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[Treatment] I am more confused than ever....
#21
RE: I am more confused than ever....
Ignore previous post. I wrote it not realizing there was a second page to this thread.
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#22
RE: I am more confused than ever....
Hi Guys,

First, thank you all for your thoughts, feedback, and advice. I appreciate having this community as a resource. Second, I made the advised adjustments (changed my EPR to 3). Additionally, I used a cervical collar last night and slept (sans foam wedge pillow) like a semi-normal human being. I felt great today. Fingers crossed this continues. Can anyone advise me if they detect a positive change in my flow limitations? Anything else I should be considering? I'm still trying to understand how analysis works. 

Best,

Justin
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#23
RE: I am more confused than ever....
Since you raised the EPR by 1, you might also raise the min and max pressure by 1.

Your FL does look a bit better.

I'd work on the leaks if you can, just to minimize them as a potential thing that might cause arousals.

Glad you're feeling better; let's hope it continues.
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#24
RE: I am more confused than ever....
Nice chart, I wouldn't change your settings for the purpose of changing them, they are good.
Do work on the leaks see what you can do there.
How you feel is an important thing to note and could provide a reason for change.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#25
RE: I am more confused than ever....
I'm in agreement with Bonjour. Raising pressure makes no sense, and an improvement is apparent with the addition of EPR and the cervical collar may have contributed. The CA events I am seeing in your charts appear to be more related to arousal rather than some idiopathic source of central apnea. For you to sleep better, the higher pressure support (PS) between inhale and exhale pressure helps to overcome the upper airway restriction that we can infer from your history of turbinate reduction surgery, the presence of fairly high flow limitation and other evidence in your results. With the Airsense 10, you are limited to 3-cm of pressure support using EPR, but bilevel machine offer much more flexibility to increase PS. This wiki article will help you understand some of the rationale of the approach Bonjour has been taking in this thread. http://www.apneaboard.com/wiki/index.php..._and_BiPAP

While everyone's input in this thread is useful, I'd encourage you to give more weight to the suggestion you are getting from Bonjour.
Sleeprider
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#26
RE: I am more confused than ever....
Please post some close ups of the flow rate where you're not having an event, thank you.
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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#27
RE: I am more confused than ever....
(12-01-2019, 09:50 AM)Sleeprider Wrote: While everyone's input in this thread is useful, I'd encourage you to give more weight to the suggestion you are getting from Bonjour.

FWIW, in case the OP was wondering, I only mentioned the possibility of changing the pressure to compensate for the EPR change. But that was just based on a general observation. 

I'd always defer to bonjour and sleeprider if in doubt.
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#28
RE: I am more confused than ever....
Hi Guys,

I feel pretty good today, although, not great like yesterday. I've attached last night's charts for review or feedback. My next question touches on the reduction of leaks. Currently, I tape my mouth and use the cervical collar to keep everything "leak proof." Despite my best efforts, leaking from the corner of my mouth is common, despite how much tape I use or how thoroughly I use it. Additionally, I often wake up, and my mouth is parched (generally, my teeth dry to my inner lips). Thus, it seems that the pressure is trying to escape my mouth eventually compromises the tape's seal. So, three questions:

1. Should I try a full-face mask? I have a Phillips Respironics mask that I used for approximately one night and hated because I felt awful. This attempt was early in my therapy, and I don't feel I was as versed in recovering from CPAP failures. 

2. If I do use a full-face mask, would the pressure need to be adjusted upwards?

3. Any other tips for a full-face mask experiment?

Best,

Justin
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#29
RE: I am more confused than ever....
Hello JL 3000. Have you tried using Somnifix strips to tape your mouth? If I purse my lips before I stick a strip on, I have zero mouth leaks. Might be worth an experiment before you try the full-face mask route.
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#30
RE: I am more confused than ever....
(12-01-2019, 03:52 PM)JL3000 Wrote: Currently, I tape my mouth and use the cervical collar to keep everything "leak proof." Despite my best efforts, leaking from the corner of my mouth is common, despite how much tape I use or how thoroughly I use it. Additionally, I often wake up, and my mouth is parched (generally, my teeth dry to my inner lips). Thus, it seems that the pressure is trying to escape my mouth eventually compromises the tape's seal.

What tape are you using? Also, please post some close ups of the flow rate where you're not having an event, thank you.
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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