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[Diagnosis] Cantabs Graphs - Printable Version

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Cantabs Graphs - Cantab - 12-17-2020

Hi all  Smile

I had a diagnosis from our local hospital about 4 years ago and eventually ended up with an S9 Resmed with humid, it recently got replaced with an Airsense 10 Elite it also came with hospital settings. I am about to finish 20 yrs of rotational shift work Jan 4 2021 and back to 'normal' 8hr days mon-fri, having the Cpap machines have been great but feel it could be better with my general tiredness.

Eventually found this board and OSCAR last month here are some screenshots, does my machine need a few tweeks ?

Thanks Cantab

RE: Cantabs Graphs - srlevine1 - 12-18-2020

Can you replace your fixed pressure CPAP machine with a ResMed Airsense Autoset machine which will allow for variable pressure to help pinpoint effective settings? If you just received the machine, perhaps you can get your doctor to claim they wanted you to have an autoset unit, not the cheaper "Elite." Not sure how things work down-under.

As for settings, I have a few ideas, but will defer to some of the forum members who are more experienced.

Best of luck.

RE: Cantabs Graphs - Cantab - 12-18-2020

I would need to go back to the Sleep Clinic at the Hospital and ask about swapping to an Auto, the Docs here are used mainly for re feral, we dont pay or need to claim insurance for a Diagnosis or a machine, i can only ask and see what they say, they prolly want to know why etc.

Thanks for your reply srlevine1

RE: Cantabs Graphs - Sleeprider - 12-18-2020

I agree that the Autoset is superior for most people. The need for pressure can and does change through the night and in response to changes related to health and age. A fixed pressure CPAP is simply a handicapped auto CPAP. Both do the same thing, the Auto just does it better. I really don't see why a change from fixed to auto should even require a doctor's review. The auto CPAP enables self-titration and normal variation in nightly pressure, without having to set pressure in the upper range of those requirements all the time.

Your charts indicate how your pressure needs change through the night. You are having obstructive apnea and hypopnea on a periodic basis. These events might require more pressure, and the Autoset can sense the flow limitations that precede an event and raise pressure to prevent it. That argument aside, what we see is a clustering of your events. When you have an obstructive apnea or hypopnea, they do not arise as isolated individual events, but occur in clusters. This is the signature characteristic of positional apnea. My take on that is in the Positional Apnea wiki http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea as a function of airway alignment related to chin-tucking. We have found a Soft Cervical Collar http://www.apneaboard.com/wiki/index.php/Soft_Cervical_Collar very effective in mitigating this pattern of obstructive apnea and hypopnea. Please read the articles, and consider the possibilities.

You are using your Resmed Elite CPAP without the benefit of exhale pressure relief (EPR). It is very likely you would find the bilevel pressure with lower exhale pressure more comfortable, and it is capable of reducing the flow limitation of 0.14 (95%) in your statistics. This can improve tidal volume and actually reduce inspiratory time, which in your case is quite long at 2.22 seconds median inhale time. This points to issues which can be improved with bilevel pressure, and even the limited bilevel available with EPR. My recommendations are for you to first consider the possible benefits of addressing your apparent positional apnea, then increase pressure by 1-cm, and add 2-cm of EPR. The EPR is in the Comfort Settings of the clinical menu. Be sure to turn it on full-time at a setting of 2. Once you have tried that, post a new chart and we can review what has happened.

RE: Cantabs Graphs - Cantab - 12-18-2020

Thanks for the very informative and well written reply Sleeprider.

My wife has noticed the positional part you mentioned and makes sense, i am usually a side sleeper, a collar is an inexpensive easy item to get, i will try this first for a few nights and then onto your recommended settings.

I will make contact with the Sleep Clinic about an Autoset , they might want to need to see the SD card and thats fine because the data is there to see.

Cheers Cantab

RE: Cantabs Graphs - Cantab - 12-24-2020

Ive made contact with the hospital about getting an 'Auto' and i have to go back to the GP for a referral back to them for a CPAP review of my aponea or buy my own.
I did go and buy a neck-brace straight away and and have used it each night, my AHI has reduced immediately.
I have also set my machine to recommendations, here is last nights graphs

Merry Xmas  Coffee

RE: Cantabs Graphs - Cantab - 12-25-2020

Hi you people up in the Northern Hemisphere   Smile   i hope you've had or having a nice Xmas day

Here are some more graphs to be advised on , thanks

Cantab

RE: Cantabs Graphs - sheepless - 12-27-2020

bump. this might have fallen through the cracks xmas day.

I don't know your particular machine's capabilities so I won't comment on settings but your ahi, flow limitations and snores are too high, suggesting the need for higher pressure. the other thing that stands out are clusters of oa and h, indicating chin tucking, which can be addressed by fewer/lower pillows and a soft cervical collar.

RE: Cantabs Graphs - sheepless - 12-27-2020

first ad I've seen in a post.

RE: Cantabs Graphs - Cantab - 12-27-2020

(12-27-2020, 05:51 PM)sheepless Wrote: bump. this might have fallen through the cracks xmas day.

I don't know your particular machine's capabilities so I won't comment on settings but your ahi, flow limitations and snores are too high, suggesting the need for higher pressure.  the other thing that stands out are clusters of oa and h, indicating chin tucking, which can be addressed by fewer/lower pillows and a soft cervical collar.

Thanks for seeing my posts Smile

I can adjust my pressures , from what ive read about the place is gradual increases and perseverance, i bought a cervical a few days back and have used everyday. Some days AHI is lower, i use a single pillow which has the cut outs on the ends.

After my nightshift this morning my wife said my sleeping was terrible and snoring , she checked for mask leakages and chin tuck  - neither , i was side sleeping which is normal for me.

Machine is a Resemed Airsense Elite , working on getting the AutoSet.

This mornings dismal sleep , ( i can only sleep a few hrs after a nightshift, im on days off now so sleep will be longer)

I didnt see any ads.