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qt9998 Therapy Thread
#1
qt9998 Therapy Thread
   
Took home test in August.  Was told in zoom meeting my AHI was 54 - severe aepna. 
Doc ordered AirSense10 Auto and N30 mask.  Pressure set at 4-15, autoramp. 
Have been using it for 5+ weeks.  Air escaping thru my mouth so got chin strap.
No help so using 3M micropore tape instead.

I don't have trouble falling asleep on my back though I would prefer stomach/side.
In over 30 days I have yet to go longer than 3-4 hours without waking up.
I then can't go back to sleep so I take the mask off and get on my side and sleep
another 6-7 hours.  Called the doc's office but can't get appt for 3 weeks (I want to
try the F30i mask so need prescription).

I've looked at the OSCAR guide but it's too technical for me.  I'm attaching last
night's results.  I have a month's summary on my desktop but when I try to attach it
here the browse goes to my desktop BUT only shows a few files instead of all of them
like Finder does.

Anything you suggest I do would be welcome, just no push ups!
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#2
RE: Machine wakes me up after 3 hours
Hi, qt9998  Many DMEs and other CPAP providers offer a 30-day mask guarantee -- if a mask is not working, you can request a different mask within 30 days for free.  So it's worth asking the company you got your mask from.  Also, you can buy a mask without a prescription from online suppliers.  Here's a list:

http://www.apneaboard.com/forums/Thread-...plier-List

You're still having too many leaks for the machine to work properly, so getting better mask fit is the top priority.

Somewhere on the Board is a how-to about mask fitting.  I'm not finding it immediately, but I'll look further and post it if I can.
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#3
RE: Machine wakes me up after 3 hours
Here's the Mask Primer, which has a section on adjusting masks:

http://www.apneaboard.com/wiki/index.php/Mask_Primer

Good luck!
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#4
RE: Machine wakes me up after 3 hours
Your EPR setting of 3 cm is not doing you any good. With a minimum of just 5 cm pressure, there's no room for it to work. Also, this may be causing some of your central events. 
Your leaks are definitely ruining your therapy. Take a look at this mask fit tutorial and try again. Remember, too tight is almost always as bad as too loose. 
How to achieve the perfect mask fit - GUARANTEED! | Apnea Board

Once you get the leaks under control, you might want to try this suggestion. Raise minimum pressure to 6 or 7 cm and reduce EPR to 1 cm. I would also recommend turning the ramp off at this low pressure.

Also, here are some explanations on how to organize and post your OSCAR charts for evaluation. 
http://www.apneaboard.com/wiki/index.php...ganization
http://www.apneaboard.com/wiki/index.php...pnea_Board
My get-up-and-go musta got up and went.  Cool

Download OSCAR for your sleep data.  
https://www.sleepfiles.com/OSCAR


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#5
RE: Machine wakes me up after 3 hours
We need to get your pressures to work within a more narrow range to minimize disruption. You have chronic high mask leaks that appear to be mask leaks rather than mouth leaks. If you can get a Resmed Airfit P10 you will find it much easier to get a seal and will give you a much smaller lighter mask. I recommend the following settings:
Minimum pressure: 8.0
Maximum pressure 12.0
ERP On, Full-Time
EPR Setting 3
Ramp: Off

By keeping ramp off, you will achieve a good mask fit while still awake, and your current ramp time of 45 minutes is delaying an effective therapy for way too long. The best solution is to turn it off. The settings above will start therapy at 8.0/5.0 which is near the minimum pressure, so should not be too uncomfortable. If you feel you need to start with a lower pressure , the lowest I would suggest is 7.0 for a starting pressure of 7.0/4.0 (Inhale/Exhale). If you have questions on how to change settings, be sure to request the Setup Manual for the Airsense 10 Autoset. Finally, your obstructive apnea occur in clusters. Please read this wiki on how these clusters of obstruction occur: http://www.apneaboard.com/wiki/index.php...onal_Apnea
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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: Machine wakes me up after 3 hours
(11-27-2022, 11:30 AM)Sleeprider Wrote: You have chronic high mask leaks that appear to be mask leaks rather than mouth leaks.

I beg to differ.  If those leaks were mine they would definitely be mouth leaks due to their spiky appearance, cf. 
http://www.apneaboard.com/forums/Thread-...#pid457254

Mike
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#7
RE: Machine wakes me up after 3 hours
Thank you all for your suggestions!  I hope you won't give up on me and will continue to monitor and comment.

Before I turned in last night, I tightened my mask. 
I also split the difference and set pressure at 8-10, EPR at 2 and ramp off.

Well, I couldn't even fall asleep.
Air was blowing in all directions, mouthful of air wanting to escape but prevented by tape.
Gave up after 4-5 hours.

I guess I should loosen the mask tonight!  

See attachment.


Attached Files Thumbnail(s)
   
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#8
RE: Machine wakes me up after 3 hours
Spikes are mask leaks. Plateau type leaks are mouth leaks
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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#9
RE: Machine wakes me up after 3 hours
qt9998,

Having the mask too tight, or too loose, can cause leaks. Sometimes it just takes some experimenting.
If you are having trouble getting your mask leaks under control and the Mask Primer is not helping, you may want to consider a different type of mask. A FF or hybrid may work better for you instead of the nasal.

Also some tips on posting screenshots:
Maximize the OSCAR app on your desktop - Option + Green button (top left of the window)
Use fn+F12 on your Mac, or from the menu bar View > Take Screenshot, it will show more info
Jeff8356
Apnea Board Moderator
www.ApneaBoard.com


MacBook Air (2017, Intel) | macOS Monterey (12.6.3) | OSCAR v1.4.0 | VM = Win10 (19043.1446) |
How to Links:
Installing OSCAR on a Mac
Organizing your OSCAR charts
Attaching screenshots and files for the forum
OSCAR Help
OSCAR Data Interpretation

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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#10
RE: Machine wakes me up after 3 hours
Regardless of the source of leaks, there are too many, and they are causing the machine to be unable to determine the type of apnea occurring, however, a cessation of breathing is being detected. This therapy is failing, and the root cause is poor mask fit or inappropriate mask type for the user. We might be able to interpret zoomed images of the flow rate, but something needs to give in terms of a mask change.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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