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[Treatment] Need some help to start treating me apnea with S10 AirCurve VAuto
#1
Need some help to start treating me apnea with S10 AirCurve VAuto
Okey. I got myself a Resmed S10 AirCurve VAuto as most people recommended on my first thread, a slightly used one but it cleaned up nicely.


Back in 2019 the doctor who diagnosed me recommended a Bipap 18/14 , a ramp setting , humidifier and a full face mask ( like that's literally what he wrote on his medical letter and nothing more ).

Last night i did my first " test run " with the device , which only lasted about an hour or so. I've set it on VPAP-S , EPAP 12 ( since 14 seemed a bit hard to breath at start ) and IPAP 18. Most of the other settings i've left as they were or auto. I've taken the graphs and ran them through OSCAR and im adding them here. I did have a bit of trouble with dry mouth when i stopped it to at least try and get a few hours of sleep before work.

Would appreciate some guidance on what settings do i need to change and adjust to be able to use the device better ( i will also try on my end to reach a doctor but they are hell of expensive here , like 10 % of my device's price per consultation .... ) and here's to hoping maybe it can be tweeked and work for now.
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#2
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
I'm very surprised, that with a PS equivalent of 6 cm, you are not experiencing any CAs. Your doctor's pressure recommendation would have provided a PS of 4. I would try setting your IPAP at 16 cm to match this PS value. You may not need as much pressure support as you currently have. Your OAs seem to be positional and can be from chin tucking or back sleeping. OAs, caused by chin tucking, will not respond to any pressure setting, no matter how high it is set. Also, you don't specify what type of mask you are using in your profile. A profile update will be very helpful.

How do you feel?
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#3
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
I would make the following changes:


VPAPAUTO  NOT Vpap-s
Epap (min) 8
Ipap 18
PS 4

With Vauto the inhale pressure is the min (Epap + PS) = 12
The exhale pressure is Epap 8
the max is Ipap 18

This should make your therapy my easier to do.

BUT your main problem is positional apnea.  Positional apnea is when you sleep in a position where you cut off your own airway AND no pressure change can help.  You have to stop sleeping in that position.  Think of it as kinking a garden hose, if you don't get rid of the kink no water can flow through the hose...  You are doing what we call chin tucking when your chin drops down to your sternum and you can not breathe.  It may be sleeping on your back or having a pillow that is to high making your chin tuck.  However, many people have found they can not stop this unless they wear a collar.  PLEASE look at the link at the bottom of the page in my signature. (Cervical Collar)    It shows people who have no collar on and the same people with the collar, it is such a huge difference.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
@ Crimson . Updated my profile. Will see how the change goes. Do you recommend anything about the climate control settings ? since i've had some issues with the auto should i change it to manual and increase some settings from what i've saw on the auto ?

@ Stacey . I will look into the cervical collars , got a rather thick neck so i dont know how that will go.

I'll also try to fiddle a bit with my 2 + 1/2 pillows and maybe reduce their use in case they are blocking my airways .

The journey to a good long night sleep begins xD.
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#5
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
I don't want to make too many changes at once.  This can lead to AHI number chasing and disappointment.   It's best to make changes in steps to see what does and doesn't work.  

I had a feeling that you may be using a Full Face Mask (FFM).  I've found that the FFM's headgear's design places the lower back strap below the head's pivot point.  This causes the mask to tighten on the face as you look upward and reduces the mask tension as you drop your head.   Because of this positional tensioning, this would seem to encourage a person to drop your head (chin tucking) while asleep to reduce this pulling sensation. That is why something to prevent or lessen this movement is usually needed.  To reduce the changing tension, I have tried adjusting the lower back strap to sit higher with some success, but my ears keep getting in the way. Big Grin

I have a thick neck as well and have had problems using a cervical collar.  I have a "dog-bone" shaped CPAP pillow that allows me to tuck one of the ears up under my chin as I sleep on my side.  This produces the same result as the collar without putting pressure on the side of my neck.

The climate control is a subjective topic.  All I can say is, try playing with different settings if you don't like the feel.  If you feel your airway is dry in the morning, increase the humidity setting.  Just watch out for rainout, and if it occurs, turn the humidity down.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#6
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
Day 2 , tweaked the IPAP to 16 as suggested, I also set the climate control to manual , tube temperature at 27*C and humidifier to 5 but after almost 2 hours my mouth was very dry and i stopped the machine. Charts are below.
Suggestions ? Except increasing my humidifier to 6 tonight and seeing how that goes.
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#7
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
Except for that 10 minute blob of events, starting at 16:10, your 1 hour 50 minute chart doesn't look that bad.  It is a starting point to work from.  Whatever you were doing or, the position you were in, at 16:10 is definitely not your friend, though.   16:10 and 17:05 appears that you may have been on your back (snore).   You need to work on that.  A pillow against your back or a tennis ball attached to the back of a Tee shirt are some ideas.  Were you in your bed or trying to take a nap on the sofa or in an easy chair?

Your dry mouth may be caused from mouth breathing.  If that is the case, there isn't a humidifier, or settings, large enough to overcome it.   You need to find something that will work for you.  You might consider trying wedging a portion of a pillow under your chin, a soft cervical collar, Biotene mouthwash, Xylimelts, or even tape to overcome this.   The previous ideas are not in any particular order.

Until you overcome your sleeping hindrances, I am not going to recommend any additional CPAP changes.

- Red

EDIT:
If you could provide a 2-minute zoom screenshot on an area around 17:30, that includes your Flow Rate graph, would be helpful.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#8
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
Here is the two minute screenshot.
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#9
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
And this was day 3. Increased the humidity here up to 6. I also used some nasal decongestion drops because i felt like my nose was a bit too clogged but at the end i woke up with the most  dry mouth yet...
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#10
RE: Need some help to start treating me apnea with S10 AirCurve VAuto
Except for the 10-minute span from 15:55 to 16:05, your data doesn't look bad.   You need to figure what you are doing and "STOP IT!".  Big Grin Really, I do see that position problem as the most important thing to address. Your 2-minute flow rate appears to be normal. That is a good thing. The obstruction "spasm" seems to be happening only once per a sleep session. . . odd!

Are your graph times the actual time that you are sleeping? If so, could some type of disruption be occurring that seriously disrupts your sleep?


How are you feeling?

Thoughts?

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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