Custom 68 Therapy Help Thread

[custom68]

Here was the next shot.  Going to CPAP mode and no EPR.  No real change however it does look like my flow rate went up and a bit higher leak rate.  next, I can try the same pressure and a EPR of 3 to swing this to the other extreme...
Dave

[jdougc]

No real change in how you felt when you woke up?
You are having glusters of events indicating positional apnea. No settings or pressure increases can open up this kinked airway.
Are you using a soft cervical collar?
You leaks are high and could be affecting your therapy.
Extreme changes are not considered good as it takes time for our bodies to adjust to changes. Try EPR of 2 for a few days and see if the Flow Limits improve and keep and eye on the CAs as the might increase until you get used to this change.
Good luck.

[custom68]

No real changes in how I feel but I didn't feel bad before I started treatment. I believe I have had this level of apnea for years so I may not know much different if that makes sense. My wife told me I needed to get checked and said it's been similar to what she hears the last 10 years. I snoring amped up some so she believed I needed some help.
I don't wear a colar only a chin strap. I had understood the positional was indicated br clusters of OA not the CA that dominate my charts.
I had been on ERP of 2 until I tried that last night. I can give it another night or two but I could tell I was more labored in my breathing with this setting.
Again thanks for your help
Dave

[jdougc]

Make sure the chin strap is under the chin and pulls straight up, not back making the apnea worse.
You had small clusters of hypopneas in your deep or REM sleep.

[custom68]

I had skipped over that fact. You are correct. I hadn't had the cluster like that before I don't believe. I will do some adjustments. Maybe a colar is next.
I was extremely tired last night we were awoken very early on Saturday then I worked outside a lot of the day. I was hoping it would force me to sleep better lol
Dave

[custom68]

Here is the latest.  I know there are a few leaks and maybe I can ignore the stuff at the end as I had woke up earlier than normal that morning.  I find it odd that at the "big" leak in the middle of the night there wasn't any events during that time.  I have tried CPAP mode and the APAP mode.  This seems to be the normal for me and the CA event count pretty much match what my sleep study had indicated.  
Based on the overview maybe I need to go back to the original settings.  I wasn't collecting data then but it was 6-16 EPR 2.
Dave

[jdougc]

Your apnea are well maintained, but the CAs are still an issue.
Consider CPAP mode of 8cm.
Constant pressure will prevent the flow limits from increasing your pressure. Maybe the lack of pressure swings might help the CA issue, maybe not .
I think you need a different machine.
Hopefully you get some great rest.

[custom68]

I had tried the CPAP mode at 8.4 with an epr off I didn't see much change.  Also tried at 7 with no epr.  They were close but did drop the numbers just a bit but not significantly.  
I was hoping not to need a different machine.  I would more than likely need to pay most if not all out of pocket as my deductible hasn't been met so it come from there.

[jdougc]

Consider a lightly used one
When you tried the 8.4 you had positional apne and large leaks, not a  true test.
Do you have a soft cervical collar for the positional apne?

[custom68]

good point, I will give it a try again. What EPR would you recommend? I will settle on something and get some tape you have recommended or even a full face mask and give all this some time to settle in. I do have a partial mask I tried but didn't give it a fair shot at the time.
No I don't have a collar, that night was the first and only time I had clusters other than the continuous CA groupings.
We will get there one way or another, even if it is a new machine.
Thanks a ton for your help and patience,
Dave