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[Pressure] Pressures over 20?
#41
(03-08-2015, 02:37 PM)justMongo Wrote:
(03-08-2015, 02:25 PM)PaytonA Wrote: No despair on my part. I use a full face mask (Mirage Quattro).

Best Regards,

PaytonA

Me too! Just looked at last night's data -- wow, I was really snoring in the early morning hours. That pinned my pressure up against IPAPmax.

Let's take a poll.

Another Mirage Quattro. But since my new machine is a Phillips Respironics System one I'll try their mask when I need a replacement. It might work better with the machine.

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#42
@Mongo: Yes, did have it set for pillows. I have tried every mask style now and am always careful to set it to what I am using when I try a different one.

@Bob: I think I would do better with a FFM myself (solely because of mouth leak). All I have tried so far is the Simplus in medium and large and both leaked too much. I will be trying a small when I receive it in the mail... my last chance at getting the Simplus to work for me. After that, I either find another FFM brand or model to try or find another solution to the mouth leaks.
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#43
(03-08-2015, 04:20 PM)TiredToo Wrote: @Mongo: Yes, did have it set for pillows. I have tried every mask style now and am always careful to set it to what I am using when I try a different one.

@Bob: I think I would do better with a FFM myself (solely because of mouth leak). All I have tried so far is the Simplus in medium and large and both leaked too much. I will be trying a small when I receive it in the mail... my last chance at getting the Simplus to work for me. After that, I either find another FFM brand or model to try or find another solution to the mouth leaks.

I tried a Simplus. Their fitting template said that I needed a medium, which I got. After trying it, I decided that I needed a small. It did work better for me and all you need is a new set of pillows to change size. I had the same experience with my Mirage Quattro. Started with a medium but went to a small and like it better.

I generally get fewer leaks with the Mirage Quattro. It takes some work to get it leak free but once you do, you just put it on every night and punch the on button on the machine. No fiddling. After a while the straps will stretch a little and I need to make an adjustment but then am back in the groove. You might want to give the Mirage Quattro a try if you give up on the Simplus.

Best Regards,

PaytonA
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#44
Well... I received my Simplus small cushion yesterday and I gave it a try today (working nights right now so sleeping during the day).

On the plus side, I had virtually no leaks and I would say they were well-controlled. However, AHI was bad. I was running at fixed pressure of 20, but had EPR set to 3. I guess my thought was that if I had no leaks then I may stand to benefit from a little relief when exhaling. Not shown in the screen shot is that every time I had an apnea event, the pressure at the mask was typically around 17-18 - presumably due to the EPR.

Obviously the next time I go to sleep I am going to turn EPR off. But once again now, I am wondering if 20 is not enough for me. Sad

Edit: Added screen shot of a couple events zoomed in showing mask pressure.

[attachment=1340]

   
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#45
It may be worth letting it run for a while to make sure that this is somewhere in the normal area for the way you have it set up. You might be right about the EPR. Try turning it off if you can live with it off. It is great that your leaks are well controlled with the Simplus.

Sleep well.

Best Regards,

PaytonA
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#46
Well your ahi isn't all that bad, but my goodness you're running at 20 to get where you're at? I think you might want to discuss this further with some respiratory folks. Is there something else going on that could be impacting this? Have you noticed your wife putting a plastic baggie over your head at night when you're not looking? Do you still have a cat in the morning? Fur and all? What about the kid's hamsters? Still in their squirrel cage?

Sitting on solid 20 is a lot. I just think there should be an answer for you that would make this easier.
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#47
(03-06-2015, 05:37 AM)TiredToo Wrote: When I had my second night in the sleep lab (CPAP titration), the final report said that my apnea events were "abolished" at a pressure of 10 cm/H2O, hence this was the setting they gave me on my machine - set to a fixed pressure of 10.

"Abolished" may mean something different to you than it does to whoever told you that. It's normal for the AHI to be high at first until you adapt. It may very well be that you'd have the same AHI as you're having now if you had left the machine set at 10.

Have you talked to the doctor about all this?
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#48
I haven't discussed it with my doctor yet. My GP really doesn't know a whole lot about this stuff and of course anyone related to the sleep study is pretty much on to the next patient as soon as you walk out the door.

My AHIs do vary, although I don't know what the factors are. I know I've had off and on problems with leaks (mask and mouth), which so far the small cushion on the Simplus seems to have taken care of both. I am considering one other possibility, which may in fact improve at lower pressures: Could it be possible that some of the air being forced into my nose (and mouth with a FFM) is going into my stomach? I know I have read about some people experiencing bloating and gas while on CPAP, and I do feel that I have been more gassy than usual (talking "southern" winds here Smile), which my wife would argue was pretty often even before CPAP.

Since my events are all obstructive (very rarely do I see an OA) I would have expected my AHI to drop considerably at a pressure of 20, which was more or less an experiment to see if I could obtain a "0" or close to it. Either my throat is severely blocked off when I sleep or the pressurized air is finding another path and of less resistance. Since my machine reported essentially no leaks during my last sleep session and I still had quite a few events at 20 cm H2O, I'm running out of ideas and feel like it must be going somewhere else that cannot be detected as a leak.

I'm working again tonight but I think before my next bed time I will try APAP again, maybe 10-16 and see how it goes for a while.
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#49
(03-10-2015, 08:36 PM)TiredToo Wrote: My AHIs do vary, although I don't know what the factors are.

Measurements of AHI are not that precise. For example, any number under 5 is clinically the same as any other number under 5.

Do you know what your AHI was during your sleep study? This would have been part of the diagnosis. So for example if it was above 30 you would have been diagnosed with severe apnea. Also, was your diagnosis just obstructive sleep apnea or were there other complications?

It's possible that the machine is not identifying your events correctly.

My advice is that you put the machine back on a setting of 10 and see what happens. After a week or so, if your AHI is still above 5, call the medical providers who gave you your machine. If you're not happy with them, find another. Communication with your medical care providers is essential at the start of therapy. Failing to do this is one of the major causes of what they call noncompliance. I call it the "machine in the closet" syndrome.

You need your machine to live a productive life.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#50
I'm not concerned about non-compliance. I've felt utterly terrible for years and even though my numbers aren't as good as I'd like to see, the fact is they are much better than without CPAP and I do feel better. I guess I'm just a bit jealous of those who are managing to get AHIs of 0 or close to it. Unsure

Last night I had an AHI of 6.04. I had it set at 12-20 in auto. Median pressure was 15.14 and 95% pressure was 19.98. I suppose I will just try this for a while to see where it wants to be.

--------------------------
Sleep study results:

AHI: 31.8
Sleep efficiency: 62.3%
Minimum SpO2: 82%

Stage N1 sleep: 29.2%
Stage N2 sleep: 60.8%
Stage N3 sleep: 0.0%
REM sleep: 10.1%

Classification: Abnormal
1. Severe obstructive sleep apnea
2. Heavy snoring
3. Oxygen desaturations
4. Periodic leg movements
5. Abnormal sleep architecure
--------------------------

I just want this machine to help as much as it possibly can. Big Grin
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