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Seeking advice on SH screenshot
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vsheline Offline

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Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #11
RE: Seeking advice on SH screenshot
Hi Frank,

Regarding
"Any thoughts on further adjustments would be seriously appreciated. I am probably going to try lowering the MIN pressure a little to see if I can get the CA's down a little."

Your number of CA is fine, not a problem.

You don't want to decrease the Min Pressure, not as long as your pressure needs are so high. Presently your main problem is the obstructive stuff.

If anything, the Min Pressure could be raised a little, but not until after you have found a way to decrease the tightness of your mask, so it's not painful.

However, Obstructive Sleep Apnea is usually highly positional, and flat on our back is usually the worst position, requiring the highest pressure to treat. If you can take precautions which would prevent your ability to roll onto your back, your pressure needs might be greatly reduced.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 07-04-2016 02:21 PM by vsheline.)
07-04-2016 01:58 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #12
RE: Seeking advice on SH screenshot
"TiControl’s Ti Max and Ti Min parameters play a significant role in maximizing synchronization by
effectively intervening to limit or prolong the inspiratory time when required. This ensures
synchronization even in the presence of significant mouth and/or mask leak."

The way I read this and use it, is that Ti Min will not drop the inhale pressure until after this amount of time no matter what the patient is doing ie "prolong the inspiratory time when required" it tries to keep you inhaling. I know for a fact that Ti Max will cut off the inhale after the time set as this is exactly what it was doing to my very slow inhales-quite disturbing if not "needed"
07-04-2016 02:35 PM
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FrankNichols Offline

Advisory Members

Posts: 714
Joined: Mar 2016

Machine: AirSense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed F10 and/or P10
Humidifier: Builtin
CPAP Pressure: 17-19
CPAP Software: ResScan SleepyHead Other Software

Other Comments: I've figured out how to get my AHI down to 5, I quit sleeping!

Sex: Male
Location: Live Oak, Florida

Post: #13
RE: Seeking advice on SH screenshot
(07-04-2016 01:43 PM)green wings Wrote:  Hi, Frank. Amazing job on getting rid of the REM "cluster bomb" OAs! Mine are better, but not gone. I guess I'll have to stop saying "but they're not as bad as Frank's."

You're not using any EPR at all? Wow, that's amazing. It feels comfortable? Did you try using EPR and get bad results?

Thanks, I tried EPR and didn't feel it made me more comfortable. In fact, the only time the pressure bothers me is when I try to use the P10 instead, and then it is only a couple minutes before I am used to it. I guess I am one of the "lucky" ones that the pressure doesn't bother, in fact sometimes I wake up and I am not sure it is on unless I inflate my cheeks or raise the mask a little to get a leak.

I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
07-04-2016 02:54 PM
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FrankNichols Offline

Advisory Members

Posts: 714
Joined: Mar 2016

Machine: AirSense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed F10 and/or P10
Humidifier: Builtin
CPAP Pressure: 17-19
CPAP Software: ResScan SleepyHead Other Software

Other Comments: I've figured out how to get my AHI down to 5, I quit sleeping!

Sex: Male
Location: Live Oak, Florida

Post: #14
RE: Seeking advice on SH screenshot
Vsheline,

Thank you so much for your insightful comments on my screenshots. You have given me a lot to think about.

Frank

I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
07-04-2016 03:00 PM
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justMongo Offline

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Posts: 3,844
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #15
RE: Seeking advice on SH screenshot
As Vsheline has pointed out, zero crossing in the flow waveform is way the machine counts BPMs.
That fine structure in the flow waveform is crossing zero, and the machine is scoring a breath.
Looks like there are from 3 to 5 zero crossings between where Frank makes a big exhale.
And, the big exhales are space at about 4 seconds (or 15 BPM).

I'd show those graphs to my doc... They are unusual.

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.
07-04-2016 03:34 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #16
RE: Seeking advice on SH screenshot
Hi Frank,

The zoomed-in periods show you are gurgling at a rate a little higher than 1 Hz. I suppose this may be too slow to be counted as snoring.

This is obstructive stuff.

I think a different sleep position or neck/head position could avoid it.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 07-04-2016 03:48 PM by vsheline.)
07-04-2016 03:36 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #17
RE: Seeking advice on SH screenshot
(07-04-2016 02:35 PM)PoolQ Wrote:  "TiControl’s Ti Max and Ti Min parameters play a significant role in maximizing synchronization by
effectively intervening to limit or prolong the inspiratory time when required. This ensures
synchronization even in the presence of significant mouth and/or mask leak."

The way I read this and use it, is that Ti Min will not drop the inhale pressure until after this amount of time no matter what the patient is doing ie "prolong the inspiratory time when required" it tries to keep you inhaling. I know for a fact that Ti Max will cut off the inhale after the time set as this is exactly what it was doing to my very slow inhales-quite disturbing if not "needed"

That makes sense.
07-04-2016 03:53 PM
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kwhenrykerr Offline
Wiki Editor
Advisory Members

Posts: 238
Joined: May 2016

Machine: DreamStation Auto, AirSense 10 Auto
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Philips, AirSense 10
CPAP Pressure: 12-20
CPAP Software: SleepyHead

Other Comments: 2L added oxygen with CMS50F to check usage

Sex: Male
Location: Florida

Post: #18
RE: Seeking advice on SH screenshot
The larger the mask the more pressure on the straps. Can you use a smaller mask size or type?

Just my personal opinion. My posts are not medical advice or a statement of fact. Please consult a qualified physician or other qualified medical personnel. Please comply with all applicable laws, codes, regulations, and protocols.
07-07-2016 09:28 PM
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