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New to the board and using a bipap
#1
(Copied from another thread)
I am new to the board and using a bipap. I was using a Resmed S9 and used my new my bipap last night. Woke up this morning with a headache and severe dry mouth. Any words of advice on what to adjust on my machine? I turned on the clinical settings this morning so I can see my ahi.
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#2
Hi disnynerd, thanks for starting your own thread.  You should get some responses.  

Will need a little more information from you.  
Pressure settings and pressure support?
What was your AHI and breakdown?  Obstructives, hypopneas, or mostly Clear Airways?

Do you have a high leak rate?  Usually a dry mouth suggests mouth breathing.

You can access all this information and more by downloading SleepyHead software.

Once you've done that, study the tutorials in my signature line to organize a Screenshot from the daily page of SleepyHead and use an outside source like Imgur to upload a screenshot here.

Keep your responses in this thread and ask questions if you need help.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

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#3
Welcome to the forum, and thanks for the new thread.  It will keep a history for you and separate your advice from others.

You were referred to this link http://www.apneaboard.com/wiki/index.php...re_success

Lot's of info there.

For your settings we need more info.  
Post a copy of your sleep study/studies.  
and Why are you using a BiPap/BiLevel machine?  I'm sure there is a reason you are using an advanced machine.
And finally, post your daily charts.  We can tell a lot from these and if we don't explain why we came to the conclusion we did, please ask.

Dry mouth is frequently a mouth "breathing" leak,  and the dry mouth is common even with a full face mask.  
Adjust humidity, both up and down.
Try Biotene or xylomelt.

And read the Mask Primer,  Has a bunch of info on leaks in there  (see my signature).

The headache could be either pressure or sinus related.  Charts will help with that.

Fred
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#4
Welcome to the forum, disnynerd.
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#5
Based on your profile, you are using your VAuto machine in fixed VPAP-S mode at 16/12 (PS 4). We would need to see some data from SleepyHead to see if that is ideal, or if you might benefit from using VAuto mode and a variable pressure or different pressure support. Your machine is capable of working at variable pressures, starting lower, and increasing as needed.
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#6
Thank you for the info. Even though I have worn a cpap for a few years I am new at looking at the data. 

I will try to make this story short:
I was prescribed a Resmed S9 in 2011. I wore it for a few years but then I grew tired of it and I was not using as much as I should have. I then investigated using a TAP (oral appliance). My insurance approved it but I had to go to an oral surgeon to get one with a referral from my PCP. I wore the TAP for about a year. I started wearing my cpap again because I was having extreme jaw pain/bruxism and my chiropractor recommended it. She also recommended I find out if the TAP was the correct solution for me. I spend time visiting my dentist (total waste of time) and then decided to visit my sleep doc. My sleep doc told me I should of never been prescribed a TAP because I have severe sleep apnea. I was never told this. I need to find a copy of my sleep study but my sleep doc said that he recommended that I go on a bipap even based on my sleep study from 6 years ago. Six years ago I was with another sleep doctor and just recently switched to another sleep doctor in the same practice. My sleep doc said that it is difficult to get approved for a bipap. He was't even sure if I was going to get approved for a bipap because I have UHC. Sleep doc said insurance companies want apnea patients to start on a cpap and then upgrade to a bipap when they can designate the apnea patient as a cpap failure. 

Yesterday, when I picked up my new bipap, the therapist said that I have some Central Sleep Apnea. Again, first time hearing this. This is really worrying me. My Dad has Parkinsons and I see this is one of the symptoms of Central Sleep Apnea.

I need help with:
How to read my data and adjust my machine to help me
Understanding what Central Apnea is

I have attached a screen cap of statistic from last night. Let me know what you need to see out of Sleepyhead. 
I also installed ResScan. I can provide info from ResScan if that is helpful.
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#7
Your API is not bad. Can't tell what type of events you have on a summary sheet. Could you upload the charts from the Daily please?
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#8
Daily chart attached


Attached Files Thumbnail(s)
   
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#9
I have dry mouth from time to time and I like to keep water next to my machine. If I wake up in the middle of the night with dry mouth I will get a small mouthful and just swish it around a minute or so. Dry mouth is uncomfortable for sure but the benefits of the therapy far outweigh my occasional discomfort
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#10
Let's try something a bit different to get you more comfortable.  Your AHI of about 2 is good, with .5 obstructive, 1.3 central and just a few hypopnea.  You are indeed using fixed pressure at 16/12, and I think you might enjoy a variable pressure built around your currently good results.  It's clearly your choice whether to try this or not, but as an experienced user you may see some benefits to trying this out.

You will need to enter the clinical menu for settings by pressing the control knob and home button at the same time.
Change mode from VPAP-S to VAuto
Change minimum EPAP to 10.0
Change PS (pressure support) to  3.0
Change IPAP max to 16
Change Ramp time to 15 minutes
Change Ramp minimum EPAP pressure to 6.0 or minimum IPAP pressure to 9.0 (should be 9/6 to start)

This allow you a pressure range of 13/10 to 16/13 with the machine automatically adjusting pressure based on its sensors.  You may find the lower starting pressure more comfortable, however if the machine detects potential obstruction, it will increase pressure to prevent apnea.  The lower pressure support of 3 rather than your current 4 should reduce CA events.  The IPAP max is the same as your current IPAP setting, and I don't see any need to exceed that currently.

With that suggestion out of the way, be assured your central events are not serious, nor an indicator of an underlying health condition.  You have a very low, normal event rate for CA, and you should not worry about it unless that event rate becomes much much higher.  The purpose of these suggestions are comfort and optimization, and it retains the basic prescription you are currently using, but allows variable pressure.  Good luck.

[Image: attachment.php?aid=3819]
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