[CPAP] xirokx - Therapy Thread

[xirokx]

hi there 

Just wanted to check in and let you know I am gradually increasing my min pressure, currently at 11.2 will try 11.4 next.

I had a leak the other day otherwise its going well.

Can you see anything else I may need to change to improve anything?

Thanks so much

[G. Szabo]

You were hitting the 13 cm maximum pressure setting. I suggest increasing it to 14 cm.

Your current AHI figure is driven by CAs, which have been highly irregular. A while ago, based on your testing figures, I concluded that your CAs are not affected by the EPR setting. Nevertheless, you can give it a try again at this higher pressure and turn off the EPR to see the outcome.

I figure it could be frustrating not to be able to reduce your CAs. It appears that you might want to consider switching to an AirCurve 10, which would allow you to better control your ACs.

[xirokx]

Hi G.Szabo

5 days ago I did as you suggested increased max pressure and switched off EPR.

Since making these changes I am waking up with a dry mouth after 5hrs of sleep so I increased the humidity to 5 without any impact and do not want to further increase humidity in case of rainout. What do you think about reducing tube temperature to 26?

If I remember correctly the last time I changed EPR I had a similar experience.

I unfortunately cannot afford to replace my machine at the moment.

What do you suggest to stop the dry mouth please?

Thanks so much I am really grateful

[G. Szabo]

Contrary to some earlier trials, this time, turning the EPR off results in fewer CAs. Hence, I suggest staying in this EPR setting.
    
For dry mouth, our members report the benefits of using Xylimelts tablets. Alternatively, you can tape your mouth (if you can tolerate it) to prevent mouth breathing. I use two 1" wide pieces taped in an a X shape over my mouth. Others use a single piece of 2" wide tape. Do not forget to fold the tape's end back so you can quickly grab and remove it if needed. Do not eat 4 -5 hours before bedtime to prevent throwing up during sleep.

You can reduce the hose temperature until you have a rainout.  

[xirokx]

Contrary to some earlier trials, this time, turning the EPR off results in fewer CAs. Hence, I suggest staying in this EPR setting.
    
For dry mouth, our members report the benefits of using Xylimelts tablets. Alternatively, you can tape your mouth (if you can tolerate it) to prevent mouth breathing. I use two 1" wide pieces taped in an a X shape over my mouth. Others use a single piece of 2" wide tape. Do not forget to fold the tape's end back so you can quickly grab and remove it if needed. Do not eat 4 -5 hours before bedtime to prevent throwing up during sleep.

You can reduce the hose temperature until you have a rainout.  

Thanks so much for your continued help and support, honestly would be lost without you

Ok I will maintain this EPR setting and see how I get on despite the day time sleepiness (maybe due to late night sleep) and dry mouth. 

I will reduce the hose temperature  to 26 and keep humidity at 5, if I get rainout without dry mouth I will try reduce humidity. Is that correct?

My sleep clinic mentioned trying nasal pillows after jt septorhinoplasty surgery to reduce dry mouth, what are you thoughts about that? Will it just result in a very dry nose? 

I've heard of xylimelts and they're really expensive here in the UK. 

I also heard of mouth taping and may try that

First let me try reducing hose temp see what effect that has and then I'll try mouth taping if required.

It's reassuring to note my CAs are lower since EPR is off. What are CAs and why are they so relevant anyway? I think I ought to have asked this ages ago ?

Thank you I really appreciate your help

[G. Szabo]

You can find some details about EPR on this link
Can someone explain how EPR reduces flow limitation?[color=rgba(0, 0, 0, 0)] ( [/color]1 2 3 )

It would be best not to reduce humidity, but you can try decreasing the hose temperature to combat dry mouth. 

A dry mouth does not necessarily mean that you will have a dry nose. Some people have nasal congestion at high humidity, while others have congestion at low humidity. 

The mouth taping is worth trying. It also reduces your AHI. 

I switched from an FF mask to a nasal one and never regretted it. However, it can be an expensive option because you might need to test different models.  

[xirokx]

You can find some details about EPR on this link
Can someone explain how EPR reduces flow limitation?[color=rgba(0, 0, 0, 0)] ( [/color]1 2 3 )

It would be best not to reduce humidity, but you can try decreasing the hose temperature to combat dry mouth. 

A dry mouth does not necessarily mean that you will have a dry nose. Some people have nasal congestion at high humidity, while others have congestion at low humidity. 

The mouth taping is worth trying. It also reduces your AHI. 

I switched from an FF mask to a nasal one and never regretted it. However, it can be an expensive option because you might need to test different models.  

thanks so much

when you say nasal one do you mean

a) pillow mask p10 or b) N30i nasal mask 

As I have been offered to try one so wondering what in your opinion is the best option for me to trial?

Also do I have to change any settings in the machine?

Thank you

[G. Szabo]

The P10 mask has an unheated connection tube where water condensation can occur, which is not the best option at high moisture. It is also not the best for side sleepers, but I have not tried it yet. 
I have good experience with the Ni30. It is easy to attach/ detach, and it fits well to the head. It is perfect for side sleeping. The Philips Dreamweaver under-the-nose mask is very similar, and its cradle nose piece is superior to the Ni30, but it does not sit so well on your head. 
If you switch to these masks, you should change the instrument setting to PILLOWS.

[xirokx]

thanks so much I am so grateful to you, I cannot thank you enough

I will ask if they will let me trial a N30i mask