the rapid rise in pressure that had such a disruptive effect on her therapy. We could also lower the max pressure, but I'm hoping that won't be needed if we get the minimum where it needs to be.

The leaks correlate with higher pressure, and no doubt the arousals from FL and OA that occur at the same time. I think she will be fine, and this is just the excess pressure increase we see when minimum pressure is not optimized.

You probably saw that period where pressure did not fall below 14 and kept going higher, That is where I get concerned because if baseline pressure goes that high, a bilevel is a lot more comfortable.
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#7
What ever you do, DO IT SLOWLY, one step at a time. All input here is valid but you can not make more than 1 change at a time, and you need a waiting/trial period of a week or so to see if you can show a decrease or increase in any one area.

I'll throw this into the mix.............Start with a chin strap, although your leaks don't seem awful. (I can show you what a bad leak looks like) if you would like to see.

Leave lower pressure at 10, and most would suggest and rightfully so, to make .2 or .3 type adjustments to pressures. I would lower the upper to 15 and give it a week. I personally think that with that wide a range with a pillow, especially over 14 can cause many issues. I'm a firm believer since I have been here, that a wide pressure range causes most problem directly as the machine is constantly trying to "keep up" with your bodies changes.

Also, the snoring is a non issue (sorry) because other than it may make a partner somewhat annoyed, your personal gain buy a good nights sleep is for your overall good health. I would like to see the snore graph. If I'm not mistaken, the VS and VS2 are the snoring? My machine rates it differently so a graph would help me understand. You may find that as you get a better handle on some issues, other issues such as snoring will decline. In my case, when I finally got dialed in to minimize my leaks, my snoring went up a tick, but not significant enough to warrant a reversal of my adjustments to get me where I am now.

Keep in mind, that it is a slow process. I do 30 day adjustment tests (mostly), and it took over 6 months to get me where I'm at. Not perfect, but my daily readings are within a VERY REASONABLE RANGE, and VERY CONSISTENT.Sleep-well

Chuck
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#8
Ginzo, I agree with slow changes, however, unlike Resmed, PRS1 machines change in 0.5 cm increments. A 1.0 cm change to prevent obstruction, is not excessive given that the machine is going up by 8.0 cm. As far as a chin strap, I don't see a mouth leak pattern in the graph, and a chin strap can move the jaw back worsening OA. Disagree.
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#9
Im on a prs1 machine . The leak rate isnt the problem i dont think
I realize going slow is good but being one that desats very fast if im going over ahi of 1.5 much at all I dont have that luxury.
So im a bit more used to making larger adjustments.

Bump you min pressure up to 12. Your spending alot of time way above that anyway.
Leave every thing else alone.
Run a week at that if your still getting snores much bump min up .5 at a time until your not or if the snores stop bump down .5 until you find the sweet spot for min
But your min is definitely too low.
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#10
if the pressure is difficult to tolerate at the amount required for treatment, you should talk to your sleep doc about bipap. You don't have any tendency to CA from pressure changes - at least not on this night... and may benefit greatly from some pressure support.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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