ceezee - Therapy Thread

[ceezee]

I have slept with my Resmed Airsense 10 for a few nights before this without an SD card but now I was able to see my first full nights worth of sleep data on OSCAR. My doctor prescribed a pressure range of 8-16. 

I have been browsing the forum for hours and I have a vague idea of how the results can be interpreted but would anyone have any insights they could share with me for this first night of data? Anything I can tweak in terms of pressure or settings to try and make improvements? Anything that sticks out that I should take notice of?

Thanks

[Sleeprider]

Two things that can significantly improve your therapy are the use of EPR (exhale pressure relief) and to read the positional apnea wiki. https://www.apneaboard.com/wiki/index.ph...onal_Apnea You have relatively high flow limitations with a 95% flow limitation index of 0.26. If you go into the clinical settings, you can turn EPR on, full-time at a setting of 3. While you will remain at 8-16 pressure, you will get 3-cm of pressure relief on exhale, so bilevel pressure range of 8/5 to 16/13 (inhale/exhale). That bilevel pressure not only makes exhale easier and more comfortable, the increase in pressure as you inhale significantly reduces the flow limits. I would expect this change to result in a 95% FL of less than 0.10 and a lot more comfort and less variable pressure. Your obstructive events are clustered, especially at 07:20 and 08:00. That is probably poor cervical alignment caused by the position you're sleeping in or pillows too tall or firm. As you can see, the CPAP provided its maximum set pressure during these clusters, so you know pressure alone is not the solution. Read the wiki for some ideas.

[ceezee]

I was using the F20 mask for two nights comfortable and breathing almost forgetting it was there until I woke up today with it pushing onto my face when exhaling as if air is building up in it and suctioning to my face when i breathe in. the flaps in the elbow seem to be opening and closing each time I breathe as well. I don’t think anything is dirty as it’s only the third time being used and there is no water accumulation as I use a heated tube. Please if anyone has any insight as to why this is happening it’s making it impossible to use!

[ceezee]

Good to know!

 I will implement the EPR setting and see if this improves flow limits. I think you are also likely right about the positional apnea due to the height of my pillows. 

Thank you so much for the insight!

[Sleeprider]

When you say pillows instead of pillow, it pretty much affirms my suspicion.

[ceezee]

I applied the EPR setting of 3 and did find it easier to breathe before I fell asleep. I read up on positional apnea and slept with only one pillow, which in comparison to my setup of the night before did feel like it would be much harder for my airway to physically obstruct. Even after applying these two changes my flow limit is still high and still having clusters of OAs.

I wonder if I should try a soft cervical pillow? If you have any other suggestions based on these results please let me know.

Thanks!!

[Sleeprider]

Read the soft cervical collar wiki http://www.apneaboard.com/wiki/index.php...cal_Collar We have not observed very effective results with pillows because we tend to move around at night. There are some reviews to different collars linked in the wiki.

[ceezee]

For background: I am using a ResMed AirSense 10 with an AirFit F20 full face mask. I have a prescribed pressure range of 8-16. I have EPR set to 'off' as when I tried it out at level 3 my AHI increased. 

Based on older results I noticed clusters of OAs that led to the pressure maxing out at 16 and me waking up. I adjusted my pillow height and now I am seeing in the OSCAR data less clusters of OAs but that my pressure maxed out still and was going up to 16 until I eventually woke up.

Based on this does anyone have any insight or suggestions as to what I should do? Should I increase my pressure range? 

   

[Crimson Nape]

ceezee - Therapy Thread - All 3 of your threads dealt with your therapy and questions surrounding it. For that reason, I have merged them so all your information is located in a central location. Please keep all further posts dealing with your therapy in this thread.

- Red

[BoxcarPete]

I would recommend eliminating ramp, or at the very least increasing the ramp pressure. The 4cm H2O machine minimum pressure is insufficient to properly provide for your respiratory needs due to the way it has to pass through all the bits and pieces before getting to you, and at that pressure the machine can't provide you enough volumetric flow at such a low pressure. I say this looking at your early night breathing and from my own experience with similar respiratory stats, and I am confident that you'll be better off without it because you mentioned earlier that you hardly notice the mask at all. Ramp is meant for people who have trouble falling asleep because of the way the pressure affects their respiratory process or have really high pressures that are uncomfortable to shoot up to immediately.

As for your positional issues, it can be a tough one to track down the true root cause. Some try a collar, get a lot of benefit from it, and just go with it. Others need to dig a little deeper. I believe a few members here have found it useful to record themselves sleeping and check out the footage from clusters of events to see what's going on.