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Return to APAP with P30i mask many CA
#1
Return to APAP with P30i mask many CA
Some history.

I started on APAP on April 2016.  Took a break from using my Airsense 10 for Her during May 2017 thru Feb 2019.  During this period my wife was slowly loosing her battle with Multiple Sclerosis and passed away on Nov 25 2018.  Went back on APAP from Feb 2019 thru Sept 2019.  

Returned to APAP on Sept 2020 using a new mask, the ResMed P30i as suggested by my respirologist.

Adapting to the new mask has been a challenge. Initially mask leakage was a major problem but I believe mask leakage is now in acceptable range.

Below is an extract from last night and is dominated by CA(37).  I zoomed in on what appears to be a waxing/waning breathing pattern which is in an area of high number of CA.  

Any suggestions on reducing the CA's?

   
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#2
RE: Return to APAP with P30i mask many CA
Hi Roy289,
Sorry to hear of your wife's passing.  Never easy to go through, but it's good that you are back to giving your Cpap therapy a chance.

Did you experience Clear Airways prior to this or is this new for you? Are you on any new medications?

The one thing I would like you to do is turn your EPR setting down to 1.  See if that helps with the CA's and we will go from there.

Repost after a day or two.
OpalRose
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OSCAR Chart Organization


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: Return to APAP with P30i mask many CA
Thanks for the quick response.

I have always had a high number of CA's.  No major medication changes.  I'll drop EPR to 1 as suggested and post the results in a few days.

Thanks
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#4
RE: Return to APAP with P30i mask many CA
In addition to changing EPR setting, I think you could increase your minimum pressure. Currently you are at 7. You could probably go up to at least 9 and feel more comfortable.

NB I notice you don't show your pressure chart. That is an important one to include.
Sleep-well
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#5
RE: Return to APAP with P30i mask many CA
I was trying to include the leakage rate.  Attached screenshot also includes the pressure.  My typical med pressure is 11.  I'll increase the min pressure after results of reducing EPR to 1

Thanks

   
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#6
RE: Return to APAP with P30i mask many CA
Opalrose

Attached is a two hour session using EPR=1.  Since my initial post on Sep 27 I've been unable to wear the P30i mask any length of time.  Toward the end of the sessions I loose the tongue seal as pressure increases and have one of two choices, let air out through my lips or swallow the air resulting in aerophagia.

On the screenshot I had reduced max pressure to 12.

Do you have any suggestions to get over this issue so I can wear the max throughout the night?

   
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#7
RE: Return to APAP with P30i mask many CA
Practice.
From the mask primer
Tongue Trick. Place the tongue on the roof of the mouth, Practice during the daytime. The idea is to train the tongue that this is a good place to be, does not happen overnight, but it works for some. The tongue trick is where you want to be but it takes a lot of time and some people just cannot get it. Place the tongue on the roof of your mouth and breathe with your mouth shut. Breathing thru your nose, right? Now leaving the tongue where it is open your mouth, you should still be breathing thru your nose. Now that you have that down move your tongue, breathing thru your mouth right? OK, put your mask on, under pressure, and repeat the above. Expect to need to turn your machine off when you start to repeat. Add talking while under pressure, It takes a while to get any of this down. It took me months. The exercises above are to help you understand the positions that cause the issue and how to correct it. For all this to become automatic will take a while.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#8
RE: Return to APAP with P30i mask many CA
bonjour,

Thanks for the details on using the tongue seal method.  I've been moderately successful using this method in the past.  I guess returning to CPAP after a long time I need to retrain myself.  Lately the seal around my tongue slowly lets pressurized air leak into my mouth.  Not sure how to maintain the seal while asleep.  Talking while under pressure sounds difficult.

Guess its practice and more practice

thanks for your help
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#9
RE: Return to APAP with P30i mask many CA
Looks like you are heading in the right direction. Are you using the ramp feature! You probably don't need it as you are only ramping up to a minimum pressure of 7cm. Try to wean yourself off of ramp, your not likely to notice it.

I would hold steady with current pressures for a day or two and watch results.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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: Return to APAP with P30i mask many CA
Yes I was using the ramp for 20 min on last nights session. I'll try without ramp and keep working on maintaining a good tongue seal.
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