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Need help with pressure settings
#11
Last nites results:
https://imgur.com/a/xPUDb

Pressure 16 - 18.4. EPR 3  I could go higher on top pressure?, just increasing the top pressure slowly.  I have not tried the cervical collar yet, however the pillow I am now using is firmer than my usual pillow.  I really don't understand the comments made about tidal volume or respiratory rate made by ajack.

Could use some ideas about fixing red mark on bridge of nose!  Really like this mask except for that.

Thanks for all your help.
2010 sleep study 63 AHI
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#12
Followup.  I am doing much better.  See chart from last nite,

https://imgur.com/a/OlGIt


EPR is now 3; Pressure 16 - 18.4.


  How  does my Tidal Volume look now?  I am not using the soft cervical collar, what I did change was the side of the bed I sleep on.  Now sleeping on the right side of the bed as I sleep on my left side.  Seems to make a big difference in my ahi.  The hose is now positioned better for my mask.

Thanks
2010 sleep study 63 AHI
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#13
You have managed to cut your AHI, particularly OA in half to acceptable levels. Your tidal volume has increased from 280 to 340-400, which is a notable improvement. If you're sleeping comfortably and feeling good, this is getting pretty close to success. If you feel that you want more, I will stick with my original impression that a bilevel with more pressure support couldn't hurt. This looks pretty good.
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#14
Thanks. Is a bilevel hard to adjust to?
2010 sleep study 63 AHI
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#15
Bilevel therapy is similar to your Airsense 10 Autoset, but capable of more total pressure and more difference between exhale and inhale pressure. When you changed your EPR your results improved. Pressure support does more of the respiratory effort, so people with upper airway resistance or pulmonary resistance (COPD) can benefit from less breathing effort. It can also increase ventilation, improving tidal volume and minute vent. Bilevel lets you build on the progress you experienced from increasing EPR. It is considered much more comfortable than CPAP for most people.
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#16
Not sure if I am doing the right thing, but have scheduled a sleep study mid January to look at whether bipap will help me.  I am sleeping good, ahi decent, but when i get up in the mornING my eyes and cheeks are swollen.  Very uncomfortable and takes a couple hours for deflating.  I could not get a clear answer from the doctor as to whether bipap would help me.  Any rhoughts?
2010 sleep study 63 AHI
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#17
I'm not a pro at this stuff but I'm wondering about your resp rate (as mentioned previously).  I was able to get my AHI down with CPAP but I still suffered with the pressure (even as low as 5) but the resp rate was still a problem; I simply couldn't exhale with the machine well enough.  BiPAP helps with this, the pressure goes up and then drops back down to make it easier to exhale.

When I had my BiPAP titration study the breathing felt so much better since I could exhale finally and my resp rate never went above 16 during the night.  On the down side, some have a difficult time if you have a back up rate and the machine starts to push some air, it may initially wake you up as your drift off to sleep.
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#18
(12-22-2017, 05:37 PM)readyforsleep Wrote: Not sure if I am doing the right thing, but have scheduled a sleep study mid January to look at whether bipap will help me.  I am sleeping good, ahi decent, but when i get up in the mornING my eyes and cheeks are swollen.  Very uncomfortable and takes a couple hours for deflating.  I could not get a clear answer from the doctor as to whether bipap would help me.  Any rhoughts?

BiPAP /VPAP is really nice! It's more comfortable and can have some therapy benefits. In your case, you need to emphasize to your doctor that the higher pressure required for effective treatment is "intolerable" and is causing the side effects you mention. Generally, a bilevel machine can be prescribed and approved for reimbursement when the patient "does not tolerate" CPAP (i.e. has discomfort and other effects). A pressure threshold that is often mentioned for going to bilevel for comfort is 15 cm, which your settings exceed. 

If you are proposing to self-finance a bilevel machine, you could probably just ask for the script, or buy one on Amazon or Craigslist.  I bought my first System One BiPAP Auto on Craigslist for $350, and used my experience with that to argue for one that was covered by my insurance.  I self-titrated and used the data to document better results, and argued the comfort was superior.  If you want a machine covered by insurance, get a copy of the approval criteria for CPAP, BiPAP and other DME, and read it.  If you meet the criteria, you'll be covered, but if not, then they will offer a CPAP when the time comes.  Insurance coverage criteria are often available online or in the details of your policy.

Are you currently using the full EPR of 3 on your Autoset at 16-18.4 pressure?
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#19
I would also see a lung specialist, to see if the high respiration rate and low tidal volume is an issue. If the machine is accurately reporting, I'd want it checked out. From the start it didn't look like apap was for you and you would do better on bpap. I would still zoom in and see if the machine is miscounting in sections
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#20
Sleeprider!  Merry Christmas.  You have reassured me that I am on the right path.  I am trying the insurance route so the sleep study is mandatory. I was hesitant because of the expense of the sleep study - I have a high deductible. (Normally I pay out of pocket for cpap stuff I can't deal with the local dme ). My last sleep study was 8 years ago.  I guess I can handle another one.  

My pressure is now 16-19.6 and full epr at 3.
2010 sleep study 63 AHI
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