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Trying to find the right settings
#1
Trying to find the right settings
Hello everyone, I have been using CPAP for a little over a month now.  The first week or so I spent trying to get used to wearing it while awake as others suggested.  I made a lot of progress to wearing it while in bed.  My next obstacle was falling asleep.  Of course the pressure was initially set for 5-20, but I felt like I was suffocating, so it was bumped up to 7.  My sleep doctor prescribed me Trazodone to help me sleep.  I graduated to falling asleep, but would wake up after an hour and struggle the rest of the night.   My pressure was changed from 7-12 after my follow up visit.  I noticed I kept hitting 12 every night in the little time that I used the CPAP.  

I got tired of waiting for my DME place to adjust my pressure, so I tried to learn and understand what I needed to do, as Ive been tired of struggling.  I noticed I was waking up when the pressure would fluctuate too much.  I narrowed the range down to 10-12 but OSCAR was showing snoring and regsitered hypopnea.  

Last night, I changed it to 14 with a small ramp.  I do not remember waking up and taking off the mask.  I looked at the machine and was surprised that I used it over 3 hours.  I plugged my SD card in my PC and these were the results.  I  want to understand the main things to look at in these charts and understand them. You see the flow limit and it still registers some snoring.  I am wondering what I need to adjust and change next to help make it through an entire night.  Thank you everyone.


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#2
RE: Trying to find the right settings
Welcome to the forum.
First you deserve an attaboy for navigating thru all this on your own and achieving a perfect zero. But as you realize numbers aren't everything.

The most important stat you can provide is how you feel and what you perceive. Please make a critical evaluation of this and include in your future posts.

Analysis:
Your 95% flow limit stat is 0.19 we like to see this stat at or below 0.10. the best tool for this is EPR. Please set EPR = 3 fulltime.

Seeing your flow limits high and a zero AHi I want to see your sleep study results including the charts and tables, not just the summary. This is to check for RERAs and UARS. These are heavily flow li.it dependent. The RERA stat being there says you have a history of them.

Also zooming to a 3 minute view and scan your flow rate. Provide a screen shot of what most of the night looks like and a couple screenshot of what looks different.

The basics of titration are increase EPAP/exhale/min pressure to manage OA obstructive events.

Increase IPAP/inhale/PS/EPR to manage hypopneas, RERAS, UARS, Flow Limits.

Just the EPR change for now because I want to s| the difference in flow limits from the change but In the future we will work a small range back in so we can see what the algorithm is trying to do.

Realize that with your AHI comfort rules so your evaluation of how you feel is very important
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#3
RE: Trying to find the right settings
Here are the results from last night.  Wasn't able to make it but an hour, and dont remember taking off the mask.  Had leak issues around my nose as shown in the pictures.  I also highlighted my flow rate at a 3-minute interval to show normal and deviation.  This has been the norm for me for weeks in terms of sleeping 1 hour.  I know I am in the right ballpark pressure wise, but I still need to fine tune some things.


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#4
RE: Trying to find the right settings
Based on your statement of< "making it an hour", would suggest that you should try sitting with it on and running while you watch TV in the evening. This will allow you to adapt to it sooner. Have patience. This will not be a one night affair.
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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#5
RE: Trying to find the right settings
My interpretation would be comfort has been negatively impacted by something. I don't think EPR would be the culprit, but it might be. The main shot otherwise looks pretty calm.

Maybe it's just me, but when you submit a zoom, still include the other charts, just zoom in regarding time over a specific area.

It appears there's a Ramp there at the beginning. Lots of users make the mistake in setting it for too long a time and/or too low a pressure. Sometime in the future, minimize the time and increase pressure to maybe just below your therapy setting, with the end goal to turn it off altogether. And take note the ResMed Ramp starts every time you push the Start button, robbing you of the more useful therapy time. Ramp can increase disturbed sleep due to the transition to therapy from Ramp's static pressure.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Trying to find the right settings
(11-06-2021, 11:03 AM)SarcasticDave94 Wrote: My interpretation would be comfort has been negatively impacted by something. I don't think EPR would be the culprit, but it might be. The main shot otherwise looks pretty calm.

Maybe it's just me, but when you submit a zoom, still include the other charts, just zoom in regarding time over a specific area.

It appears there's a Ramp there at the beginning. Lots of users make the mistake in setting it for too long a time and/or too low a pressure. Sometime in the future, minimize the time and increase pressure to maybe just below your therapy setting, with the end goal to turn it off altogether. And take note the ResMed Ramp starts every time you push the Start button, robbing you of the more useful therapy time. Ramp can increase disturbed sleep due to the transition to therapy from Ramp's static pressure.


I think it is something with comfort.  I had the same thing again last night.  Only an hour before taking the mask off and no recollection of it happening.  I watched some TV the last few nights with the mask and these settings, trying to get accustomed to everything.  OSCAR doesnt show really anything happening that leads to me waking up.  

I set the ramp to 5 minutes to go from 12 to 14.  It doesnt even take the full 5 minutes to get to 14, or at least it doesnt seem to take that long.  Its helped me get used to the "new" pressure.  

I just dont know what Im doing wrong or if the mask is just too tight.  There's something keeping me from staying asleep and reaping the benefits of my therapy.
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#7
RE: Trying to find the right settings
Hang in there, it is a journey to find what works best for you - it took me 6 months of fine tuning before I got it sorted.

I would suggest you don't make changes daily, alter one aspect of the settings and then give it three or four days to see how it settles.. one night of data isn't a conclusive gain or fail.

Good luck on the journey ahead.. good sleep will come.
- They are not spelling/grammar errors.. I live in Australia, we do it differently Down Under  Big Grin -
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#8
RE: Trying to find the right settings
(11-08-2021, 11:33 PM)Ockrocket Wrote: Hang in there, it is a journey to find what works best for you - it took me 6 months of fine tuning before I got it sorted.

I would suggest you don't make changes daily, alter one aspect of the settings and then give it three or four days to see how it settles.. one night of data isn't a conclusive gain or fail.

Good luck on the journey ahead.. good sleep will come.

Thank you, and thanks to everyone for the advice and kinds words.  

So I was able to use it 3 hours straight last night.  I did wake up momentarily and remember having the mask on then I closed my eyes and I dont remember after that.  I still dont remember taking the mask off, which has turned into a common thing now.  I still feel about the same, I will see over the course of the day.  But curious to see what you guys think about this.  Thanks again.


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#9
RE: Trying to find the right settings
Of course last night barely managed an hour before waking up.  Just sticking with these settings for a few more days.
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#10
RE: Trying to find the right settings
I'm just commenting on mask removal. I did this myself when starting my ASV therapy in 2017. I'd get a few hours logged then I'd somehow end up with the mask off. To break the habit, I had to consciously put the mask back on the moment I realized it was off. For myself, not putting it back on was training myself to remove the mask after a few hours.

So the key is when you see the mask is off, put it back on immediately. Do not scrap the session. Make yourself put the mask on.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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