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[Treatment] Need Help Dealing With TECSO
#1
Need Help Dealing With TECSO
Hi all! 

I need help for what seems like a question asked every day, but I still can't find usable answers.

I got a sleep study done on November 22, 2024 and got diagnosed with OSA with an AHI/RDI of 25.2. I got an Airsense 11 the next day and have been using daily since then. There has been zero daily personal symptom relief, however my AHI score is 2.84. 

The problem is after looking into my OSCAR data recently it looks like my OSA is practically cured, however it looks like I've developed TECSO with an average of 2.09 for CA index. 

I have tried adjusting my pressure from my original 6-12, to 7-13, to 8-13, to 9-9. EPR I've tried all settings including disabling it. I have also struggled with aerophagia the whole time, but would much rather have that than continue to feel the fatigue I do.

I've posted a recent days info, the total stats from my machine and my study scores.

Does anyone have any recommendations that I could try to relieve these, besides just waiting and seeing if it resolves itself, as that's what a lot of my TECSO research came up with. Some context for asking a doctor, the part of Canada I'm in has public and private clinics. I went with the private one as the wait time for the public one was well over a year. However after the 1 month trial period of an APAP, the clinic basically tosses you on your rear.


I appreciate you reading this and taking the time to respond, Thanks!


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#2
RE: Need Help Dealing With TECSO
TECSA is a tricky beast. Usually you reduce EPR to help with it - but I think you are chasing the wrong issue. You are still having obstructive apnea events, and at a far higher pressure than your baseline minimum. That means you might consider raising your pressures. The chart you posted has very, very low pressures until you get an obstructive apnea, at which point it shoots your pressure up to almost 11. That you're dealing with aerophagia is also tough, but there are many suggestions on helping with it that you can research on your own.

As far as pressures, here is my suggestion:
I would try slowly starting to raise your minimum pressure until you get to at least 10, preferably about 11, which is as high as your machine is going when it fixes your obstruction. The goal of this is to reach a point where you don't have to have the machine do APAP, you will set a straight pressure all night. This can help with aerophagia and also nighttime wakeups from pressure changes. Remember, APAP can only react AFTER an event, and in this way can mess with our sleep quite severely. The best way to fix this is to be proactive.

Some people recommend lowering EPR for central events. This absolutely does and can help, but if you have any flow limitations can be difficult, and for you specifically would probably result in worse aerophagia - usually what I'd want to see is fixing your pressures first, then tweaking EPR afterwards once we're certain your obstructive apneas are taken care of.

Additionally, your CA's correspond to leaks, so likely what is happening is you might be waking up and falling back asleep, and the interim results in a CA. Fix your leaks and you should see fewer of these.
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#3
RE: Need Help Dealing With TECSO
Wow TECSO? I must have Tesco on the mind haha.

Thanks so much for the reply, I'll give that a shot, moving up to 10 and then 11. What should my EPR be set at then? As just yesterday I tried a constant pressure of 9 with EPR turned off. EPR of 3?
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#4
RE: Need Help Dealing With TECSO
Treating Tecsa:

1) You could wait and hope it goes away, it might
2) EPR off
3) VCOM
4) 2 VCOMs
5) EERS
6) EERS + VCOM
7) Add O2
8) acetazolamide

Keep pressure as low as you can while still treating OSA
Increased pressure increases minute vent and blows off more CO2
TECSA is caused by being over sensitive to CO2 changes
VCOM slows the flow down, some people its enough.  It helped me but I still needed EERS
VCOM should reduce or eliminate your aerophagia
Breathe through your nose
Reduce sugar and processed food
Soft collar and seal your mouth

Sleep-well
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#5
RE: Need Help Dealing With TECSO
Thanks a lot ChadBSr. This is a great list to go through with things to try. I actually really enjoy tinkering amd modding stuff like this so I'm definitely going to look into these options more.
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#6
RE: Need Help Dealing With TECSO
I have a thread going with my current EERS trial and hope to have a big improvement coming in the next few days after I get some parts in the mail.

https://www.apneaboard.com/forums/Thread...-and-Trial
Breathe through your nose
Reduce sugar and processed food
Soft collar and seal your mouth

Sleep-well
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