Abdulfakih - Therapy Thread

[Abdulfakih]

I just looked over all the zoomed in images.  Very thorough.  Thank you very much.  

The H's are almost gone with VAuto's increased pressure support.  But a lot of CA's now.  Some CA's occur individually, but a lot of your CA's are grouped together also.  

You already have "very high" trigger setting - this is best to stop CA's.  It will help start the inhale with the least amount of effort on your part.  

You might want to try these settings for a few weeks and see if you "adapt" to it and the CA's decrease or not.  


If the CA's don't decrease, you may be headed to ASV IMO.  

If Sleeprider sees anything I missed, he will post.  He has been doing this a lot longer than me.

Omg I am so dumb! I showed you the wrong day of data! I apologize the tiredness is messing with my head, let me show the correct one

[Abdulfakih]

I just looked over all the zoomed in images.  Very thorough.  Thank you very much.  

The H's are almost gone with VAuto's increased pressure support.  But a lot of CA's now.  Some CA's occur individually, but a lot of your CA's are grouped together also.  

You already have "very high" trigger setting - this is best to stop CA's.  It will help start the inhale with the least amount of effort on your part.  

You might want to try these settings for a few weeks and see if you "adapt" to it and the CA's decrease or not.  


If the CA's don't decrease, you may be headed to ASV IMO.  

If Sleeprider sees anything I missed, he will post.  He has been doing this a lot longer than me (most of what I have learned is from him).

This is the correct link https://imgur.com/a/p8cdUya

[Jay51]

To reduce the H's pressure support is increased in the VAuto.  No need to rush.  Small increments of maybe 0.2 per night or per 3 or 5 nights or so; then increase another 0.2 if necessary, and so on until H's are under control.  Hopefully no CA's begin to appear with the increased pressure support.   

Also, you could try a few positional apnea techniques if you want to as well:  lowering pillow height, side sleeping instead of back sleeping, and a soft cervical collar.

[Abdulfakih]

To reduce the H's pressure support is increased in the VAuto.  No need to rush.  Small increments of maybe 0.2 per night or per 3 or 5 nights or so; then increase another 0.2 if necessary, and so on until H's are under control.  Hopefully no CA's begin to appear with the increased pressure support.   

Also, you could try a few positional apnea techniques if you want to as well:  lowering pillow height, side sleeping instead of back sleeping, and a soft cervical collar.

Okay perfect.

I will start increasing PS accordingly and will try to use a different pillow. I am currently using one of those cervical pillows (the ones that have the shape of the neck) and is memory foam but I can try a lower one.

Thanks man

[Abdulfakih]

To reduce the H's pressure support is increased in the VAuto.  No need to rush.  Small increments of maybe 0.2 per night or per 3 or 5 nights or so; then increase another 0.2 if necessary, and so on until H's are under control.  Hopefully no CA's begin to appear with the increased pressure support.   

Also, you could try a few positional apnea techniques if you want to as well:  lowering pillow height, side sleeping instead of back sleeping, and a soft cervical collar.

Good Morning guys, id like to share my experience in increasing 0.2 in PS.

The graphs: https://imgur.com/a/thNwyaM

How I am feeling:

For some reason I am waking up demolished, like a truck ran into me. I remember waking up at like 4am and felt so tired and bad that I took the CPAP off. I am looking at the grapgh but my AHI is normal...

Another thing id like to mention is that I get the feeling sometimes that my lungs are "tired" of using the cpap sometimes.

All in all, i feel horrible and it is visible on my face this morning lol.

[Abdulfakih]

Also now that I am thinking about it, I also had a sensation during the night where my throat was completely dry. So much that I remember I was struggling and wokeup because of it

[Sleeprider]

Leaks may account for the dry throat. There comes a point in time when if the respiratory events have been resolved, we need to start considering the lack of satisfying sleep probably comes from something else. Without some kind of sleep study, video recording of your sleep or other investigation, it is very hard to suggest solutions.

Please try to include the summary data in the left column without the monthly calendar. I think you can move PS to 3.4. If you haven't done so already, get rid of that foam cervical pillow. I have seen them make positional matters much worse. I see some repetitive flow limitation followed by arousal. This is the cause of your fatigue and we need to resolve it. Seem images below:

[Abdulfakih]

Leaks may account for the dry throat. There comes a point in time when if the respiratory events have been resolved, we need to start considering the lack of satisfying sleep probably comes from something else.  Without some kind of sleep study, video recording of your sleep or other investigation, it is very hard to suggest solutions.

Good Morning Sleeprider, I do have a sleepstudy, 3 actually;

First sleep study: https://imgur.com/a/1KITrd8 they suggested me to use cpap

 second sleep study (I did it after the titration study to confirm): https://imgur.com/a/pv6ByUC suggested me to try antidepressants and that cpap isnt needed as much

Titration study (it was meant to be only titration but they did a study half night without cpap and half with cpap) : https://imgur.com/a/q2Ms2WF told me to do cpap

[Abdulfakih]

Leaks may account for the dry throat. There comes a point in time when if the respiratory events have been resolved, we need to start considering the lack of satisfying sleep probably comes from something else.  Without some kind of sleep study, video recording of your sleep or other investigation, it is very hard to suggest solutions.  

Please try to include the summary data in the left column without the monthly calendar. I think you can move PS to 3.4.  If you haven't done so already, get rid of that foam cervical pillow.  I have seen them make positional matters much worse.  I see some repetitive flow limitation followed by arousal.  This is the cause of your fatigue and we need to resolve it. Seem images below:

Hi again Sleeprider,

I think I nailed it this time with the calendar thing https://imgur.com/a/C93BoVP . Regarding the pillow, I changed it to a different one last night, I used one that is very thin. It isnt as rigid as the last one but it is thinner. Any recommendations on which to use?. The PS i had in there was 3.2, but I will increase it to 3.4.

Regarding the comment about the arousals and flow limitations, how do I deal with that? If I am completely honest, I am currently having to tighten the mask too much onto my face to prevent the leaks. I have the impression that it can perhaps be counterproductive in terms of breathing properly, however If i dont tighten it up to that level, it will leak from the nose bit upwards or into my eyes, which is annoying.

[Jay51]

Abdulfakih, here are the best tips from our wiki on decreasing mask leaks: 

 Mask Primer

• Mask leak solutions                                                                                                                                                                                                                                                                                                                                                Hopefully you find something in these articles that works.  I have about 5 different masks.  There are ApneaBoard members who have tried more than even 5 to get the correct one for them.   Just saying hopefully you can optimize this mask to work for you, but if not, there are many, many, many more masks on the market with different styles.