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[Pressure] ResMed hypopnea need help tuning settings
#11
RE: ResMed hypopnea need help tuning settings
For now, correct. EPR isn't currently playing well with the CA events. You'll want to monitor to note if/when those Centrals do diminish. This signifies that soon afterwards you may want to add EPR back in.
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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#12
RE: ResMed hypopnea need help tuning settings
What all the others have said. Great to see that the centrals weren't on the original sleep study, that's wonderful news. Hopefully, within a few weeks the centrals will diminish (certainly within the first couple of months or so if you stick with it every night).

Sometimes, my Resmed marks breath holds as obstructive too. That's basically because Resmed has to "estimate" whether an event is obstructive or central without a chest strap and occasionally they can mismark centrals as obstructives. This is why they call them clear air events rather than central apneas because technically they're looking for airway patency rather than breathing effort. That said, if you're having an apnea and the airway is clear, then it's not an obstructive apnea, but occasionally an apnea with some obstruction can be a central apnea instead.


See my comparison of Viatom/Wellue and CMS50F oximeters here.

Not a doctor, definitely not your doctor, all advice is given as-is and represents simply my own understanding as a fellow patient and OSCAR user.
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#13
RE: ResMed hypopnea need help tuning settings
Thanks all for the responses!  I'm definitely closing in on optimal!

I still get air bubbles coming into my mouth that are keeping me awake (I am such a light sleeper).  I assume I have to just get used to those?  or do I have to get a full mask?  I saw some other posts about chipmunk cheeks or something, I'll go read up on those suggestions.

I must have drifted off because I woke up one time starved for air - is the strategy for this to just slowly increase from 8.0 until that stops happening?
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#14
RE: ResMed hypopnea need help tuning settings
The chipmunk cheeks are a nuisance... but let me be clear, the FFM doesn't stop it automatically either. I'm perfectly capable of looking like a hamster in a peanut factory even with an F20. LOL

What I found helped me was a) trying to train my tongue to stay up by consciously touching it to the back of my top incisors which blocks off the air into the mouth. The problem I had was when I dozed off, my jaw would drop, even with my lips taped shut, and whoomph. I blew up like a pufferfish. For me, a chin strap stopped it, but it's also something that I've found has improved with time for me, at least with the FFM. So as long as I used my chin strap and tape my mouth closed (to everyone else's happiness!) that minimises being woken up by the cheeks puffing out.

Ooops, I forgot to ask: What was happening when you felt starved for air? Was this during a big mouth leak? Had your mask shifted to block the airflow? If you know roughly what time it was, we can take a look at your OSCAR data and see if there's anything obvious there.


See my comparison of Viatom/Wellue and CMS50F oximeters here.

Not a doctor, definitely not your doctor, all advice is given as-is and represents simply my own understanding as a fellow patient and OSCAR user.
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#15
RE: ResMed hypopnea need help tuning settings
Yes to both possibly.

You might want to explore full face masks. And Min. Pressure will likely need to go up a bit. But if as an example, a full face prevents leaks and such maybe settings will be OK.
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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#16
RE: ResMed hypopnea need help tuning settings
I've attached last night's.  I didn't go very long because I was awake for most of it - trying to control the cheeks - and realized I needed to get some sleep for work.  Out of breath happened around the end, probably the hypopnea?

I have used tape, it just tends to make my cheeks bigger!  my new chin strap should arrive in a day or two.  I do think my jaw drops open like you say, so maybe this can help


Attached Files Thumbnail(s)
   
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#17
RE: ResMed hypopnea need help tuning settings
IMO the Ramp is probably redundant, you're already at 8. Even a useful Ramp setup shouldn't be as long as 45 minutes. I did that mistake myself the first 2 nights of my ASV therapy in '17. I thought it was a good idea as my sleep onset is very long. Nope it's counterintuitive. Yours isn't my ASV but even so I'll surmise the Ramp ain't your friend.

Again with therapy pressure at 8 and Ramp at 8, it's a redundant echoing duplicate reverberation.
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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#18
RE: ResMed hypopnea need help tuning settings
I took a couple of nights off to catch up on sleep while I waited for the chinstrap.  It arrived, so I wore it last night and actually slept with CPAP on for about an hour!  At the end of the hour, I woke up ok, but then soon after got the freak-out feeling of low oxygen, so I stopped for the night, wanting to end on the feeling of success!  (...though I probably want to find a more comfortable chin strap)

I have attached last night's hour in case I was doing anything wrong.

Steve


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#19
RE: ResMed hypopnea need help tuning settings
If you feel low oxygen is an issue, you'll need a pulse oximeter. Ones that record such as Contec CMS50F like I have or a Wellue ring would be the best, seemingly most popular choices on the forum, likely due to being able to integrate the SpO2 data files into OSCAR.

I have sometimes low oxygen due to COPD. Not scolding you but this potential low oxygen state is too serious to guess. Start monitoring it.
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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#20
RE: ResMed hypopnea need help tuning settings
PS your PAP flow rate looks choppy and ragged just after 0005 to the end. Very different than all the rest prior. Maybe worth a zoom in for detail. A 10 and a 3 min zoom for expert chart readers to see it. It could be a SWJ thing... Sleep wake junk, as in you're waking up and more ragged breathing as wake breathing is.
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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