APAP necessary?

[Deborah K.]

Your chart still needs a little work.  Use the F12 button to copy your chart (F12+FN if using a Mac).  This will show what we need to see. Please ensure that we can read to the very bottom of the flow limits.  

[lazmit]

Thank you, I uploaded tonight's chart using F12.

[Expat31]

Sorry, back again

It my be easier for you to show just these 5 key graphs at the moment :-

1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations


This will give us a good initial overview.

[jdougc]

Great sleeping, how did you feel when you woke up?

You have obstructive events in your deep or REM sleep, like I have been having lately.
You might be tucking your chin if the soft cervical collar is loose, I loosened my for comfort, my a bit too loose and I may be forcing my chin through the collar to my chest, not sure yet. My deep/REM sleep has short events that are not counted.
Don't tighten the collar too much though.

Zoom in  the Flow Rate chart and scroll around these times of deep or REM sleep, and see what is happened before the Obstructive events:
2:40
3:00
3:30
4:00
5:00
Gasp at 0:30

Your minimum pressure is very low for an adult, especially with EPR set at 3.
Consider raising Your minimum pressure to 8 cm and raising your ramp pressure to 7cm for only 5 minutes for comfort.

You can lower your maximum in a few days, if these changes are working out. 
Your pressure swings could be smaller and you may have less arousals.

[lazmit]

Thank you - once again - for your useful comments!

With your suggestions I have significantly improved my sleep.
However I do not want to touch the settings of the cpap device yet - I am going to ask my doctor about the proposed changes at the scheduled meeting in 3 weeks from now.

I have re-uploaded the screenshot of 11th of April with just the 5 key graphs (as Expat31 suggested).
I zoomed in the flow rate graph (as jdougc suggested) at the specific time periods he suggested but I do not really understand what happens there (and if its something I could correct/improve).
Also I have uploaded the zoomed-in graph of the grasp at 00:30. Any idea what this indicates?

Best regards to all!

[jdougc]

That zoomed in area of ragged breathing is either REM or deep sleep, without and EEG we can't tell which.
No adjustment needed in the zoomed in area.

Many of the other stages or REM or deep sleep have events, large leaks also. Looks like mouth breathing through the night, the flat regions of leaks. Pillow type masks are affected more so than full face masks by these "small" leaks that are under the red line, IMO.
Consider using athletic tape cut to 2x4 or 5 inch strips or a SomnoSeal device, very pliable soft oral sealing device to promote nasal breathing and prevent mouth leaking

Your collar might be to loose, for comfort or not tall enough. I would think the former. You may have forced your chin through the collar when you were in the REM or deep sleep, thereby letting you have a small cluster of  OA events.

3 weeks to a long time to be at the extremely low minimum pressure. 
Are you feeling starved for air when you 1st start the machine?

Settings of 7-11 cm would probably be more comfortable.
Ramp at 5 minutes at 7cm pressure also

[lazmit]

What is EEG?
I will look for some athletic tape to try to eliminate mouth leaks!
My collar is quite tall so I will tighten it more - I hope I will not get suffocated!

Yes, I am feeling starved for air when I start the machine.
Since I see several people suggesting changes in my settings I will try the 7 cm min pressure and see how it goes.
Do you think I should leave the max pressure to 14 cm?
Just to clarify about the ramp: you suggest I remove the ramp from Auto to 5 minutes & change Ramp pressure from 5 cm to 7 cm?

I hope my doctor does not get upset when he sees my experiments!!

[jdougc]

An electroencephalogram (EEG) is a test that measures electrical activity in the brain. without it we can't tell if it is REM or deep sleep.

Do not overtightened your collar....

I suggested the lower maximum pressure to minimize pressure swings, many experience arousals when there are pressure swings.

Change the ramp from Auto to 5 minutes & change Ramp pressure from 5 cm to 7 cm.

Your doctor will understand when you describe your issues with being starved for air.

I like this tape from Amazon. cheap also.
   

[lazmit]

ok, I will try min pressure 7cm & max pressure 11cm and also the changes with the ramp.
I will keep you updated.

Many thanks!

[lazmit]

So, I changed Airsense 10 settings to:
Min pressure = 7cm
Max pressure = 11cm
Ramp = 5 minutes
Ramp pressure = 7cm

I used an athletic tape to eliminate mouth leaks. This went exceptionally well. I did not expect to accept the tape so easily!
I also used a new head pillow & a pillow between the legs and of course the soft cervical collar.
I avoided sleeping in supine position with the use of a backpack.

Anyway, I have attached tonight's screenshot - there seems to exist a few apneas at the beginning & end of my sleep. I am not sure what might have caused them...