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+--- Thread: Another new guy... (/Thread-Another-new-guy)
RE: Another new guy... - UnicornRider - 03-14-2025
TnG80, When I saw your SpO2 in your posted sleep report, I decided to call in the most knowledable experienced forum members.
Several years ago my family caught a nasty respiratory illness, all four of us lost our respiratory drive, my mother ended up on supplemental O2, the rest of us ended up wearing a Pulse/Oximeter that has alarm function to remind us to breath. Otherwise we would have to have supplemental O2 throughout the day.
At that time my SpO2 looked better than your lab report, I could not believe they let you walk out of there. When we showed up at the doctors office they made a big stink about all of us walking around without supplemental O2. After I showed the doctor the functioning of the Checkme O2 Max wrist worn Pulse/Oximeter and how the alarms reminded us to breath, she hesitantly allowed three of us to walk out, with a serious warning to strap on supplemental O2 if we could not keep our SpO2 above 90%. If our SpO2 level dropped to 88% we were to strap on supplemental O2 and head to the emergency room.
Follow Sleeprider's setting advice: Mode Vauto
IPAP max 25.0
EPAP min 16.0
PS 4.0
Trigger Sensitivity Very High
In addition I would like to see you eliminate Ramp as soon as possible, you receive no therapeutic value from the ramp feature. You should be able to cut Ramp Time to 15 minutes and gradually reduce Ramp Time with the expectation you will turn it OFF in the near future.
Most adults feel starved for air at any pressure less than 7 cmH2O, your Ramp Pressure is currently at 4 cmH2O, I would like to see that raised to 7 cmH2O for the duration that you are using Ramp.
So now the Machine Setting should look like : Mode Vauto
IPAP max 25.0
EPAP Min 16.0 PS 4.0
Ramp Time 15 minutes
Ramp Pressure 7,0 cmH2O
Trigger Sensitivity Very High
As for the Aerophagia, Hopefully changing mode to VAuto will allow the machine to only apply the pressure necessary to provide relief, thus reducing the degree of aerophagia. No guarantees on that issue.
With weight loss, you may find that you need a different mask to seal properly. watch your leak rate, it will guide you. With major weight loss your PAP machine setting may need some adjustment. Seasonal allergies and respiratory illness also result in me adjusting my therapy settings. Once you get your machine dialed in these adjustments are minor adjustment but the results can be amazing.
PAP therapy is a life long journey, as you age your therapy needs will change. You have a positive mental attitude towards improving your life, that is very important in making PAP therapy work for you.
Review the information in my signature,
As always any questions, concerns or comments, please post back.
RE: Another new guy... - TnG80 - 03-14-2025
Settings are updated, reduced ramp to 5 minutes though. I'll suck it up and deal with it.
Surprisingly, during waking hours my sp02 is normally 99ish. Even after 30 years of smoking. I went to the hospital for a possible DVT (it wasn't...) and on their meter it bounced between 98 and 100.
As far as leakage, any suggestions for a mask for beards? I spent 23.5 years of being told how to dress, cut my hair, and shave. Shaving my face is currently a non-negotiable. I feel like my masks wouldn't leak so much if the pressure wasn't as high. I really have to crank them down on my face.
RE: Another new guy... - SarcasticDave94 - 03-14-2025
Have you tried any other mask types than full face? The nasal pillows and nasal masks would not be hindered by facial hair.
RE: Another new guy... - TnG80 - 03-14-2025
I can't breathe through my nose... well, barely able to anyway. Been like that for as long as i can remember. Nasal strips help, but i cant wear them for more than a couple nights. I thought it might be better after I quit smoking, but it isn't. Might need to see an ENT.
RE: Another new guy... - TnG80 - 03-15-2025
Wow...I am blown away for your assistance. Exactly one night with these updated settings. Please keep doing what you are doing (all of you that helped me or others.) I'm going to give it a few nights and get back you.
Oh, and according to my watch, min sp02 was 92. My watch seems to be a few points lower than the finger pulse oximeter, so I will take that as a good sign
RE: Another new guy... - Sleeprider - 03-15-2025
Somebody really screwed the pooch when they setup your machine. It actually appears the pressures were right, but they missed the mode. This is exactly what I expected to see. Tidal volume median at 640 is excellent for an ex-smoker. This is an error they need to be told about, or it will happen to others. Now that we see the pressures set the way they were intended, you may be able to back-off on very-high trigger to high, and you can choose what is most comfortable. Your residual 95% flow limit is 0.14, so let's increase PS to 5.0 to tame that a bit. and let's titrate the EPAP min down to 15.0. Leaks are an issue here, what mask are you using?
RE: Another new guy... - TnG80 - 03-15-2025
Using the F20 with silicone mask. Tried the memory foam and cant get it to work. I also have an f40, but i leak more with it. Full beard.
I am pretty sure I need to adjust the masks now that the pressures are different. With the "ventilator" setting, i had to really crank the mask down to get it to seal.
Side sleeper mainly but roll to my back sometimes. Using a coop pillow with the shoulder cut out. Most comfortable pillow ever.
RE: Another new guy... - SarcasticDave94 - 03-15-2025
Maybe take a look at the mask I've recently used, the Fisher and Paykel Evora Full hybrid. It's seeming to be as minimal as you can get while being full face. It is a hybrid, meaning the lower half is like a full face, the upper is a nasal cradle. There would be 3 sets of straps to adjust, lower and upper face for tension, then overhead for positioning.
RE: Another new guy... - TnG80 - 03-20-2025
Updates over the last few days
I switched to the f40 mask on the last two days, not sure why my F20 was leaking so much on the previous 3 days.
Any insight?
Thanks!
RE: Another new guy... - TnG80 - 03-22-2025
Heres a couple more. SPo2 has been above 89....