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Therapy-Airsense 10 Autoset to Aircurve 10 Vauto
#21
RE: First night with CPAP: Suggestions?
Hi,

I have used the recommended settings last night. Here's the chart:

   

It was a good night and felt comfortable. Had to get up earlier than planned due to a power shortage. I am still trying to resolve my mouth breathing issues so there are some leaks probably from my mouth. Interestingly the tidal volume is less than yesterday. 1 Central, 1 obstructive event. Do you have any additional suggestions?

Thanks...
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#22
RE: First night with CPAP: Suggestions?
Your leak rates look good unless the leaks are disturbing your sleep.
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#23
RE: First night with CPAP: Suggestions?
Hi,

Tonight was a little bit odd. I woke up 3-4 times, trying to adjust my mask and thought my AHI would be slightly worse due to these events but I was surprised to see these results:

   
   

Apparently I had a cluster of central events in the beginning. I checked my video camera recordings and saw that I was using my iPad in bed until 01.12 a.m. and then started the sleep process and while my eyes were closed I wasn't probably completely asleep yet. I remember taking some deep breaths thinking I wasn't getting enough oxygen at this period, but after those deep inspirations (which my tidal volume shows), I also remember not exhaling for a longer period and thinking "oh, I am not exhaling, this will mess my AHI score". After that period was over and I started sleeping, there were no central events anymore. Why did I have this period? Can I change something to correct it?  

Thanks...
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#24
RE: First night with CPAP: Suggestions?
The bunch of CA’s seem to have occurred when you were still awake, we call this Sleep Wake Junk and can be safely ignored as the Resmed has no means of deciding if your actually asleep.
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#25
RE: First night with CPAP: Suggestions?
The purpose of recommending the new settings with a minimum pressure of 7.0 with EPR 3 was to sort out the events we were seeing. I don't think EPR has increased your CA event rate, and this pressure is stabilizing your CO2 related to hyperventilation. The therapy looks good, excluding the period you were not sleeping, and it will be interesting to see if your pCO2 results improve at your next exam.
Sleeprider
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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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#26
RE: First night with CPAP: Suggestions?
Hi,

Last night I've tried 2 new things. I wanted to try a full face mask, because of my mouth breathing, so I've bought a Dreamwear Fullface mask. Very comfortable to wear with practically no leaks, so was quite happy with the sensation. Also, my main complaint with the nasal mask (not the pillow, the under the nose version) was that it tended to get displaced when I was side-sleeping, and while the full face mask is much larger and has a larger surface contact area with the pillow, it doesn't get displaced thanks to its second set of straps. I also started using a CMS50i oxymeter (and can confirm that OSCAR crashes when trying to import directly from the unit) to measure saturation. I had a fairly good night's sleep, waking up briefly 2 times and in the morning I was feeling refreshed. I thought I was about the have my best AHI score, due to how I felt.

How wrong I was......

   
   

I had the worst AHI (nearly 7) ever since I've started the therapy. It seems the maximum pressure wasn't enough (even though I never needed higher than 9 with the nasal mask). Lots of obstructive events, hypopneas. Also, lots of SpO2 events. Please help, I am panicking now. Can changing a mask make such a huge difference? Or was the problem with the nasal mask, which somehow reported much better results compared to the full face mask.
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#27
RE: First night with CPAP: Suggestions?
The accuracy of the info on the bad night's chart depends on if you changed the mask type setting on the machine when you changed masks. If you did that, sometimes each one of us will get bad nights like this.
Dave

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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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#28
RE: First night with CPAP: Suggestions?
You did fine. Notice how the events are clustered in groups? It's possible you started tucking your chin with the new mask. Read our wiki on Positional Apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea and how the Soft Cervical Collar works to eliminate that http://www.apneaboard.com/wiki/index.php...cal_Collar
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#29
RE: First night with CPAP: Suggestions?
I do have a theory on why it might have happened but I am not sure if it is technically possible:

When I slept with the nasal mask, the air was going through my nose-nasophaynx-oropharynx and then the lower respiratory tracts. If I have a problem with my soft palate losing its muscular tonus, the air going through the nasal way would be able to keep it patent. I was, of course, opening my mouth, but as the pressure coming from my mouth wasn't very strong compared to the nasal flow, it couldn't create a complete obstruction. With the full face mask, there also is air under pressure coming from my mouth and as it is a bigger orifice, there will be more air coming from there. It will push the soft palate upwards, compressing the passage. If this theory is correct, then using a full-face mask could be more dangerous for mouth breathers. I'll test this by 2 different methods.

1) I'll wear the full face mask, but tape my mouth (3M Micreopores arrived at last)
2)I'll use a nasal pillow (I received the nasal pillow for Dreamwear and it seems to be more stable compared to the under nose version) with taping.   

Does my theory make any sense?
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#30
RE: First night with CPAP: Suggestions?
The mechanisms of obstructive are varied and the pharyngeal vellum of the soft palate is susceptible to occlusion by both internal and external pressure. In CPAP we look for positive pressure in the airway sufficient to stent the entire nasophrynyx, but no amount of pressure can stent physical obstruction from positional or chin tucking. Nasal breathing does not preclude simultaneous oral respiration and vice versa. As far as I know, stenting the soft palate And oral breathing should not interfere with nasal breathing, and I’m not aware of increased risks for mouth breathers.

The main problem for most full face mask users is that pressure in the mouth can make the cheeks puff out which may be uncomfortable and change mask fit. Nasal breathing is preferred, but where an individual cannot exclude pressure from the mouth a leak will occur without the FFM. We do our best to encourage nasal therapy, but a significant number of people need the mouth covered and pressurized.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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