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Tell me how you've Modified your P10 to make it VENT more
#41
RE: Tell me how you've Modified your P10 to make it VENT more
(09-15-2020, 10:56 AM)Hydrangea Wrote:
(09-15-2020, 10:43 AM)Coffee Man Wrote: Do you use the Flex option on your Dreamstation to reduce pressure on exhalation?

I don't, because that constant pressure-shift throughout the night causes my ears to click & clog all throughout the day.  (My ears are very sensitive due to chronic illness as a child.)

I don't know which is worse: excessive daytime sleepiness, headache, & irritability (what I get with poorly venting masks), or excessive clicking and clogging of my ears with every breath & jaw-movement throughout the day (what I get with flex/EPR).

Do you have eustachian tube dysfunction?: I do, and also have the clicking/clogging issue. It's maddening. I play classical guitar and this can cause my instrument to sound like a cheap transistor radio to me. But I've always assumed it had to to do with allergies as the issue is far worse in the spring and lately with smoke from fires in the air for a month and a half.

sudafed can help, but I can't take that for other reasons. I notice my ears pop when i put on a mask--that's the valsalva manuver effect. I thought cpap might actually help. 


would you mind explaining what you do to avoid this a bit more fully and without shorthand like EPR? sorry, I don't follow all the lingo and trademarks; apologies. I use both P10 and P30 masks.
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#42
RE: Tell me how you've Modified your P10 to make it VENT more
(10-06-2020, 03:34 PM)hegel Wrote:
(09-15-2020, 10:56 AM)Hydrangea Wrote:
(09-15-2020, 10:43 AM)Coffee Man Wrote: Do you use the Flex option on your Dreamstation to reduce pressure on exhalation?

I don't, because that constant pressure-shift throughout the night causes my ears to click & clog all throughout the day.  (My ears are very sensitive due to chronic illness as a child.)

I don't know which is worse: excessive daytime sleepiness, headache, & irritability (what I get with poorly venting masks), or excessive clicking and clogging of my ears with every breath & jaw-movement throughout the day (what I get with flex/EPR).

Do you have eustachian tube dysfunction?: I do, and also have the clicking/clogging issue. It's maddening. I play classical guitar and this can cause my instrument to sound like a cheap transistor radio to me. But I've always assumed it had to to do with allergies as the issue is far worse in the spring and lately with smoke from fires in the air for a month and a half.

sudafed can help, but I can't take that for other reasons. I notice my ears pop when i put on a mask--that's the valsalva manuver effect. I thought cpap might actually help. 


would you mind explaining what you do to avoid this a bit more fully and without shorthand like EPR? sorry, I don't follow all the lingo and trademarks; apologies. I use both P10 and P30 masks.

I've not heard of eustachian tube dysfunction.  But whenever I've asked doctors about my ears, they tell me I'm normal, so I've given up on asking them for help with that.

Growing up, I had a lot of ear infections, and I think that could be a factor in my ear troubles.  I played woodwind instruments, and sometimes had trouble keeping the air going the right direction (ie: it sometimes wanted to come out my nose or even my ears, instead of my mouth).  I don't know if those are factors.  I also struggle with my ears popping or getting clogged when I change altitude, even small changes of altitude. 

I avoid the valsalva maneuver at all costs, because it hurts.  I do sometimes experience that effect if I have my mask going and I yawn or swallow, so I've taught myself to not do those when I'm masked up.  (People have corrected me about this.  I'm sure I do swallow in my sleep.  But I've learned to do this more gently rather than forcefully, since the forceful swallow is what irritates my ears when I have my mask going.)

I'm not an expert on EPR, but I'll try to say what I have experienced.  On your ResMed machine, you can set the EPR (exhale relief) to off, 1, 2, or 3.  This decreases the pressure (by none, 1, 2, or 3 cm of pressure) when you exhale.  Some people find this more comfortable because they don't have to exhale against as strong of a pressure.  What I've found is that when I use EPR (set it to 1, 2, or 3), my ears pop & clog throughout the day.  What I've concluded is that my ears are just VERY sensitive to pressure changes (as evidenced by my ears popping even when I change altitude by driving over small hills, for example), so the constant change of pressure with each breath (inhale at one pressure, exhale at a different pressure) is too much for my ears.  So when I keep my EPR *off*, my ears are happy and I don't experience the clicking and clogging during the day.

Before I figured out the EPR factor of my ear clogging/clicking, I consulted an ENT (ear nose throat doctor) in a casual way (ie: not at an official doctor appointment) and he reassured me he was confident he could fix my problem easily through surgery.  Ha!  No thank you.  And I'm proud that I was able to discover the solution myself, and such a simple solution at that.
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#43
RE: Tell me how you've Modified your P10 to make it VENT more
Thanks for that. I also had a ton of ear infections and many surgeries in both ears. As it turns out mymain problem, cholesteotoma, is related to eustachin tube dysfunction. (basically your tubes clog and don't allow fluid in your ears to drain, etc. etc.). There is no good surgery or other cure for this for ETube Dysfunction itself. I can't imagine what your ENT was thinking...altho it may well be to place small tubes in your ear drums to allow pressure and fluid to discharge. Yes, This is doubtless what he had in mind. It's very common and easy. I've elected not to do that but my new ent says to keep it in mind. I don't want to mess with my already poor hearing but I may change my mind.


My ahi is very low and I'm wondering if less pressure overall might be something worth trying--as well as turning off the pressure thingamajig.
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#44
RE: Tell me how you've Modified your P10 to make it VENT more
That makes a lot of sense.

As far as the ENT I talked with... I'm aware that surgically-trained doctors tend to opt for surgery as a solution to things. So I usually prefer to consult with doctors who aren't surgeons, as my first type of doctor to consult. Thus I wasn't too surprised when the ENT I talked with jumped straight to that as a solution.

For your clogged ears, have you tried any dietary interventions? Eliminating dairy from my diet has helped me enormously with that regard.

I would encourage you to start a thread, showing some OSCAR screenshots, to get some opinions on how you might tweak your pressure settings!
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#45
RE: Tell me how you've Modified your P10 to make it VENT more
So my machine has a Pressure Relief setting with the options of 'on' or 'off'. Mine was on, I turned it off. I'm assuming this is what you're talking about?

p.s. I assume this will have no effect on my therapy; i.d. alter pressure settings.
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#46
RE: Tell me how you've Modified your P10 to make it VENT more
It will not alter pressure settings, but it will impact your therapy.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#47
RE: Tell me how you've Modified your P10 to make it VENT more
Hydrangea: as luck will have it I saw my ear specialist today. I asked about the clicking sound we both experience. She said, that's caused by the hinge in the jaw that sits just below the ear--you can actually feel it if you put your finger in the right spot. She suggested that it's benign, but annoying to some people. It tends to affect those who clench their teeth (guilty) most of all. she also concurred with my sense (which I doubted after your post) that cpap pressure is actually good for eustachian tube collapse and clogging, like I experience. Maybe my diagnosis for you of eustachian tube dysfunction is off base--imagine that!
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