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[Pressure] Newbee - 1st Evening Failure
#31
RE: Newbee - 1st Evening Failure
Alternate is to drop EPR to 1. I think it's at a point of balancing things out to not have many CA but also to not let in OA or Hypopnea.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#32
RE: Newbee - 1st Evening Failure
Are the CA events just sleep-wake-junk? You describe taking some time to fall asleep with the mask on and the graph shows around 35 minutes before your breathing becomes stable.

Would it be worth switching the auto-ramp feature on here? The autoset is picking up flow limitations when you are clearly still awake and ramping up the pressure which would only add to your discomfort. Once breathing is steady it is bringing the pressure back down again with no events.
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#33
RE: Newbee - 1st Evening Failure
I'd suggest you stick with at least some EPR, maybe 2 tonight. Like kappa, I suspect you're seeing some sleep-wake junk (SWJ). The highest goal right now is to get you comfortable with the machine so you can get some more sound sleep with it, so I'd be inclined to ignore the flurries of CAs and stick with some comfort-providing EPR.

It's encouraging that you feel you've made some progress. Believe me, it'll get better.

About the mask: a few people do report some clogging in the vent holes, but that's very rare and usually shows up after long usage. If that were your problem, I don't think it'd come and go. But for your peace of mind, you might try ordering a new quiet elbow, or I think you should also be able to track down a standard elbow, which will be a little noisier but which you might like better. I think they run around $25 USD.

Keep us posted, would you?
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#34
RE: Newbee - 1st Evening Failure
(10-23-2020, 06:37 PM)Dormeo Wrote: I'd suggest you stick with at least some EPR, maybe 2 tonight.  Like kappa, I suspect you're seeing some sleep-wake junk (SWJ).  The highest goal right now is to get you comfortable with the machine so you can get some more sound sleep with it, so I'd be inclined to ignore the flurries of CAs and stick with some comfort-providing EPR.

It's encouraging that you feel you've made some progress.  Believe me, it'll get better.

About the mask:  a few people do report some clogging in the vent holes, but that's very rare and usually shows up after long usage.  If that were your problem, I don't think it'd come and go.  But for your peace of mind, you might try ordering a new quiet elbow, or I think you should also be able to track down a standard elbow, which will be a little noisier but which you might like better.  I think they run around $25 USD.

Keep us posted, would you?

@ Dormeo - It is only a hire machine i am using until mine comes in 2 weeks. I had a delay buying the machine and stuff and had to juggle finances around, but it is identical to the one i have purchased. That issue with the mask has only happened since we implemented the EPR and also, only in the second "session" each time. So who knows, it may be paranoia, but I don't think so. I think that is what gave me the panic attack a night ago and why i jumped up fighting and unable to breathe. Last night i just woke up like i would "Pre-CPAP Days".

@ SD94 - sounds like a plan, EPR down from 2 to 1 and starting pressure reduce to 8 assuming it is comfy.

@ Kappa - I don't think that the ramp would assist because in all honesty, I am now relatively comfy with the mask. I guess the only uncomfortable part is getting it adjusted right and the fact you get a bit hot with that on your face and it can be pretty hot at night in Australia. The actual breathing in against the pressure of 8 and no EPR was no issue. At first it felt worse with the EPR because of a time lag and then the Face Mask seemed to go thump. But that seems ok now.

Thanks for the advice guys Smile 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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#35
RE: Newbee - 1st Evening Failure
(10-23-2020, 06:52 PM)Snooks Wrote: @ Kappa - I don't think that the ramp would assist because in all honesty, I am now relatively comfy with the mask. I guess the only uncomfortable part is getting it adjusted right and the fact you get a bit hot with that on your face and it can be pretty hot at night in Australia. The actual breathing in against the pressure of 8 and no EPR was no issue. At first it felt worse with the EPR because of a time lag and then the Face Mask seemed to go thump. But that seems ok now. 
Some parts of Australia aren't quite so muggy... ;p
Auto-ramp is supposed to detect when you're asleep and then increase pressure if required. Last night your pressure went up to ~12.5 while you were still awake but dropped when you were asleep back to ~10. Worth a try I would think...
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#36
RE: Newbee - 1st Evening Failure
We may have to get Ramp to Off, but we need you to be able to use the PAP more than anything. We'll tighten pressure swings as we need to. I think we are still in the see-saw of balance between comfort and control of CA vs Obstructive, H.

Just keep tabs on the numbers, and do post OSCAR here with your answer to how you feel. This all is data that helps us guide the therapy and to get it, and to maintain, being on track. Let us know after next use. And good luck to ya.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#37
RE: Newbee - 1st Evening Failure
(10-23-2020, 07:05 PM)kappa Wrote:
(10-23-2020, 06:52 PM)Snooks Wrote: @ Kappa - I don't think that the ramp would assist because in all honesty, I am now relatively comfy with the mask. I guess the only uncomfortable part is getting it adjusted right and the fact you get a bit hot with that on your face and it can be pretty hot at night in Australia. The actual breathing in against the pressure of 8 and no EPR was no issue. At first it felt worse with the EPR because of a time lag and then the Face Mask seemed to go thump. But that seems ok now. 
Some parts of Australia aren't quite so muggy... ;p
Auto-ramp is supposed to detect when you're asleep and then increase pressure if required. Last night your pressure went up to ~12.5 while you were still awake but dropped when you were asleep back to ~10. Worth a try I would think...
Does that mean it will blow at 8 and only increase when i am asleep and having an event?

Just clarifying so i know for sure.

OT - we are in a hot pocket, the place that recoded 48.7C last year. (119.66F)
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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#38
RE: Newbee - 1st Evening Failure
(10-23-2020, 07:07 PM)SarcasticDave94 Wrote: We may have to get Ramp to Off

Ramp is already off... seems that it's ramping due to wake breathing patterns, hence the suggestion to try ramp time = auto with ramp starting pressure the same as the minimum pressure.

Resmed increases pressure based on flow limitations in order to avoid events and only starts doing this once the ramp completes.
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#39
RE: Newbee - 1st Evening Failure
I am pretty certain an Auto Ramp refers to time, it automatically switches from Ramp to therapy settings when it thinks you've actually gone to sleep. However, note if you're not using Ramp now, if you can avoid it, I think it's best to avoid as it does seem to add variability to pressures and swings.

So I myself would have you try dropping EPR to 1 and let everything else alone in an attempt to drop CA. And again this appears as treatment emergent, but I'm looking at the beginning of thread to be sure. Mostly best practice is only one edit per night so we can tell before and after change differences.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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.
Post Reply Post Reply
#40
RE: Newbee - 1st Evening Failure
(10-23-2020, 07:24 PM)SarcasticDave94 Wrote: I am pretty certain an Auto Ramp refers to time, it automatically switches from Ramp to therapy settings when it thinks you've actually gone to sleep. However, note if you're not using Ramp now, if you can avoid it, I think it's best to avoid as it does seem to add variability to pressures and swings.

So I myself would have you try dropping EPR to 1 and let everything else alone in an attempt to drop CA. And again this appears as treatment emergent, but I'm looking at the beginning of thread to be sure. Mostly best practice is only one edit per night so we can tell before and after change differences.

Cool.

Will drop EPR to 1 and touch nothing else, will post Oscar in the morning.

Thank you everyone, it's easy to say...... But i truly mean it. I don't think i would have even gone this far without your assistance.

Cheers.
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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