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Newbie in need of suggestions to improve my experience
#1
Newbie in need of suggestions to improve my experience
    Hello, I have been using my CPAP machine for 2 weeks now, and I think everything is going ok but I would like some improvement suggestions if need be.  I am using the Resmed Airsense 10 with a heated hose.  Pressure is 6-15.  Mask is a Phillips Dreamwear Nasal Cushion?  I experienced significant mouth leakage as well as an extremly dry mouth  I added a chin strap and that seemed to help.  I am not sure if I NEED to switch to a mask but I have a Dreamwear mask on the way.  I am having trouble getting a screenshot with all the 6 recommended charts in the same shot.  I have just downloaded the Oscar app and I am trying to make sense of it all.  Here is the screenshot
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#2
RE: Newbie in need of suggestions to improve my experience
Pressure swings quite a bit, mostly due to flow limitations not shown on the graph, which can be disruptive to sleep. Your AHI is very low, and most of what we see is OA which calls for a higher EPAP or minimum pressure. This is a pretty simple problem to solve. We need to increase minimum pressure to get a step on OA events and take EPR to 3 to reduce the flow limits and hypopnea. I'll suggest taking pressure to 8.0 and EPR 3, and will expect to take minimum pressure just a bit higher later.

Other than the above, your therapy is excellent with very good looking respiratory statistics, and low AHI. If possible, make the graphs a little shorter in height so flow limitation and leaks can fit.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#3
RE: Newbie in need of suggestions to improve my experience
Thank you Sleeprider.  I made the changes on the machine and I will try and post my results with the new settings.  I think I was able to make the changes for a proper screenshot.  Here it is.


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#4
RE: Newbie in need of suggestions to improve my experience
Good job! You can see how small increases in flow limitation results in pressure increases, and also where the OA events usually initiate at lower pressure. You have a really good machine to deal with all of this and hopefully your therapy will become even more comfortable. With your current settings you start at 6/4 (IPAP/EPAP) pressure and have a median near 8.5/6.5 The new settings start at 8/5, and I'll be the first to say I think we are going to want 9/6 to optimize, but it never hurts to take it slow.
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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#5
RE: Newbie in need of suggestions to improve my experience
I appreciate the advice.  I would be totally lost without this forum. Can you tell if my leak rate warrants a switch the the face mask or is the leakage not that alarming? Thank you
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#6
RE: Newbie in need of suggestions to improve my experience
I would not worry about your leak rate at this time if you find your mask comfortable there were a couple of periods of large leak but not enough to adversely affect your therapy unless the leaks wake you up
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#7
RE: Newbie in need of suggestions to improve my experience
The leak problem is something you have to either adapt to or fix...and any of those orientations depends on your druthers, level of anxiety, and how greatly they affect the quality of your sleep.  Said more succinctly, how you feel about your therapy, and how well you feel served and rested, are as important as the numbers.  You need confidence in your equipment and to acknowledge what it tells you are pretty solid improvements.  Give it, and yourself, credit.

That pat on the back aside, leaks have a way of intruding.  They can arouse you, make you feel like something horrible is going on when you're not looking, or just not make you feel very rested upon waking.  Dry mouth is most often a symptom of excessive mouth leaking, but it can also be due to low humidity levels in your setup.  Since you already know you have leaks, you can safely assume your dry mouth is, like mine and about 200K others, due to leaks from an open mouth.  The remedies are, in no particular level of preference or efficacy:

a. changing masks to a fuller coverage area;
b. using a cervical collar, a soft foam kind;
c. using a chin strap; or
d. use a suitable tape to cover your closed lips prior to donning your headgear at night (it's what I have done since Night #2.  Night #1 was my learning experience.  Blink)

But, don't discount those great numbers.  They mean you're 90%+ of the way toward pure bliss...if such a thing were ever in the offing with PAP.
Serial Tapist
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#8
RE: Newbie in need of suggestions to improve my experience
    [attachment=24568][attachment=24568][attachment=24568][attachment=24568][attachment=24568][attachment=24568]Thank you all for the input.  I have a full face mask on the way, and then I will decide which mask works best for me. Last night was the leakiest night I have had in the 2 weeks using CPAP.  I will monitor how that progresses.   Sleeprider, the setting suggestions you gave me were a huge improvement.  Before, it felt like I was fighting the machine for air, now I can just breathe easy. Here are last nights charts.  I am open to more suggestions on how to improve my therapy.
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#9
RE: Newbie in need of suggestions to improve my experience
The new settings worked great, and I think with a better fit on the mask, it may get better. Glad to hear it is more comfortable.

Another version of full face mask is call a hybrid mask, and consists of nasal pillows with a mouth covering, rather than a rigid frame over the nasal bridge and chin. Hybrids like Mirage Liberty, Innomed and Philips Dreamwear Full Face have provided a good solution for many users, and Supplier #1 offers a 30 day fit guarantee.
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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#10
RE: Newbie in need of suggestions to improve my experience
I had what I feel is my best night sleep since starting the therapy thanks to Sleeprider's suggestions.  I tightened the chin strap and I think that limited my mouth leaks.  I still woke up when I turned onto my side and noticed leaking later in the sleep cycle.  I have the Dreamwear full mask on order but it is on back order until the 22nd.  Thank you to everyone who has posted on this board as it is immensely invaluable as my Doctor and my supplier gave me zero instructions.


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