[Treatment] jjdresselhaus - Therapy Thread

[jjdresselhaus]

First was mostly good. I had a hard time falling asleep on my side. It felt like either the nasal pillow was getting compressed in a weird way, or the hose connector would leak and blow on my pillow making lots of noise.

Woke up a few times. Ended up taking it off at around 7am and going back to sleep for a few hours.

Any thoughts or tips?

Resmed Airsense 11. Was prescribed API of 5-15, but changed it to 7-15 after an hour or so. Using the Philips Dreamwear Pillows.

Oscar Charts -- 

   
   

[super7pilot]

Your median pressure was 9cm. So make this your minimum and leave the max alone. Report back with the results from that change. You might even keep notes on how you feel with each setting. After mucking about in settings. We can get confused and don't recall what did or didn't work.

Are you using a PAP type pillow? I.E. pretty flat and with side cut outs to help lessen mask interference.

If your pressure change helps. Then try going to EPR3 and see if that helps.

And count yourself as very lucky to have had a decent first night. There can be a learning phase for your body/mind to adapt to pressurized breathing. I felt like death warmed over for a month or so. Even though I had low AHI. It is a process, so take it slow and be methodical with your adjustments.

[jjdresselhaus]

I'll give that a try. Thank you!

Is there any insight into why the pressure rose so much around 1:45 without any events listed? Would love to learn how to interpret these graphs on my own.

[super7pilot]

I'll try and explain that. But first. Try and set up the oscar display with a few less items. All the group needs to see is events, flow rate, pressure, Flow Limitations and leak rate. You can add in tidal volume. But the first 5 I listed are what we need to see and the screen shot will be far less cluttered. If you can. Put the flow limitation, flow rate and pressure next to each other.

The ResMed internal pressure programing has a strong link to your Flow Limitations. If you look just before the pressure goes up. You will see your flow limitation go up. The problem can be that as the machine is reactionary as opposed to proactive. You can have an event between the FL going and the machine upping the pressure. In your case your FL didn't result in an Obstructive Apnea or a Hypopnea.

So that usually results in a question by a new person (what the heck is Flow Limitation) Simply put. It is a restriction to the flow of air in your airway. This can be cause by several things. The biggest reason is that your airway gets partially blocked by your tongue falling back or your soft palette partially collapsing. Secondarily, the things I listed can be made worse by a stuffy or small nasal airway.

So FL's are basically like a clogged air filter on your car engine or home HVAC. So when you see a Hypopnea. This is flagged by the programing as a narrowing of the airway by a certain percentage, But didn't go into a total airflow stoppage (an obstructive apnea) On Resmed machines. You can set the EPR to 3 and this helps reduce the Flow Limitations, But might induce a few Clear Airway events.

[jjdresselhaus]

Night two. Definitely had an issue with waking up a bit throughout the night. Annoyingly had to turn off my machine to fix my mask (it got disconnected), but then when I turned it back on, the pressure started low again...

   

[super7pilot]

You might turn off the ramp function. Most on the forum advise to not use it as it just takes away from therapy time. otherwise you actually had good results with just 2 OA's in over 8hrs.

[Deborah K.]

Your chart will be better if you press the F12 button to copy it (FN+F12 for Mac).  That usually sets it up right.  We need to see the following, and only the following, in the order listed:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

We need to be able to read to the bottom of the flow limits.

[jjdresselhaus]

Hey All! Just completed Night Three. Averaging an AHI below 1. But I don't feel rested, I don't feel like I'm sleeping well, and my sleep ring (Happy Sleep), backs that up -- last night I only got 5m of Deep Sleep. 

Is this just my body getting used to CPAP? Anything I can do to help?

[Deborah K.]

We'll need to see a couple of Oscar charts to offer you good advice.  Press the F12 button (FN+F12 for Mac) to copy your chart.  That usually gets it right.  We need to see the following, and only the following, in the order listed:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

We need to be able to read to the bottom of the Flow Limits.

I'm glad to see that you are having a great AHI.  It does take some time to become accustomed to having a foreign object attached to your face and blowing air up your nose.    Stick with it, it will get better.  

[jjdresselhaus]

Here is last night and the night before -- you can ignore the first few events for last night, as it was me being curious if I could trigger higher pressure by holding my breath ?