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New to the board! Looking for a little feedback!
#1
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New to the board! Looking for a little feedback!
Hello! I've been on therapy for about 5 years now, I have mild/moderate apnea to the point my ENT believes I don't need therapy but instead to use a mouth guard. I was diagnosed by a sleep specialist 5 years ago and ever since, I've been struggling with therapy. I couldn't tell you a time where I consistently slept through the night, I have very good sleep hygiene as well. I've done just about every mask they have to offer but always settle on the full mask since I'm a mouth breather. Anywho, I wanted to post a screen of last nights usage, as you can see, I only got about 3.5 hours of sleep which is pretty normal. From time to time, I can get 7+ hours but that is pretty rare but when I do, I feel so much better the next day. Just seeing if anyone had any recommendations on adjustments such as pressure/humidity/etc?


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#2
RE: New to the board! Looking for a little feedback!
What about your treatment makes you struggle? 

To check whether you need CPAP is actually a pretty simple task - just do a simple polysomnography at home with your ENT and you have your answer - have the same thing planned for the next year with my ENT.

What I noticed about your settings:
  • The minimum pressure of 5 & maximum pressure of 11 looks a bit low to me.
  • The ramp is set to on - I'd recommend you to disable this feature completely. It made me feel like I can't breath and brought really a lot of discomfort to me.
Other than that, you surely know that a sleep duration of 3 1/2 hours is too low and therefore I'd rather tackle this issue first. 

You're always free to not wear the mask and try a night or few without it. If you don't feel any difference when you get up, you have your answer too (at least about the impact on your general wellbeing, other than that, the CPAP therapy may still be medically indicated that's why I'd always honour a doctor's opinion about it).
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#3
RE: New to the board! Looking for a little feedback!
The pressure looks low in general or just min?
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#4
RE: New to the board! Looking for a little feedback!
(12-30-2021, 06:14 PM)flippytuck Wrote: The pressure looks low in general or just min?

Both. I can only judge from my personal treatment and what I've read on several forums. I started with 8 to 14 in July this year (so I am pretty new to this topic) and still stick to these settings and tolerate them well. 


The only thing which bothered me was the ramp which starts as far as I can recall at 4. So for me, I guess a pressure of 4 would be way too low to tolerate the treatment. But your milage way vary.
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#5
RE: New to the board! Looking for a little feedback!
Welcome to the board.  Lots of people here that have a lot of knowledge and can help with about anything.

for information

Min is the exhale and inhale pressure unless you also use EPR (exhale pressure relief)

But the absolute lowest the machine can go is 4 which is used for kids - same machines are used for them also

Your min is 5 so the EPR (3) you have set can not work.  Min 5 minus 3 can not happen because it is lower than the machine can go.

I would suggest that you raise the min

Min 7
EPR 3

would give you an inhale of 7cm and an exhale of 4cm.   Most if not all adults need more that 4cm of pressure or you feel air starved - you just can't get enough oxygen at 4.

Give it a try tonight I think you will feel a difference and like the difference.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: New to the board! Looking for a little feedback!
While the stats look good, we can make it more comfortable. But there's a few edits I'll suggest.

1. Since EPR 3 is active, your Min pressure needs to be 7 or you miss some pressure relief benefits. EPR is trying to drop your pressure by an actual 3 cmH2O, but your PAP has a low cutoff of 4.

2. Ramp 4 at 30 minutes is far too long and too low. You lost 30 minutes therapy due to this. Reclaim that time by cancelling ramp. At the least, raise pressure up to 6 for 15 or less minutes. Note ramp is active every time you hit start, so if you had multiple sessions, you lose 30 minutes each session as it is now.

No offense when I say this, but pressures 4-5 are typically reserved for pediatric duty. Most every PAP user needs 6 at least to start.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: New to the board! Looking for a little feedback!
The suggestions you're getting for revising you settings are well worth trying and certainly can't hurt you. But the big question is why you can so seldom sleep long enough. What happens -- do you wake up and then find you can't go back to sleep, even after giving it some time?
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#8
RE: New to the board! Looking for a little feedback!
I recommend cognitive behavior therapy for insomnia. You should look into sleep hygiene issues to see if you have any. Bed should only be used for sleep or sex. Everything else should be done off the bed, and outside the bed room would be much better.

Most important aspect to cognitive behavior therapy is trying to wake up at the same time everyday, and only going to bed when you feel sleepy to keep your sleep drive up.

But overtime, you should be seeing improvements with CPAP therapy with the right settings. Raising your minimum to 7 and EPR of 3 should help stabilize your pressure better.
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