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[Pressure] Newbee - 1st Evening Failure
#11
RE: Newbee - 1st Evening Failure
(10-20-2020, 09:13 PM)Snooks Wrote: It makes me wonder how well the machine has been serviced and cleaned, given C-19 and the fact that there is no air filter in it. That's odd, hopefully it can't hurt me.

So it's a hire unit rather than a new one? Is there no actual filter present (sits in the perforated panel to the rear of the SD card) or are you referring to the "Antibacterial Filter" setting reported in OSCAR? It would seem exceptionally unusual to have no filter there...

Is the humidifier tank a HumidAir "S" or "C" (S/C in the box to the right of "HumidAir")? "C" is designed to handle higher temperatures for cleaning (such as in a dishwasher).
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#12
RE: Newbee - 1st Evening Failure
(10-21-2020, 01:58 AM)kappa Wrote:
(10-20-2020, 09:13 PM)Snooks Wrote: It makes me wonder how well the machine has been serviced and cleaned, given C-19 and the fact that there is no air filter in it. That's odd, hopefully it can't hurt me.

So it's a hire unit rather than a new one? Is there no actual filter present (sits in the perforated panel to the rear of the SD card) or are you referring to the "Antibacterial Filter" setting reported in OSCAR? It would seem exceptionally unusual to have no filter there...

Is the humidifier tank a HumidAir "S" or "C" (S/C in the box to the right of "HumidAir")? "C" is designed to handle higher temperatures for cleaning (such as in a dishwasher).
This is a hire unit identical to mine, that is coming next week. I just wanted to get in and get started whilst i could work up the motivation.

I am working on Oscars report of no filter but will check when i am back there, im out at the minute. The Humidifier i need to find out about.

Hopefully tonight goes better and i should have all the info to post in the morning.

Thanks for the comments and information. Smile
I am now 59 and that means that I am old enough to forget, but i'm still young enough to learn. Your advice is gratefully accepted, your opinion is highly valued and your patience will probably be tested when assisting me.
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#13
RE: Newbee - 1st Evening Failure
Trying to help you clarify the filter aspect. There's a filter that is rectangular and flat under the door on the left of the machine. I do not think any area of OSCAR states anything on this one. There is an area on OSCAR that reflects a setting for AB filter, that is an antibacterial filter, a rounded filter that goes on the hose. 2 completely separate filters.

I'll add an image regarding each. First up is the location and look of the machine filter. Make certain you do have a filter here as it protects the machine. Second is an AB filter. This is optional and not needed for most users.

   

   
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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#14
RE: Newbee - 1st Evening Failure
Snooks, sorry to learn that you've had a rough start. How about a restart? You've gotten some good advice about changing your settings and checking the filter and water tank. Here's an additional idea for you.

Try a couple of days using the machine in the daytime or evening, setting it up outside your bedroom. If you have a couch or recliner where you can get horizontal, great; if not, no worries. Watch TV, read, use your devices -- whatever is pleasant and distracting for you. This allows your mind and brain to get used to the novel experience and to stop reacting to it with fear/worry/panic.

During this interval, don't try to use the machine at night. You need some time to get used to it before you try that again. When you do restart nighttime use, don't beat yourself up if you use the machine for only part of the night. As you continue to acclimate, you will be able to stay with it for longer and longer periods.

In other words, for many people, easing into works a lot better than jumping in. You're looking at the long haul, not the short run.
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#15
RE: Newbee - 1st Evening Failure
Good Morning, thanks for the comments and I have addressed or I am in the process of fixing or changing what I can.

So last night I decided to lay down and try the machine and get accustomed to it. I can honestly say that I am certainly getting better and feeling more comfy. By no means am i 100% comfy but I certainly am not terrified any more. I feel that last nights attempt and data will assist us to smooth things out and get the treatment fine tuned and working better.

I have endured Insomnia really bad since around March, caused by the virus and terrified of getting it and because I know the OSA is killing me if I do not get it under control, so I think that I try and not fall asleep....... even though i try to, if that makes sense.

So last night I laid in the recliner watching TV and had the mask going for about 30 odd minutes as I recall. Then I got a runny nose, so got up and I was off treatment for around 1hr 45 minutes  whilst I tried to get sleepy. I feel like i was awake that whole whilst time on the machine. I felt reasonable comfy on the machine except I tended to fiddle with the straps adjusting tensions and just trying how to wear it the most comfy.

I got a bit sleepy and went back into the chair after the 1hr 45mins and 20 minutes or so later I felt the starting pressure was too low so i stopped, increased it to 7.6 and when i started that still seemed low so increased it to the 8.4 that it is currently set at.

Then, I think it was only 20 minutes or so and I must have drifted off. I ended the treatment when I did because I, for some reason, woke up terrified and jumping sky high. I took the mask off and was very concerned but do not recall what scared me. I then just slept in the recliner off treatment, it was like 3am and I was desperate for some sleep.

I did notice that even though I was awake, I honestly think that I was asleep. Sounds silly I know, but i can see events which seem to indicate that I was asleep, but I recall being awake. I felt myself sort of holding my breath a few times and the machine seemed incredibly slow to build up pressure, but again, i swear i was awake.

I have mentioned all these details and rambled on because i think that the more I mention, the more that can be connected to the data in the graphs. Thank you in advance for any comments on how to move on and improve treatment. Obviously I need to spend more time on the machine and hopefully I will have a greater improvement tonight.


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I am now 59 and that means that I am old enough to forget, but i'm still young enough to learn. Your advice is gratefully accepted, your opinion is highly valued and your patience will probably be tested when assisting me.
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#16
RE: Newbee - 1st Evening Failure
Do you usually sleep in the recliner? If so, you might try doing your acclimation in another spot that you don't mentally associate with sleeping. Small thing, but it might help.

As you can see, you didn't have any obstructive apneas, which is good.

Central apneas occur when you stop breathing for more than 10 seconds but there is no obstruction in your airway. They often happen when we are hovering between very light sleep and being awake; awake breathing is a lot less regular than asleep breathing. (Notice sometime how often you stop breathing for more than ten seconds when you're concentrating on something, for example.) This in-between state fits your description of your night very well. It also fits the bristly appearance of your flow rate graph except for around the final hour. So the CAs may well just be what we sometimes call "sleep-wake junk." For now, I'd say they should not be your focus. Instead your focus should be on getting more comfortable and working your way toward getting more solid sleep.

The final hour looks a lot more like solid sleep, and the good news there is that during that time you had no events.

You had some hypopneas and some flow limitations. They can sometimes be reduced by introducing some EPR (expiratory pressure relief). Occasionally EPR will lead to an increase in CAs, so I'd suggest that you try an EPR level of 1 to start with. That will drop your exhale pressure by 1 cmH2O relative to your inhalation pressure. To compensate I would suggest you raise your minimum pressure by 1.

You can try that experiment now or later. Sometimes it makes sense to stick with one setting for several nights, since there's so much natural variation between nights. Your call.
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#17
RE: Newbee - 1st Evening Failure
I don't think that you were actually asleep until a bit after 1:15. That, at this scale, is what good, full, restful sleep looks like.
The real grassy look of the flow rate looks like an awake or non-restful sleep.

You did a good job of bumping up your min pressure to find a comfortable level. That level for me is 10 cmw but I'm me and not you or anyone else. If you cannot achieve comfort , well that usually leads to failure.

It does take some time to adjust for most people and it varies. I started at an Rx of 19 Fixed many years ago, ok 18 because my matching would not adjust to the prescribed 19 and at the time I didn't know I should complain about it. I was one on the lucky ones, I took to it like a duck to water as of the first night, but I am very unusual in that regard. Bottom line practice, practice, practice.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#18
RE: Newbee - 1st Evening Failure
@ SarcasticDave94
I checked those filters and despite the machine saying no filter, it is within the machine in the spot you indicated. Thanks.

@ Dormeo
I was in the recliner (not my normal sleeping place) and although we did not have a hugely successful night, it was far better and showed significant improvement is not only possible, but happening soon. I may be a tad uncomfortable with the machine, but except for where i stated that i woke up terrified, the rest of the night I did not hit panic mode Smile I will be trying the recliner again tonight and I am feeling much more confident today.

I will try the EPR adjustment tonight and see where that takes us.

@ Bonjour
Thanks for the comments and for looking at the data. I will do an EPR of 1 tonight and increase the starting pressure by 1. Assuming that this feels comfy i will use that and see how we progress over the next couple of days.

Thanks for the comments and suggestions everyone Smile
I am now 59 and that means that I am old enough to forget, but i'm still young enough to learn. Your advice is gratefully accepted, your opinion is highly valued and your patience will probably be tested when assisting me.
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#19
RE: Newbee - 1st Evening Failure
short sessions with the grassy or hairbrushy flow rate is indicative of arousals. sometimes, not always, a flow rate that looks like that is due to periodic limb movement (plm, plmd, plms). hopefully not, in your case, but I'm tossing it out there to be considered if a) you see a repetitive pattern when scrolling through the hairbrushy areas at a 10 minute view scale, and/or b) you don't feel like you're getting refreshing sleep after optimizing your machine settings. you won't be aware of plm but some with plm experience restless legs in the evening. you might check the details of your sleep study (not just the summary), assuming you had one, to see if it recorded plm. could be something else entirely but mentioning as a possibility. view scale can be adjusted by the view size slider at the bottom of the daily/events tab.
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#20
RE: Newbee - 1st Evening Failure
Snooks, your last session looks better, but let's get some EPR on full-time at 2. It's going to be more comfortable, and at this point we just need you to get some sleep with the therapy. I agree with Bonjour that your real therapy starts at about 1:15. My suggestion is:

Autoset mode
Minimum pressure 9.0
Maximum pressure 15.0
EPR full-time at 2.
Sleeprider
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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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