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[Treatment] fly by night's therapy settings
#1
fly by night's therapy settings
I am a recent CPAP user, and new to these boards. I am using a Resmed Airsense 11, which came to me set for 4.0-2.0, EPR 1, basically factory settings, from my understanding. My diagnosis was "mild" apnea, 9.8 pAHI, and the RX was for the settings stated above.

The therapy has already improved my life. I am sleeping much better, and my "numbers" are very good. I will attach yesterday's and today's OSCAR screenshots below. (I have not included the "snore" graph, because snoring has disappeared.)

On both days, my EPR was set to 1, and minimum pressure set to 5.0. I had bumped the minimum up from 4.0, as I felt like I was not getting enough air before falling asleep. I also had the Ramp setting "on." 

I am not one to leave "well enough" alone, especially when "well enough" isn't. My problem last night was that I woke up a little before 4:00 with the pressure high, and I had difficulty breathing. I didn't really understand what was happening, I thought the machine was acting up. After a few minutes, I shut it down, went to the bathroom, and put it back on again. About an hour later, I had a repeat, and just removed the mask.

I think much of my problem is positional. For example, after removing the mask, I didn't feel as though I could breathe unless I rolled to my side. But over the long-term, sleeping on my side doesn't work for me, I really need to sleep mostly on my back.

So that is where I am. My current goals are:

  1. Keep the good numbers.
  2. Improve success sleeping on my back.
  3. Not waking up feeling "over pressured" and panicked by the therapy.

I will work on head/neck position, and have found a lot of good guidance on these boards.

As far as machine settings, I am thinking that I should bump the EPR up to 3. I think a higher initial pressure (maybe 7.0?) may be warranted, and maybe do away with the Ramp feature.

I welcome input.

   
   
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#2
RE: fly by night's therapy settings
(02-14-2023, 01:33 PM)fly by night Wrote: As far as machine settings, I am thinking that I should bump the EPR up to 3. I think a higher initial pressure (maybe 7.0?) may be warranted, and maybe do away with the Ramp feature.

I can tell you've done your homework.  A minimum of 7cm is a good place to start.  You may or may not need higher.  And yes, turn the ramp feature to off.  

Your graphs show some flow limitation, which is what's causing your pressure to rise.  
In turn, the higher pressure is waking you.

In order to lessen the flow limitation and keep the pressure in check, set EPR to 3.  

Your chart looks pretty good otherwise. Repost after a couple days.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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: fly by night's therapy settings
Thank you OpalRose!
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#4
RE: fly by night's therapy settings
OK, two days later, and two more snapshots.

Current settings are EPR = 3, Ramp off, Min 7.0, Max 16.0. The minimum pressure was increased to 7.0 and the EPR increased to 3 since the previous settings.

Additionally, I have slept almost 100% on my back (my worst position) the last two days, and without a pillow to reduce chin tuck. Back sleeping has been really helpful in reduction of back and shoulder issues. The previously posted snapshots were mixed positionally between back and sides. I have an SCC on order, and will try using it (probably with a pillow) when it arrives.

The only thing that jumps out at my newbie eyes is that the 99.5% Pressure dropped. I think that was the expected result of increasing the EPR?

Any suggested changes?

   
   
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#5
RE: fly by night's therapy settings
Results look really good. Are you comfortable with these settings?

I'm not sure I see a need for a SCC, but since you sleep mainly on your back, it could prove helpful.

There is no reason to change settings unless your numbers start to change drastically.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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: fly by night's therapy settings
(02-16-2023, 01:14 PM)OpalRose Wrote: I'm not sure I see a need for a SCC, but since you sleep mainly on your back, it could prove helpful.

Thank you OpalRose!

I am quite comfortable with these machine settings, and will leave them alone. I think I am at the maximum benefit the machine can give me, and I am quite satisfied with it.

About the SCC, though my OSCAR numbers don't show a need, that is mostly because the data is so short-term and incomplete. Here is are some snippets from my sleep study results.

Positional Apnea:

   

Positional Snoring:

   

As you can see, when I sleep on my sides, I really don't have much of an apnea problem, besides some snoring. But, on my back, the apnea is significantly worse, and the snoring is increased. This was my experience before the study as well.

I want/need to sleep on my back, as the side sleeping really isn't working for me as far as spinal and shoulder issues. So, I am also been actively trying to sleep on my back. I can stay on my back if I don't use a pillow (even though I have a thin pillow), at the cost of decreased sleeping comfort.

My last two nights were without a pillow, and nearly 100% on my back. Without the pillow, the combination of less restriction (less chin tuck), and decreased side-sleeping comfort, cause me to stay on my back.

But I like the pillow, it is more comfortable! With the pillow, when I feel the restriction and/or increased CPAP pressure it drives me to my side, either consciously or subconsciously.

I am hoping that with an SCC and the pillow, I will find my comfort sweet spot, and can stay on my back. It is a continuing experiment.

Once again, thanks!
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#7
RE: fly by night's therapy settings
Understood.  Smile   Unfortunately, I know all too well how pain dictates sleep position.  

Your stats are good, so put comfort first.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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: fly by night's therapy settings
A few days later, sleep is improving, though still a work in process. I won't post my OSCAR screenshots, because they won't add anything at this point.

Apneas are well under control, as well as flow restrictions. Snoring is gone.

Funny, tonight my wife said that I no longer kick her when sleeping. I didn't even know that (RLS? PLM?) was an issue, but OK it's gone too.

Sleeping through the night is still an issue, but it is getting better.

If anyone is interested, current setup is pressure 7.6-13.0, EPR 3 full-time, no ramp. Sleeping flat on my back, no pillow, no SCC.

Thanks to this forum, the OSCAR devs, and OpalRose for your help. (It is a strange world where we have to make friends of strangers on the Internet in order to get medical care.) 

I am blessed and encouraged by you.
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#9
RE: fly by night's therapy settings
Thanks for letting us know how you are doing. I think sleeping through the night is an issue for many of us, but it sounds like you are progressing well.

Feel free to post an updated chart, especially if you have any changes or questions.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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