[Treatment] John70's Therapy Thread

[John70]

MASK CAUSES CHANGES:
 
My journey here on the apnea was to see what I can do to breathe though my nose and not have to use a FF mask. The 2” cover all tape with a nasal pillow p10 is what I used last night.

Apparently there were still some leaks, none considered events.

What is amazing my chin-tucking has been eliminated with using a very soft pillow I got from Costco (Beautyrest Black) My OA clusters may have been caused from using a contour neck pillow?

I have tried over 10 CPAP masks. The one I have used the most is the F30. I do not know how long I can continue using the mouth tape while using a nasal or pillow mask. I will continue working on an alternative so I can use a nasal or pillow mask long term.

I only had 11 CA events last night with a PS of 3 a 75% improvement with a PS of 4. Should with try a PS of 2.8? IPAP 14, EPAP 7 looks good now. Will my pressure settings change if I change to another mask?

I will do my best to continue with P10 and mouth tape. What is optimum therapy, with what mask?

I understand breathing through my nose is preferable. Especially since breathing through my mouth causes dry mouth, hence causes tooth decay of cavities.

Many thanks to Sleeprider, Gideon, Sarcastic Dave and everyone who taken an interests in these post. 

John70

[John70]

Hi Dave,

To be honest, I feel good. Not great as the temperature in the room was 77 - 78 degrees. So I was awake a few times during the night. There are not too many nights I sleep without waking up. The mouth tape may be an issue with a pillow mask. 

I am a work in progress. I will leave my pressure settings alone tonight. I will use my F30 to see what changes. 

Thank you for your response. 

John 70

[SarcasticDave94]

Yes that's best. If you're feeling good for the effort of masking up, then let's try to see what trends you can build. It's sounding promising to me really. Check in often OK? Glad you're getting some success John.

[John70]

Good Morning Dave,

Last night 56 Central Apnea Events. using my F30 and Swift RX pillow for the last hour with no mouth tape. 

What is the difference in using a FF and Pillow mask that causing more CA's?  Am I to conclude that using a FF mask, I should not use PS?

Let me know your thoughts,

Thanks,
John

   

[John70]

I switched to a VAuto BiPap PS 3 to lower Centrals. It worked with the P10 pillow mask. Last night switch to F30 which dramatically increase centrals. 

Can you explain why a mask can effect Central Apnea's?

My therapy thread has my Oscar data in it.

Thank you

John 70

[Crimson Nape]

John - For historical reference reasons, we prefer to keep a member's posts in one thread. I have moved your post above into your thread to maintain continuity.

[John70]

The explanations in this post has really be enlightening. Central Apneas regarding CO2 levels is amazing that the brain tell the lungs to breathe. 

Thank you for keeping me out of trouble with AB.

John

[Gideon]

The only reason I can think of for the masks being different is that you are retaining slightly more CO2 with the P10 mask. Note these are very small differences that I am talking about. The only cause I can see for this would possibly be the mesh in the P10 being damp. To demonstrate, use the P10 briefly and note your breathing and the amount you exhale. Now wash your P10 mask getting the mesh wet, shake it out and put the P10 back on and repeat the breathing. (Do this the CPAP running). You should notice a lot less air moving out the vent. Now let the P10 dry thoroughly before using it again, it will be fine. That is physics at work. The tension of water on the screen essentially seals the 'pores' of the mesh. A practical use of this involves a pair of jeans, without rips, please. Tie each leg closed near the cuff. and in a pool, ocean, lake throw them so as to catch air in them and you have a makeshift float/life preserver. Same principle.

See the cluster of obstructive events at 0230 and 2100, those indicate positional apnea or what we call chin tucking. See the link in my signature on soft cervical collar.
And by observation, most of your CA events are occurring during the 'lower' pressure portion of the night. Let's bump both min and max pressures up by 1

set Min EPAP=8
and Max IPAP = 15+ (how high makes little difference since our pressure is not running away, you should be able to set your max to the machine's max of 25 without any problems from it.)

[John70]

Retaining CO2 with the P10 makes sense since the mesh screen is so fine. However, last night I used the F30 due to some congestion and not wanting to mouth tape. 

I raised my EPAP to 8 and IPAP to 15, PS still 3. 

Gideon, the $50,000 question is whether I can use a nasal pillow or nasal mask? In the four years of PAP therapy, my best results have been with FF mask. Now I am trying to change with the tongue exercise, breathing exercises, chin strap, cervical collar, mouth tape and anything else I can try. 

My first titrate study 4years ago, I did well with a DreamWear cushion, with chin strap recommended. I could not keep the chin strap on, hence moved to FF. 

Honestly, what I am learning I need a cervical collar, chin strap, and maybe some mouth tape if the chin strap falls off that would allow me to use a nasal mask. 

I thought my problem was congestion. I learned today that I should use the nasal mask for a least 5/minutes to clear up any congestion. I will not give up at least not yet to use a nasal mask. My Oscar report, show pillows as the last hour I used my Swift FX so it was changed from FF. I know I should not do that. 

As far as retaining CO2, do you think there would be much of a difference between SwiftFX and the P10? 

Thanks,
John 70

[SarcasticDave94]

I've not used the P10 myself, even so I'm curious, are you changing Mask Type on your machine when changing between pillows, nasal, and full face? I'm not sure it's going to make this much difference, but maybe it does matter to you. I'd also think any full face would be harder to evacuate all the CO2 per breath. Maybe it is or isn't the case normally, but for you specifically maybe it matters a lot.