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[CPAP] Need Help Finding Right Settings
#1
Need Help Finding Right Settings
I am having trouble parsing out this data. It appears to be that a lower constant flow rate is better, but I have other data that says the opposite.

I also have a lot of trouble keeping my mask on at night; any advice for that? I use tape on the sides of my face but it ends up catching my hair and I have to break off the ends of it :/
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#2
RE: Need Help Finding Right Settings
Update: I realized yesterday that my mask frame is one size too large; I have a new one coming soon which should help.

One user also messaged me saying that I should try a ramp period to make it easier to fall asleep. I definitely will give this a go as well.

I also just started using ClimateLine tubing so I am excited about that, but it has not seemed to help my mask-removal issues.
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#3
RE: Need Help Finding Right Settings
You have an instrument capable of automatically adjusting the treatment pressure. You should utilize it and abandon the constant pressure (CPAP ) setting. Try Pressure minimum 8,  maximum 14,  EPR=3 full time. It is better not to use the ramp.
The lower minimum pressure might help with your mask removal issue.
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#4
RE: Need Help Finding Right Settings
I switched to CPAP mode because I was struggling with aerophagia, but I have been getting better results with lower pressures so I will try APAP again with a lower range. Will report back as this progresses.
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#5
RE: Need Help Finding Right Settings
iwesterbeck - I too can get aerophagia if the pressure changes too fast or too high.   If you find that you are getting aerophagia from G. Szabo's recommendations, try lowering the maximum pressure to tighten its range.  You should find an acceptable pressure envelope.
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#6
RE: Need Help Finding Right Settings
Here are some updates:

Everything is comfortable now and I have a great mask fit. However, my issue is still keeping my mask on at night. I have tried tape but it does not seem to make any difference; I still take my mask off without fail, every single night.

I have changed my pressure min and max to be less intense. I also tried switching to nasal pillows but they did not work for me, so I am using my regular nasal mask again. It is much more comfortable with the properly-fitted frame.

I have a ClimateLine tube but I found warm/high-humidity air to be too thick so I lowered the humidity down to 2 and the temperature to 66º; it is still nice having control over these features.

From what I have read so far, most people recommend putting the mask on for 30mins here and there throughout the day to get used to the feeling. Do any of you have thoughts on this? Have you done that before?

Thanks ?


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#7
RE: Need Help Finding Right Settings
(06-03-2024, 11:41 AM)iwesterbeck Wrote: Here are some updates:

Everything is comfortable now and I have a great mask fit. ...

... I have changed my pressure min and max to be less intense....

From what I have read so far, most people recommend putting the mask on for 30mins here and there throughout the day to get used to the feeling. Do any of you have thoughts on this? Have you done that before?

Your leak rate is so high that it compromises your treatment. It means that you do not have a proper mask fit. You must resolve this issue before any other changes.

It is also clear that you hit the ceiling of 10 cm; You will eventually need to set a higher maximum when you can tolerate it. Similarly, the APAP algorithm sharply shouts up from the 8.2 minimum; hence, the minimum is too low, but I understand your issues with keeping the mask on, which should be your priority. You have quite a long time without a mask during the night. It would be best to put your mask back on as soon as possible to have at least 5 hours per night mask-on-time. I suggest activating the leak alarm so you can realize that the mask is off. Then you should force it back. 

If the pressure makes the mask uncomfortable, then daily training might not help. But if you need to be comfortable with the mask on your face, then some daily training is advisable.

You have quite some clustered CAs on one of your charts. Once the leak/mask issues are resolved, you should experiment with EPR=2 to address them.    
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#8
RE: Need Help Finding Right Settings
Thanks for your reply Szabo.

As for the mask, I am going to try tightening it more tonight, and if that does not help I will look for a different mask. I used the nasal cushion fitting card from Philips and I have the correct size, and every time I try the mask fit test on my device it says the fit is good. I wonder if I just need a different mask entirely.

Also, for some reason, my device does not have the Leak Alarm feature that other ResMed devices normally seem to have. SmartStart is turned off and I am in the Clinical Menu but it still does not show up.

Thanks for all these tips.
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#9
RE: Need Help Finding Right Settings
In most cases, tightening the mask will likely make leaks worse. It will almost certainly make it more uncomfortable, increasing the unconscious act of mask removal.

It would appear you've inadvertently created the same mask removal problem I had when starting out. You have to spend time getting used to mask wearing under pressure. But you also need a mask that doesn't need to be ratcheted down with a torque wrench to prevent leaks. This enhances the urge to get the mask off.

As soon as you take the mask off, you must get it back on immediately.
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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#10
RE: Need Help Finding Right Settings
(06-04-2024, 12:21 AM)iwesterbeck Wrote: I used the nasal cushion fitting card from Philips and I have the correct size, and every time I try the mask fit test on my device it says the fit is good. I wonder if I just need a different mask entirely.

I needed to order different nasal cushions to find the right one for the Philips mask. Also, the frame size matters, and I could find the right one by experimenting.
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