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[Treatment] Seeing if anything needs to be tweaked
#1
Seeing if anything needs to be tweaked
Hello, I have been on CPAP for about a month now, and the sleep tech team has not had me change anything. Just basically ask, how am I feeling? I have been trying to acclimate more to using the machine, and have used it 100% the past month, usually 4-7 hours a night. What I have noticed the past week is I have been taking the mask off usually around 5 or 6 and not putting it back on. I am consciously doing this, and it seems to be that pressure has gone up pretty high, and my nose feels stuffy, and uncomfortable. The few nights I started experiencing this I tried to fix it, but it just didn't feel as good as when I first put it on at the first of the night. This issue seems to happen because I am a side sleeper, and tend to sleep with my face half in, half out of the pillow. I do have another mask coming in tomorrow, the Brevida, that I will be trying. Anyways I am looking for guidance to see if anything needs to be changed. I can provide more screenshots if needed as well.

Thanks,
Biscuit


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#2
RE: Seeing if anything needs to be tweaked
G'day Biscuit. Generally it looks pretty good, but there are a few things you might try to make it even better.

The first thing I noticed is that you are getting more central apneas than obstructive (though the number is quite low). Try reducing the EPR setting to 1 (or even zero) and see if that improves the CAs.

Second is that the ramp is set at 45 minutes - this means that every time you turn the machine on there's a long period when you're not getting effective therapy. Try cutting down the ramp time as far as possible, with the view of eliminating it eventually.

Some nights you're getting a fair bit of stuff happening in the last 30 - 60 minutes of sleep. This may just be "sleep-wake junk". As your body starts to transition out of sleep your breathing becomes a bit erratic. In some cases the machine is sensing this and trying to stabilise things by raising the pressure, but that disturbs you and makes your breathing erratic.. and so it goes. You could try closing the gap between your minimum and maximum pressures to minimise the swings that are happening. Reducing the EPR might help in this situation too, otherwise raise your minimum pressure by one cmH2O.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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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#3
RE: Seeing if anything needs to be tweaked
Thank you for taking the time to look and make recommendations. I am going to change the EPR to 1 tonight and just lower my maximum to 12. My only slight concern with the ramp time is before bed I like to read for about 30 mins to an hour before sleeping, and I wear my mask. If I turn off ramp will the pressure start to go up a lot when it's not needed? With the SWJ, a few of those nights if not almost all of them I have removed the mask and went back to sleep.

Once again thank you for your response.
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#4
RE: Seeing if anything needs to be tweaked
The problem wIth the ramp isn't when you go to bed. It's that you loose the therapy every time you get up.

Try it with Ramp OFF. You might be surprised. Most of the Pros here do not use a ramp.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#5
RE: Seeing if anything needs to be tweaked
Thank you for the reply, Bonjour. I am going to work towards not using the ramp. I also started using the Brevida last night which seemed to fit very well, although I started with small and woke up with the pillows stuck up my nose, so I switched it out for the Large and that seemed feel better and not go up my notrils. Here are some sleepy head reports from the past 2 nights. The first one is with settings changed and n30i the 2nd one is the first night with the Brevida. Tonight I will be starting out with the large pillows and see how that goes.

Thank you,
Biscuit


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#6
RE: Seeing if anything needs to be tweaked
I have been using the new settings for a little over a week now. Here are the last few nights results. Any input would be recommended, and if you don't mind letting me know your thought process as well. Thanks!

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#7
RE: Seeing if anything needs to be tweaked
And how do you feel?
I wouldn't chase your numbers
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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: Seeing if anything needs to be tweaked
(03-25-2019, 10:17 PM)bonjour Wrote: And how do you feel?
I wouldn't chase your numbers

Honestly, I haven't really felt different from when I started therapy. I still wake up tired, and tend to be sleepy half the day.
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