[Symptoms] Sudden change in symptoms... Help!

[KeepSmiling]

klavierchic,

Yes there could be a machine issue. I have no idea if they sale flow meters for testing cpap pressure.

Just so I understand,
- You got your machine set (6-12)
-not enough air so turned the EPR of
and used the machine and
now 3months later you have more issues?

Did you do a titration, if yes what pressure were you recommended and what type of mask was used?

What was marked on your sleep study? did you wake up often.

Masks need a certain pressure to stay on that is why mask fit should be done with a machine on. I do not know if any mask need more then 4cm, which is the minimum pressure of your machine?

Initially since you are using a full face mask, I would have changed the lower range number to 7 if EPR was off and see how that felt. If ok then turn on EPR see if you can still breath and increase lower pressure if needed.

I do not know if snores can go the coloured side under the calendar when using a ResMed machine. They do appear in your graph.

When you wake up gasping can you enlarge that area to see what the Flow Rate looks like when expanded. On the green graph place mouse just above the and keep right clicking. You will notice the time expanding. to decrease the time left click on the mouse.

Have you been changing the white filter?

Hopefully it is not a medical condition or a panic attack.

Are you more congested due to allergies.

[KeepSmiling]

Hi again,

I went to go look at my data from last night only to realize I had left the SD card in my computer… 

Bad night last night. Seems like I can’t get enough pressure, no matter what the settings are. I’m actually wondering if positional apnea is happening?! I’ve ordered a cervical collar bc I’m desperate. I do notice a difference in awake breathing if I tilt my head back. I have a comically short neck…

Can the Oscar data indicate positional apnea?

Somewhat unrelatedly, is it possible to turn off the data being sent to the DME? And keep clinical settings as the default?

I am assuming you did not have the cannot breath and gasping for the whole 3 1/2 months and you do medical condition giving breathing issues.

If you put your machine on laying down without sleeping do you issues breathing/not enough pressure etc. Read a book for about 15 min in each position. Do you experience what you experience at night.
?

For the pressure and breathing, If the machine is not broken, and you are max is 16 and you are at the level, I would have thought you would be given a bilevel machine.  

If your machine is working properly, you got the right level of pressure and still having breathing issues, maybe a bilevel should be considered because more adjustments can be made to help the breathing.

Since I do not see Central apnea on the Sep 28, 20202 report I would up the machine up the pressure.

On Sept 25,2022 You did not reach your max which was 14 and had 1 Central apnea.

If you change positions, the titration should have set your upper pressure just above it so there is not issue.  sometimes back sleep is not possible.

If you start on side and roll to another side or back there will be a cluster of events on OSCAR

back to original question what data/info was given  for the initial setting

What is the total blower hours on your machine. I am not sure Resmed does that. On the Elite 9, I only found the use I had, after I put my card in it.

[klavierchic]

Hi there, 
 
Thank you so much for your response!!
 
Data attached is from a nap I JUST had. I woke up with my throat closed and gasping for air, but the machine says there were no events. I was using a pillow to keep my head untucked.
 
To the best of my knowledge, I have no conditions other than Type 1 Diabetes and hypertension. I am obese. I have some anxiety but have never had a fullblown panic attack. Suspect positional apnea – slept better last night after using a cervical collar. 
 
I do not seem to have the initial report from my sleep study any longer, but am attaching the results of the one-month trial with the DME. I was sleeping great. I didn’t even have issues adjusting to the machine. As you can see, events were low. There were a couple instances of light snoring that I recall, but that’s it. I felt well. 
 
Initial data was set at 6-12, EPR on ramp only. Events started the night of the 21st, seemingly overnight. First night it felt like central apnea where it seemed like my body just stopped breathing. After that and every night since it’s felt like not enough pressure (despite my own increases) and continued waking up gasping. Filter has been changed, hose has been changed, mask cushion has been changed. When I tried a set pressure of 14 about two months ago, it was horrible and felt like way too much. I couldn’t sleep. Now, despite feeling like my mouth is being blown open and there is pressure there, it somehow isn’t enough?!
 
I roll all the time. I am a side and stomach sleeper, never back. No allergies, not congested or sick.
 
ANY theories or suggestions are helpful. I’m at my wit’s end!! 
 
 

[klavierchic]

KeepSmiling


What is the total blower hours on your machine.  I am not sure Resmed does that. On the Elite 9, I only found the use I had, after I put my card in it.

Hi there, sorry, just figured out how to do this - 806 hours.

[Sleeprider]

It has been suggested that you turn on EPR full-time and use a setting of 2. It is very difficult to assess issues with respiration without zooming into the flow-rate chart so the individual wave-shape can be seen. The best zoom would show a period of 3-minutes or so.. Your flow rate varies a lot and you are showing very high flow limits which is causing pressure to rise to your maximum setting. If we can get a zoomed look at this problem, we might be able to identify the issues.

[klavierchic]

Hi Sleeprider, 

Thank you for your response. When I try EPR it feels like there's even less pressure, but can try EPR again tonight. Should I increase pressure also? Is there a specific 3-minute section of flow rate I should look for? I just had a nap and woke up gasping - attached is the three minute flow rate at the end. Is this what you're looking for?


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[KeepSmiling]

First your name is on the report.

[klavierchic]

Thanks for that. Clearly sleep deprived! It was too late to edit… I made a report to the mods?

[KeepSmiling]

- An expanded view of when you gasped for air would.

- What type of mask did you have for the trial.

I would not trust the titration because:
- the AirSense 10 AutoSet For Her was used.
With:
- Set Max Pressure 12
- Set Min Pressure 6.

Titration is done with an auto that reaches 20.

There is no way to know what pressure you would have reached.

----

With the results of
Maximum 12.0 (set machine maximum)
95th % 11.8
Median 9.9

If those were real (max 20 cm) results I would have start you on an autoset of around 8cm-14cm. (maybe even 9cm)

On titrations I have seen looks like a daily so it is easier to see the min and max for the each night.

Does your sleep doctor know you were titrated with a maximum of 12cm? Maybe he ordered it for medical reasons.

----

First figure out if machine works. Maybe the pressure is not consistently the same and drops off the longer it works.

Maybe the pressure is correct but your brain is sending wrong signal.

I wonder if recording SpO2 levels and see what the actual level is.

Is to much CO2 staying in the mask. It is a fine balance.

[klavierchic]

Hi KeepSmiling,

I never had a titration study as I understand it, and don't have a sleep doctor. When they do the initial at-home sleep study, the results are sent to a pulmonologist who then indicates yea or nay for sleep apnea, but then you are dealing with DME "clinical sleep consultants," AKA glorified salespeople. But this is where my doctor referred me, so I had no idea. After the sleep study I basically rented a machine for one month (which is the results you're referring to). Going forward I will be looking for something different... just not sure where to start. 

Mask has always been the same - Evora full face. 

Expanded view of gasp for air reposted here. 

How would I figure out if it's a brain thing? How do I test for pressure or CO2 staying in mask?

Thank you


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