New User struggling, help please

[JCinPA]

You’re welcome! If it’s monitored it’s only to check you are using it, for insurance purposes. Nobody will send a SWAT team to your house if you change your settings. ? You can’t harm yourself by changing them, you’ll only find you get better/worse results from changes.

I bet raising the min pressure to 7 and going full time EPR will do well for you. After that it will be fine tuning, and peeps here are so good at helping with that.

Good luck!

[The Good Captain]

Hooray !!!

I just completed my first nights full sleep. My AHI was down to 6.8 which is a marked imrovement on my sleep study of 36.9.

The EPR was the key without doubt.

Just need to play with optimal pressure settings and see if I can trim the numbers down even further.

Thank you both so much for the help, couldn't have managed it without you

[JCinPA]

You're welcome. If you slept well, maybe do another couple nights that way and post another OSCAR page and see if anyone wants to suggest some fine tuning. If you're comfortable and the leaks are not too bad, the AHI will likely continue to come down as you get used to this.

Post your chart from last night, just for fun.

[The Good Captain]

Here theya re

[DaveSkvn]

"that doesn't bother me, it's my health !!"

That's the spirit!

That looks good. There is still the cluster of events in the first hour of sleep. If you get rid of them the AHI will drop pretty fast.

Once you get used to the machine & mask you can turn the ramp off and perhaps move the min up towards 10 (with EPR, you'd be breathing out against 7) so the machine doesn't have as far to go to get to an effective pressure. But that is for a couple of weeks time. Get used to it first and don't frighten the horses.

You've made an excellent start and good luck!

[JCinPA]

^^^^ What he said.

One tip though. Well, really two.

First, when you do your screenshots, do your entire screen. Using the view menu turn off the daily calendar so we get more data. There is stuff in the left panel we need to see as well as the graph. It looks like the below if you do it that way.

Second, we normally don't need a lot of the graphs at the bottom in your later screenshots. If we see your flow rate, flow limit, and leak rate graphs, that's usually enough info. Like the below.

[LaurenceShaw]

I should have thought of this yesterday but I see you're using a nasal mask (Philips Dreamwear?). These may well not be mask leaks but mouth leaks: i.e. the air is pumped up the nose, down the throat and straight out the mouth. You'd tend to end up with a dry mouth and sensation of a "rattled" soft pallet. Its a weird sensation and would explain your sense of panic.

You may keep your mouth closed when awake but when you fall asleep the jaw can drop and the mouth open leaving a path for the air to escape. There are a number of paths forward. (A) Some people seem to be able to train their tongue to sit behind their upper teeth blocking the escape of air. (B) a chin strap and mouth tape (a "Knightsbridge Chin Strap" seems to be favored at the moment as it does not draw the jaw back which tends to block the airway) or © a full face mask (which seem to be frowned on these days). I never got on with a nasal mask and have always used a full face mask - I don't know how it goes with a beard though.

https://www.apneaboard.com/wiki/index.php/CPAP_mask

@The Good Captain:  Congrats on solving the leaks problem!


(Please note that searching on "Knightsbridge Dual Band" will likely lead one to counterfeits.  The official site is Supplier 37!)

[The Good Captain]

    Gotcha. I think it was a good night last night until such time as I got out to use the bathroom and then the mask fell to pices and I couldnlt get it back to work again so just used normal sleeping for the last two hours !

Hopefully this screen shot is better

[JCinPA]

Wow, look at your AHI last night!

How comfortable were you? Before the mask came apart, I mean. Were you sleeping comfortably? If so you may be one of the lucky ones (like me) who takes to therapy easily.

Based on your median, 95% and 99.5% numbers you may want to try an APAP range of 10-15. If you were comfortable that is. And drop Ramp time to maybe 5 minutes. See how that goes.

You can also start walking your minimum up from 7 gradually, but I would bet around 10-15 will be where you end up. Leave EPR alone, it's working for you, it seems.

P.S. The reason for my suggestions is you are at higher pressures most of the night and the leaks are not bad at all. Starting out higher may lower the flow limitations. It's all based on how comfortable you slept. You could also go 8 min, then 9 min, etc. But I'd bet 10-15 will work well for you.

[SarcasticDave94]

Flow Limits are still a bit high. To address with these, your min 7 needs to be turned up. Slowly increase it to 9, but note your median was 11.x.

I would also try to get weaned off the 30 minutes of Ramp holding you at 5.