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Newbe with Chipmunk Cheeks
#31
RE: Newbe with Chipmunk Cheeks
Ok, I adjusted the charts, I hope.  

I can't use a cervical collar.  I had shoulder surgery and  it's still painful to have any pressure on my shoulder.  That may be an option in another month or two.  Maybe I can find a pillow to support my neck. 

I'm  practicing keeping my tongue on the top of my mouth during the day and prior to falling a asleep.  It appears that most folks eventually master sleeping with mouth closed?  I hope I can..... 


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#32
RE: Newbe with Chipmunk Cheeks
As suspected you do have considerable flow limitation and it drives your pressure to the top of your selected range. Your best results were with a maximum pressure of 16 with EPR off, and you were at the maximum pressure pretty often. I think you need that 16 cm pressure on exhale to resolve the obstructive apnea. I think if you liked using EPR previously, you can add it back in, but you would need to increase the maximum pressure to allow EPAP to reach 16 cm when needed; so if you add EPR of 2 or 3, your maximum pressure would need to be 18. Your results are trending the right direction with changes you have made on our own, and only you know your tolerance to pressure. If your last session at 16 maximum pressure without EPR was okay, then a maximum of 18 with EPR on should not fee too different, or possibly be more comfortable. It should be effective for you if you want to try it.

If you increase maximum pressure, you will likely reach it due to the flow limits that cause your pressure increases, however I expect events an flow limits to be fewer as you allow more pressure, even if you add EPR back in.
Sleeprider
Apnea Board Moderator
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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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#33
RE: Newbe with Chipmunk Cheeks
I had a much better night last night.  Thanks so much for your help.  I'm trying to understand these charts, but Sleep Apnea is a whole new language.  
I used a new chin strap and a contour pillow for my neck.  It seemed to hold my head back.  I'm going to try this for a few days.  I think part of my problem is I change something every night and some times several times a night.  I hope I have found the prefect fit.  Wish me luck.. and thanks again for your help.  

So you definitely think that nasal mask would be a failure?  It seems that most people eventually learn to breath with their mouth closed.  If I am going to get one,  I need to get it by the end of the year before my large deductible starts over for 2018.  

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#34
RE: Newbe with Chipmunk Cheeks
You had a couple of periods of large leaks (the light grey shaded areas arround midnight) so keep working on those otherwise great numbers. The CA’s should reduce over time.
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#35
RE: Newbe with Chipmunk Cheeks
Thanks for the help.  I am hopping for another good night.
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#36
RE: Newbe with Chipmunk Cheeks No More
No More Chipmunk Cheeks.  My numbers are looking much better.  I'm still using a full face mask but I think that some time soon I might make the leap to a nasal or pillow mask.  I use tape to keep my mouth closed, however, I am trying small sessions without out. 

 I ordered an Optlife mask because it has a small chin strap and I thought it might help me keep my mouth closed but I have not had the courage to try it while sleeping. I feel like I have no choice to keep my mouth closed with the air running in my nasal passages and that I am going to choke if I open my mouth. Not sure what will happen if I fall asleep.  Yes I am afraid of my new mask, I"m afraid my sinuses will EXPLODE ..lol.

 As a side note, I am about 80% better from my rotator cuff surgery.  I can sleep on my side again and no longer have pain when sleeping on my back.  I no longer refer to physical therapy as a torture session.  The end is in sight.  I am still not willing to try a cervical collar until I am completely better.  

Please take a look at my recent charts.  I lowered the pressure when I thought I would try the nasal mask.  My numbers seem a little better.

Not sure if my pressure needs to be up or down.  Thanks to everyone again.  This is a great site with very knowledgeable people.  Thanks for taking your time to help us.  


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#37
RE: Newbe with Chipmunk Cheeks
(12-06-2017, 07:52 PM)Sandyelle Wrote: My doctor did not feel that I could use a nasal/pillow due to my pressure level.

Many of us successfully use nasal masks and nasal pillows masks at higher pressures than you are using. I personally find full face masks much harder to work with at high pressure levels. They leak more, and they cause the chipmunk cheek issue.
-Amin
Nothing I say on the forum should be taken as medical advice.
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#38
RE: Newbe with Chipmunk Cheeks
On January 2 you used pressures of 10-17 with no EPR, and on January 12 it was 8-16 with EPR 3. I think the 10-17 with EPR 3 might be both more effective and comfortable, but it's entirely up to you. Your therapy is in an effective zone. The charts above are an interesting comparison because your EPAP pressure range was 6-12 when EPR was used with the lower settings, which appears to be a bit low. The 10-17 range with no EPR resulted in considerably higher pressure, perhaps too high. I think your flow chart, tidal volume, resp rate and I:E ratio all looked better with EPR. That might be coincidence, but I would keep EPR in your settings regardless of where you take the pressure.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#39
RE: Newbe with Chipmunk Cheeks
Thanks Sleeprider.  I am going to move my pressure back 10-17 with EPR 3, as you suggested and see how I do with that.  I'm away on a business trip for a few days (with my CPAP),  so I may not see the impact until after I get home.    I think I am more comfortable when I start with a higher pressure.  
.. A work in progress...... Thanks for your advice.
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#40
Wink 
RE: Newbe with Chipmunk Cheeks
(01-15-2018, 12:35 PM)Sleeprider Wrote: On January 2 you used pressures of 10-17 with no EPR, and on January 12 it was 8-16 with EPR 3.  I think the 10-17 with EPR 3 might be both more effective and comfortable, but it's entirely up to you.  Your therapy is in an effective zone.  The charts above are an interesting comparison because your EPAP pressure range was 6-12 when EPR was used with the lower settings, which appears to be a bit low.  The 10-17 range with no EPR resulted in considerably higher pressure, perhaps too high.  I think your flow chart, tidal volume, resp rate and I:E ratio all looked better with EPR.  That might be coincidence, but I would keep EPR in your settings regardless of where you take the pressure.


I am amazed at how well you understand how all this works.  If only my doctor or RT had a little bit of the knowledge the folks on this site have.   I am so glad I found this site.  


I slept extremely well, even in a strange bed in a hotel.  Then again, maybe everyone sleeps well in Orlando.  [Image: wink.gif]

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