[Treatment] Change to BIPAP vauto in hope for better therapy

[Dave Water]

Thank you Sleeprider, Gideon

I will wear the SCC and lower PS to 3 and set trigger to very high tonight. 
I think I will use a different tape for my mouth to stop the leak. 
 
I will post my OSCAR charts tomorrow morning for you to review.

Thank you for all your help and advices.

[Sleeprider]

Good luck Dave.

[Dave Water]

Thank you Sir.
Kind of strange that I am actually looking forward to sleep.

Thank you

[Dave Water]

Sleep could be better but I woke up at around 4-5am and felt nasal congested, I do have deviated septum on my right nostril. and my left side seems congested too at 4-5am,  but was breathable after a few minutes. So i tried to drop back to sleep. then OSCAR seems to show quite a bit of CA and hypopnea thereafter.

I change my setting to PS-3, trigger - very high. humidity 6, tube temp - 28. 
I thought humidity and tube temp would help my nasal congestion.
I set ramp to 5 minutes, not sure if I should remove ramp or if it makes any difference.

I change my mouth tape and I had less dried mouth and seems to have less leak.

           

[Sleeprider]

This is an improvement, particularly for CA event rate, but also for OA. I think you should stick with this a while longer, maybe increase maximum pressure to 11.0, and if you are willing to try it, start a course with Flonase or generic fluticasone propionate to reduce nasal congestion and inflammation. Please be sure to turn off the monthly calendar so we can evaluate the more important respiratory statistics.

[Dave Water]

Thank you Sleeprider

I have used Flonase but my Cardiologist have cautioned me on the Nasal Decongestant usage. He advice me to use Nasal Saline solution if for longer term. I have been doing this but there are some bad nights and most of the time, I have one nostril that give me some air to pass through so I can fall back to sleep.

I did not know that I can turn off the monthly calendar but now I know. Thanks.

I will stick with this setting for a few more days before I increase IPAP to 11 so I can give my body a bit more time to settle into the new BIPAP vAuto features.
After 3-4 days, I will increase IPAP to 11 as you indicated for comparison.

Thanks for the advice.

[Sleeprider]

Please ask your doctor about use of Fluticasone as cardiac effects are not listed as a side-effect. This nasal spray works much differently from Afrin (oxymetazoline) which is not recommended for long-term use and can result is a pounding heartbeat and other complications in some individuals. Fluticasone works by reducing inflammation and contact capillary contraction in the nasal passages and is intended for long-term use.

I think your slow path to trying these setting changes is a very good idea.

[Dave Water]

These are very good information. 
I have been looking for more reliable relief for my nasal decongestant without side effect due to my heart condition.

I will bring this forward to my Cardiologist on my next visit.  

Thanks Again.

[Dave Water]

I have collected last 6 days of OSCAR stats for your opinions. 
I have left the IPAP max to 10 for 3 days and then increase IPAP max to 11 on the next 3 days. 
I have used the SCC nightly as suggested and I have left the TRIGGER as very high, PS as 3 throughout the course.
There is a day on FEB-16 that I change my mask to N30 but AHI/leak seems bad, so I switch back to N30i 
Thank you for all your help.

                       

[quiescence at last]

I see 6 copies of only one night. Just 17 Feb.