New User - Optimization Help Please!

[Gideon]

Let's try this with EPR off
That should help the CA

[Sleeprider]

Let's try this with EPR off
That should help the CA

It may or may not, but I don't disagree. I think Dormeo expressed my feelings pretty well when he said this therapy is stuck between the Flow limitations and CA which indicate conflicting directions.  Once we get the EPR variable out of the way, I'd like to see if Sam might like to  consider EERS, so we can begin to address the flow limitation and CA hand-in-hand. I have mentioned EERS in two other posts, 2 and 13, and I hope at this point Sam has taken some time to read the Wiki to decide if this is a path he would be willing to try. http://www.apneaboard.com/wiki/index.php...ace_(EERS)

[Sam R Squared]

[attachment=25122][attachment=25123][attachment=25124]Sorry if I am misunderstanding, but I woke up around 7:48 before my alarm, which was set at 8:20 AM. 

I went back to bed for a little bit (if I had to guess, around 8:15-8:25, and then woke up again at 9:02 AM.

With this in mind, would you say these CAs are artifacts?

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Hi Sleeprider!

Thank you for all of your help during this time! I guess that I did not read carefully/thoroughly enough, as I did not focus too much on the EERS. I will look into this later this weekend, as I don't have the capacity to do so until then.

I apologize for overlooking this.

[SarcasticDave94]

I guess by artifact you might mean sleep/wake junk or SWJ. If you're convinced you were sleeping, I'd say these aren't likely SWJ.

[Sleeprider]

The CA events have been present randomly throughout the night and at consistently high rates over 5 per hour on average. Your overview data show this has happened throughout your therapy at all the various permutations of pressure and EPR that have been tried. I don't consider that an artifact, and EERS is simply a simpler alternative to recommending you pursue ASV. In addition to CA events, your therapy is quite fragmented, and your usage time is relatively short to non-compliant. What do you think wakes you up? I suspect you must be one tired puppy.

[Sam R Squared]

Hi @SleepRider,

Thank you for suggesting the EERS. Yes, I have been quite tired (honestly, for perhaps half of my life). Until I received my CPAP, I would constantly fall asleep in every single lecture, some containing 500 people where I would sit in the front row 5 feet in front of the professor. My first week of work, I fell asleep in front of my boss as she gave a presentation for me.

After reading your wiki post on EERS and the different threads of examples that you listed, I became intrigued. Since then, I have purchased the items needed for my F30i. I am excited to optimize my sleep to enable me to live a productive/efficient life. Thank you, and all the others on ApneaBoard, that have helped me so far!

Last night I tried 6 inches of rebreathing space, but could only sleep 4 hours due to my work schedule. I hope to sleep 6-7 hours consistently from here on out, as many deadlines have already passed. 

Attached are photos of my set up. A few things:
[attachment=25265]
[attachment=25264]

1. Should the Swivel be fairly loud? 
2. I blocked the vents directly on my F30i mask, but left the vents on the quick-release elbow adapter open. Should I block these too?
3. Tonight, should I try more rebreathing space?

[Sam R Squared]

[attachment=25266][attachment=25267][attachment=25268]

[Sleeprider]

Unfortunately the so-called Whisper swivel is a bit noisy. Some people have quieted it with a wrap of fabric. The swivel is your new vent, and leaving any vent in the mask or swivel reduces the rebreathing space to the location of the nearest vent. I want to see you plug the swivel vent before adding a section. The next step will be to add one more section and you should notice a significant difference in CA events. Moving the vent makes more volume in the mask and some people feel a need to raise minimum pressure. If you feel the need to take your minimum to 8.0, don't hesitate to do so. What we want to do is to eventually implement EPR at 3 to reduce flow limitation, but with EERS in place not increase the CA events. This is already a pretty significant improvement in your CAI compared to previous charts. Note your tidal volume has increase from 400 to 520, and minute vent has increased from 4.75 to 6.75 L/min. Pretty amazing to see a 2-L/min increase in respiration!

[SarcasticDave94]

The EERS did clean up the chart at that. Not too bad now.

[Sam R Squared]

This was last night with 1 6inch tube of rebreathing space, after I had plugged both the quick release elbow adapter exhaust and the F30i mask exhaust. AHI lower than 5!

The night before I took off the mask after 2 hours of sleeping. 

Should I go about adding another 6 inches? Or perhaps 12 inches? 

I turned up the pressure to 9, might turn it up higher if I add more rebreathing space. Should I go about setting EPR to 3?

Thanks for all of your help!
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