Dalemazkour - Therapy Help

[PeaceLoveAndPizza]

First, please read the link in my signature “Organise your OSCAR Charts” for the proper formatting. It saves a lot of questions and repeated posting of information.

It would be helpful to see the entire night, not just a zoomed section. Always start with the full night and if anyone wants to see something in particular they will request a zoomed in view.

My opinion is those settings are not doing anything to help you. I suggest trying the following settings:

EPAP min 8
IPAP max 15
PS 4 full-time
No ramp
Trigger med

From there we can tweak as needed. Also, look into the pillow and soft cervical collar. Between getting a reasonable starting point for settings, a flatter pillow, and a soft cervical collar, I hope things will start falling into place.

[PeaceLoveAndPizza]

Moderators: Please merge both Dalemazkour threads into one. 

[Crimson Nape]

Dalemazkour - Since all your threads deal with your therapy, I have merged them into one. This provides the reader a central point for your history. At the same time, it prevents cross posting. Please use this thread or all your posts that are about your therapy. To be more inclusive, I have renamed the thread title to, "Dalemazkour - Therapy Help".

- Red

[Dalemazkour]

Thanks I just ordered the flattest pillow I could find. I will try your settings tonight and let you all know. Just curious why the other moderator thought highest trigger setting would be most applicable but it’s medicine and my wife is in the OB part of it. She always states we practice medicine it’s not an exact science. Thanks

[Dalemazkour]

Last night was a success that I actually had the whole face mask on my face for over 7 hours! First time ever over 2.5 hours but the mask did slip down a few times during the night but was still covering my mouth. I wanted to see based on settings from yesterday that I was if you would adjust anything else as AHI is high but 75 percent less than the Inspire device which I averaged 97 AHI after last sleep study!  Please let me know and I am also waiting on my flatter pillow to come in to help with obstruction as well.

[PeaceLoveAndPizza]

Glad you felt like things are improving. There is still a long way to go, but one step at a time.

I’m going to back away from my previous suggestions now that I can see the entire combined thread. Given that with pressure support of 5 you still have significant flow limitations. You need more pressure and pressure support than you have currently configured. Maybe something like:

EPAP min 10
IPAP max 20
PS 6
Trigger med or high

In the 7 hours you used your machine last night, you had significant leaks (aka large leaks > 24 l/min) for almost 50% of the time used. That has to be corrected. Either you have a leak on your humidifier and/or seating it, leak from your hose or mask, or the mask if just not the right size for you. 

What make, model, and size mask are you currently using? Do you have any others and if so what make, model, and size are they? 

I think you need to use a soft cervical collar as the events are clustered and look like chin-tucking. Read this wiki page for more info. 

https://www.apneaboard.com/wiki/index.ph...cal_Collar

Please read the link in my signature “Organise your OSCAR charts”. Seeing the complete picture would help.

[Dalemazkour]

I took you advice and it seems we are the right track! Almost five 5 hours last night which I am really trying to get use to it and keep it on the best I can. I tried to also strap it down more which is not the most ocmfortable feeling but let me know if I need a different mask. I have a medium and large size full mask but can get whatever I need to get this going long term and have efficacy with the device. Please see last nights data and let me know what other tweaks you would make at this point. Pillow and collar were ordered and I am hoping I will be able to use as I love my current pillow. lol

[PeaceLoveAndPizza]

Getting closer, but still a ways to go...

What make, model, and size mask and headgear did you wear last night?

And for the third time, please read the link on "Organise your OSCAR Charts" and post accordingly. It will help quite a bit being able to see events, flow rate, pressure, leaks, flow limitations, and snore, on a single page.

[Dalemazkour]

I apologize about the data and the way I have been formatting. It’s not the most user friendly for someone who isn’t tech saavy. I will go back and read again and try and post in a way you can see everything as you guys are literally saving lives. 

Resmed medium full face
F20 head gear not sure on size 

Prior I was wearing the large mask and was told to try a different mask and that what I had on hand.

[PeaceLoveAndPizza]

No worries mate, I am equally a Luddite. It took me weeks to figure out how to click, drag, resize, and move things around. The good news is once you get it set up OSCAR remembers the formatting. Just a pain in the bum to get it set up the first time.

Medium with standard headgear is probably the right size, but it may be the wrong mask for you. Years ago I fought with the F20 for a few months before someone told me it was likely the wrong mask for me. I switched to the F&P Evora would solved the problem as it fit my face better. This is the worst part of figuring it out as you have to go through a few lemons to find the right one. 

If you have not done so, watch some of LankyLefty27’s YouTube videos on mask sizing and proper adjustment. They helped me quite a bit.

Good luck with the new pillow and collar. I hope they help you quite a bit as they did for me and others.

I appreciate your patience and willingness to help us help you.