[CPAP] Newbie looking for help/opinions please!

[buckrogers76]

The chart above consistently shows flow limitations and snores associated with OA clusters.  So we are dealing with obstructive apnea.  If the collar is not working, then higher pressure, and specifically EPAP pressure is needed.  I suggest removing the limit of 17 from maximum pressure and allow the machine to move up to 20 as needed.  If OA continues, then your only remaining tool is to start reducing EPR.  I hope a better cervical collar will help, but I'll at least say you're not alone in needing high pressure to resolve apenea.  Bonjour, another member here uses a bilvel at pressure up to 24 cm.

Bilevel machines are capable of higher pressure up to 25 cm.  They provide the equivalent of EPR, but it is not limited to 3-cm, so there are separate EPAP and IPAP pressures, or in auto mode, a minimum EPAP and pressure support.  CPAP is a fixed pressure variation of the auto CPAP. The traditional CPAPs did not offer much exhale pressure relief, but all machines seem to do this to some degree for comfort.  In your case, you may simply need to reduce the EPR setting, effectively raising EPAP.

Hi folks

Another mixed night of CPAP under my belt , carried out the amendments as suggested by sleeprider and the charts posted from SH below show a reduction in OA so some progress. Still a very disruptive night with lots of turning and the min pressure feels quite intense!

Whats my next move now? leave as is and go again or bring the EPR down to 2 and reduce min?

Yours Anticipating

Buck



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[buckrogers76]

[buckrogers76]

Hi again guys and girls!

I have a major concern and I'm convinced it's linked to cpap use and pressure. I've now got blurring of my left eye and dizziness. I've always had perfect vision and now writing and objects in the distance are blurred. I've noticed at night that the air from the front of the mask blows directly onto the eye(s) when I'm on my side. Has anybody suffered from this? I'm thinking I'll have to wear swimming googles or an eye mask to counter it!

Regards

Buck

[buckrogers76]

Sorry guys!

As i posted this early this morning uk time its moved right down the list , as all the US chaps are knocking about now i thought i'd bump this as I'm hopeful of some more helpful input.

Regards

Buck

[Gideon]

IMHO if this is not caused by the mask leaking and definitely blowing in the eyes I'd suggest an ENT appointment to discuss.
You do have a "higher pressure" in your airway.  Tear ducts and sinuses do have openings into this space and it is possible that this is a cause of the problem.

No mask should be venting into the eyes.  If it is a vent it should be easily moved to a different direction.

Mask leaks near the bridge are not uncommon.  These are always the result of a poor mask fit.  It is set in the wrong position, too tight or too loose, or the mask does not suit your face.

Check the manufacture videos on fitting the mask you are trying, check the fit guide, avalilable in the Mask Primer, or adjust fit, many suggestion on fit are in the Mask Primer.  
If the mask does not fit your face try a different mask.  This is IMHO the hardest part of CPAP therapy.


Fred

[buckrogers76]

IMHO if this is not caused by the mask leaking and definitely blowing in the eyes I'd suggest an ENT appointment to discuss.
You do have a "higher pressure" in your airway.  Tear ducts and sinuses do have openings into this space and it is possible that this is a cause of the problem.

No mask should be venting into the eyes.  If it is a vent it should be easily moved to a different direction.

Mask leaks near the bridge are not uncommon.  These are always the result of a poor mask fit.  It is set in the wrong position, too tight or too loose, or the mask does not suit your face.

Check the manufacture videos on fitting the mask you are trying, check the fit guide, avalilable in the Mask Primer, or adjust fit, many suggestion on fit are in the Mask Primer.  
If the mask does not fit your face try a different mask.  This is IMHO the hardest part of CPAP therapy.


Fred

Hi Fred

Thanks for the input , would you mind commenting on my charts from last night if you have a mo? should i change anything?
Been to see the doc and she thinks I've got Labyrinthitis , I've also got an eye mask to wear for the mask vent. Its the air that leaves the mask to help prevent rebreathe if that makes any sense!

Regards

Buck

[Gideon]

You are running high pressures, and your chart is calling for more pressure,  That is the exact reason I went to a BiLevel, the Vauto.  I'll add that I had an awful lot going on medically when I did.  

Keep in mind that while CPAP is Fixed Pressure and if you were at a fixed pressure I would recommend that you increase pressure.  With simple biLevel you deal with IPAP and EPAP, inhale pressure (IPAP) and exhale pressure (EPAP).  The difference is called Pressure Support.  so if I set my VAuto to an auto range of 12-20 with a PS of 3, it would be the same as you are providing with your autoset at 15-20 EPR 3.  Essentially PS and EPR are the same (bilevel allows me to set a much higher PS).

EPAP is the pressure that splints the airway.  Your EPAP starts at 12.  I'd say let's try an EPR of 1 to increase the minimum.


I see SleepRider suggested something VERY similar.


Fred

[buckrogers76]

You are running high pressures, and your chart is calling for more pressure,  That is the exact reason I went to a BiLevel, the Vauto.  I'll add that I had an awful lot going on medically when I did.  

Keep in mind that while CPAP is Fixed Pressure and if you were at a fixed pressure I would recommend that you increase pressure.  With simple biLevel you deal with IPAP and EPAP, inhale pressure (IPAP) and exhale pressure (EPAP).  The difference is called Pressure Support.  so if I set my VAuto to an auto range of 12-20 with a PS of 3, it would be the same as you are providing with your autoset at 15-20 EPR 3.  Essentially PS and EPR are the same (bilevel allows me to set a much higher PS).

EPAP is the pressure that splints the airway.  Your EPAP starts at 12.  I'd say let's try an EPR of 1 to increase the minimum.


I see SleepRider suggested something VERY similar.


Fred

Thanks a lot Fred!

Will try the EPR set on 1 tonight , would adjusting the min pressure down slightly help with me coping with the intensity seeing as the machine will auto adjust if min pressure is to low? or should i leave well alone. Might tweak the snugness of my mask swell as i could probably tolerate it a bit tighter!

Regards

Buck

[Gideon]

leave it alone, let's see what the EPR adjustment does. We are trying to raise the min pressure not keep it the same.

[buckrogers76]

leave it alone,  let's see what the EPR adjustment does.  We are trying to raise the min pressure not keep it the same.

Gotcha!