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New to CPAP/FORUM - Started Great/Went Downhill
#1
New to CPAP/FORUM - Started Great/Went Downhill
Hello, All,

I was diagnosed with OSA [AHI 73.7] in April and subsequently prescribed BIPAP therapy [ResMed Aircurve 10]. The first night I took to it very well, and the first few weeks experienced VERY good results - averaging < 1 event/hr.

Recently - within the last week - I have been waking up in the middle of the night in full-panic, ripping my mask off and gasping for breath. I can pinpoint the issue; it's that interstitial point after expiration, but prior to inspiration - nothing happens. The equipment never goes into IPAP. I can easily duplicate it when I'm awake, just sitting there until I run out of breath.

A few nights ago I started adjusting settings awake, mask-on. My adjustments were less than scientific; I just started changing settings and 'pretending' I was sleeping. I felt like I made some progress, but still not sleeping/resting like I was.

This morning I woke up at 4:30 - taking my mask off again. I changed the settings back to where they were originally and was able to fall asleep again after a while - with elevated events ~7/hr.

I'm hoping that by sharing my settings, someone can give me some input on which direction to go.

Current settings:

Mode: VAuto
Max IPAP:  16.0
Min EPAP"  6.0
PS: 4.0
Ti Max: 2.0s
Ti Min: 0.3s
Trigger: Med
Cycle: Med
Mask: Full Face
Ramp Time: Off

Tried to attach a PDF of the sleep study, but not approved format.
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#2
RE: New to CPAP/FORUM - Started Great/Went Downhill
Welcome to the forum.

Please attach a daily screen shot with the standard charts.
Events, Flow Rate, Pressure, Flow Limits, leaks

I would bump my min up by 1 cmw to see if that helps, though I don't expect it to. Your IPAP starting at 10 should be fine but there are a few of us so actually need more.

More analysis when we see the nightly charts.
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#3
RE: New to CPAP/FORUM - Started Great/Went Downhill
malfunction with machine.. sounds like more like it. But yes, OSCAR report we need to see.
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#4
RE: New to CPAP/FORUM - Started Great/Went Downhill
BlackCobra,
Download the OSCAR software.  

Then follow this link to guide you in organizing your chart, take a screenshot of the daily page and post it here.
Layout graphs as Gideon suggested.

http://www.apneaboard.com/wiki/index.php...ganization

I suspect there could be some adjustments than can be made.  I think the issue you describe above may have to do with the cycle settings. We need to see that chart first.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: New to CPAP/FORUM - Started Great/Went Downhill
Charts from OSCAR.

Wednesday of last week, and Sunday [Last night]


Attached Files Thumbnail(s)
       
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#6
RE: New to CPAP/FORUM - Started Great/Went Downhill
Apologies; just noticed it should be organized in a specific manner. I will tackle this tomorrow. Crossing fingers for a restful night.
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#7
RE: New to CPAP/FORUM - Started Great/Went Downhill
The May 9th chart wasn't that great, mostly CA's and Obstructives.  
Also showed positional sleeping, where the Obstructives are clumped together on the graph.  This indicates you are tucking your chin into your chest which cuts off your airway.  Could be from using too high of a bed pillow.  Some folk have to use a soft cervical collar to help align the neck.

The April 29th graph was good.  I'm hoping this is more representative of your nights?  
You used a lower Pressure Support of 4 which helped the CA's and the higher Epap setting of 6, where you show very little Obstructives.  Leak rate good too, and no positional apnea.

Are you still feeling a problem with transitioning between expiration and inspiration as you describe in your first post?  
There are a couple other tweaks that may help.

For now, I would stick with the settings you used on the 29th.  PS 4,  Min Epap 6 and Max Ipap 16.

Post a couple more charts and don't forget to add the Flow Limitation graph.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: New to CPAP/FORUM - Started Great/Went Downhill
The 29th was the typical night until I started waking in the middle of the night in panic. Now, it has gotten worse. I can't tolerate the mask on even when I'm awake. Not sure how it didn't bother me in the slightest for several weeks, then all the sudden I can't even wear it. I slept for 2:18 last night before I woke up and took it off. I've been up since.

I ordered a nasal pillow mask at 3:00am this morning.
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#9
RE: New to CPAP/FORUM - Started Great/Went Downhill
Is there anything different you are doing now than before? Some change like something your eating, stressing out (other than from this) etc?
Does not make sense to me that all of a sudden, it stops working. (Mechanical failure)? The other night, I woke up and found the tubing had come partially off the cpap.
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#10
RE: New to CPAP/FORUM - Started Great/Went Downhill
(05-11-2021, 08:58 AM)BlackCobra Wrote: The 29th was the typical night until I started waking in the middle of the night in panic. Now, it has gotten worse. I can't tolerate the mask on even when I'm awake. Not sure how it didn't bother me in the slightest for several weeks, then all the sudden I can't even wear it. I slept for 2:18 last night before I woke up and took it off. I've been up since.

I ordered a nasal pillow mask at 3:00am this morning.


Ok, it could be you are just experiencing some claustrophobia with your mask.  The P10 should work great for you unless you are a mouth breather.  Then you are going to have issues.  There are ways to overcome that.  

When you receive your mask, be sure to change the setting on your Cpap for type of mask.  And use the same settings as you used on the 29th.   Be sure you use a dab of nasal gel in your nostrils. This helps with any irritation.

Also, try this...  a couple hours before you would normally go to bed, put your mask on, turn on your machine and sit up watching TV or reading something. This helps adapt to the pressure and the feel of a different mask.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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