AirSense 11 Hard Exhale Transition On All Settings

[BrianL]

Hi, I cannot find a comfortable inhale/exhale transition and have chest pain after using the machine in the morning and or after a nap.  Basically right as I transition to exhale I feel immediate back pressure which takes work to “push” out the air (I feel like I am only able to exhale about half volume) - this happens on every setting I can think of on the airsense 11.  I have the mode on auto set.  I’ve tried the autoset response on standard and on soft - can’t tell a difference.  I have tried pressure range from 4-15, and tried 7-10, the EPR is on full time, I’ve tried EPR levels 1, 2 and 3.  I have tried auto ramp up and without ramp up.  I have the AirFit fF30i full face mask which fits perfectly, no leaks, good airflow.  Climate control and tube temp are on auto.  I'm 6'3", 205lbs, 39 yrs/old, physically fine (other than being sleep deprived) but having some trouble.
Any ideas??
Thanks much   

[OpalRose]

Hi Brian,
First thing to do is download the OSCAR software. Be sure there is an SD card in your Cpap. It must be in your machine while you're are sleeping.

It seems you've made a ton of pressure changes that aren't working for you. In order to advise you better, we need to see is a Screenshot from the Daily Page. Follow the link below in my signature line on Organizing your chart.

Take a Screenshot using the F12 key, then post here for evaluation. Use the Attachment Feature.

The graphs we need to see: Events, Flow Limitation, Pressure, Leak Rate, and Flow Limitations.
Include the left sidebar, but remove the calendar and pie chart.

Until we can see some data, I suggest you use 7cm minimum pressure, and 15 maximum with an EPR of 3.

Also, if you had a sleep study and have a copy, post it here.

[BrianL]

Alright. Thx - I'll work on getting this data.

[multicast]

For how long have you been using your machine? A muscle soreness is typical at the beginning of the therapy.

[BrianL]

Okay, here's last night's Oscar data attached.

This is the rest of the left side bar data which did not fit the screenshot https://prnt.sc/FrKJtshGPDxA  

Also, here are the sleep study lab report links:
https://prnt.sc/riXUQqqWE6aE
https://prnt.sc/AB6SYTv0RghQ
https://prnt.sc/XSSX1YT3g-lW
https://prnt.sc/RhI_TrY3b8dH
https://prnt.sc/5Fe2fykn9APe

Thanks very much.

[Gideon]

You are having some positional issues, do the problems you are talking about occur at the times you see the clusters of obstructive events?

Do these clusters appear frequently or are they just a one time thing?

If they are occuring with any regularity you need to address them. This could be as simple as using 1 vs 2 pillows or a flatter, less firm pillow. If not you are a candidate to use a soft cervical collar to resolve the issue. Basically it occurs because you are tucking your chin to your chest. Read the wiki on cervical collars in my signature and the wiki on positional apnea in that article.

[Sleeprider]

The pattern of positional clusters of obstructive apnea and hypopnea were also evident in the sleep study hypnogram.  You can read more about how this pattern is identified and tested here http://www.apneaboard.com/wiki/index.php...onal_Apnea

[SevereApnea]

Hi BrianL welcome

The only thing I can add is that I struggled with F30i and other FFMs during 2020/2021 for exactly the same reasons.
Chest pain, palpitations, headaches, air hunger, air starvation etc. Even landed up in hospital from the chest pains etc.

All resolved after switching back to nasal masks. I prefer the P30i over the N30/N30i.

With good head/neck/pillow position and soft cervical collar my required pressures are way down.

My personal theory (and it is only a theory) is this.

With the F30i I would switch between nasal breathing and mouth breathing (indeed that was part of the attraction of the mask: I could switch to mouth breathing when I got nasal congestion). I suspect that what happened was that when I started off with nasal breathing, flow limitations or nasal congestion led to Higher Flow Limits, which pushed up the pressures, then at some stage during sleep the body bailed out of nasal breathing and switched to mouth breathing, for which the pressures were too high. I never could find a way to control this. 

Have you tried a nasal mask/cushion/pillow?

Don't know if this applies to your situation, but I thought I would just throw this out there.

Your flow limits and pressures are not too bad but on the chart you posted your leaks could be better.

[BrianL]

Thanks for the info. 
Here's last night's data for example attached.  I was only able to use the machine for about 4 hrs, chest pain progressively got worse and I had to turn it off.  Today chest pains are pretty sore from last night, worse than the night before.  I'm only a few days into using a cpap machine.  I have a very flat pillow and last night I worked on keeping my chin up at all times.  
I breath through my mouth all night - a nasal pillow wouldn't work for me would it?

---

The pattern of positional clusters of obstructive apnea and hypopnea were also evident in the sleep study hypnogram.  You can read more about how this pattern is identified and tested here 

Thank you, that is good info.

[BrianL]

You are having some positional issues, do the problems you are talking about occur at the times you see the clusters of obstructive events?

Do these clusters appear frequently or are they just a one time thing?

If they are occuring with any regularity you need to address them.  This could be as simple as using 1 vs 2 pillows or a flatter, less firm pillow.  If not you are a candidate to use a soft cervical collar to resolve the issue.  Basically it occurs because you are tucking your chin to your chest.  Read the wiki on cervical collars in my signature and the  wiki on positional apnea in that article.

Hi, I've only been using the machine for a few days and last night's data is attached.  My difficulty breathing and exhaling feel like they happen the whole time I'm hooked up - along w/ chest pains which got so bad after 4 hrs of use last night I had to quit.   Today the chest pains are pretty bad at the esophagus down to mid/lower chest.  I do use a very flat pillow and last night made a point to keep my chin up.  Anyway, let me know what you think.  Thanks.  The collar wiki info and positional apnea read was good.