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Dalemazkour, there are two things I'd like to do. Earlier on in this thread you were using PS 6.0. I'd like to get you back to PS 5.0 because you do better with higher pressure support. EPAP needs to come up to 8.0 because your events are obstructive. Your events are also clustered, so something about the collar or pillow is not working and causing an obstruction to your throat or not maintaining a good airway alignment. In summary EPAP min 8.0, IPAP max 20, PS 5.0, trigger high, and work on the positional issues. There is no central apnea anywhere in your results, so ASV is not where you need to be.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(05-04-2024, 02:24 PM)Dalemazkour Wrote: Went to sleep doctor on Wednesday and he said that anything under 13 AHI is fine given what I was at prior. He said my oxygen saturation levels are extremely low so I added a T Tube with an o2 concentrator set at 2 liters. I was curious if you guys find this data better and also been trying to tighten the mask a little more for leaks. I did try the other mask recommended from Vitera and wasn't a big fan so this data is with the medium resmed F20 mask. Let me know your thoughts if you would change anything. I am waking up with extremely dry mouth but AHI is better than earlier this week.
Dale, I am going to cover a lot so do not feel overwhelmed. You have a lifetime of PAP therapy ahead of you. You will not get it all in one night. I have to go back and review Wiki information often. This is your thread, you will be able to refer back to this thread to review.
You have an O2 concentrator, was it prescribed for all day use, or only at night with Bi-Level PAP? What prescription level was prescribed? X.X Liters/Minute.
Who calculated your setting for use with your AirCurve 10 VAuto? At 2 liters/minute connected to your ResMed I do not think is sufficient if you have serious desaturations. Just seat of the pants, WAG.
Your leak rate will seriously degrade the FiO2(fraction of inspired Oxygen). So first of all you need to get your leak rate under control. Leaks are a demon I fought for a long time, then some one guided me to the WIki article: Mask Primer
Be sure to read everything down to "How to achieve the perfect mask fit - GUARANTEED! by Jeffy1958"
Jeffy1958 puts all of the previous information in to an easy to understand practical application. Most people tend to over-tighten their mask. His method corrected over 10 years of my using a mask wrong. At my therapy pressures with the masks that I use, his method allowed me to achieve 0.00 leak rates. Read and reread and practice his method.
Chart Organization helps the forum members help you. So I am going to recommend a couple of YT videos that a forum member "CPAP Friend" has put together, After you get your mask leak tight, I suggest wearing your mask at therapy pressure while reviewing the YT videos and Wiki articles. It will help acclimate your body to the fit and feel of your mask under pressure.
A brief personal history and testimonial. My family caught a nasty respiratory illness last September, we tested negative for Covid, Flu and RSV. But we all lost our respiratory drive. My mother ended up on supplemental O2, the other three of us, because we could respond to the audible and vibratory alarms of our Pulse/Oximeter then hyperventilate to restore our SpO2 to somewhat normal levels, it was recommended we not go on supplemental O2 unless absolutely necessary. At that time the medical staff said it could be 6 to 9 months possibly a year before our respiratory drive was restored. It has been 8 months and we are getting better, but we all wear a Pulse/Oximeter all day, short of time to download data and recharge the device.
Ratchick, a fellow forum member wrote a product review that inspired me to purchase 4 ea Wellue "Checkme O2 Max" Pulse/Oximeters when we found out we were walking desaturated zombies. I will link you to the product review where she starts with the upgraded Checkme O2 Max, you can start at the beginning of the thread to see the evaluation of the straight Checkme O2.
If you are desaturating and need an O2 concentrator as well as a Bi-Level device, the true measure of your body's response is with a Pulse/Oximeter, You probably need one. Although the Wellue Checkme O2 Max documentation says it is to be used to monitor SpO2 and Pulse during sleep, we wear ours all day unless activities of daily living makes us take it off. We do wear fingerless gloves to ensure good contact of the sensor to the finger, shield the sensor from ambient light, prevent snagging the Micro USB cable from sensor to wrist device and protect the sensor ring from physical damage.
Now for the hard dart. How to figure out your FiO2. It is not as hard as Chinese Arithmetic, but a good understanding of Cooke Book Math helps.
So the last settings you recommended I woke up about an hour later and had a major chocking attack which had never happened while having the machine on. Only happens when I dont have the mask on a few times a month like I am choked on my spit and wakes me up panicked and cant breathe. I had to adjust down to what I posted and I have ordered a Fitlife mask to try and resolve the large leaks. I have that thing strapped to my head extremely tight but I will wake up and the mask slips down off the bridge of my nose at times. I like the current settings as I am not waking up and way under 97 AHI which was my last sleep study. I feel much less tired but not sure how much benefit I am getting if its leaking so much. Last night was the longest I have been able to use the Bipap.. Please let me know.. Also has anyone else tried the Fitlife mask? Fits over the whole face..
Unfortunately, the leaks aren't controlled as they should. Going extremely tight with any mask to attempt leak control immediately indicates it's not fitting you as it should. In most cases, very tight adjustments with the mask only makes leaks worse not better. A median leak of 43, and you only might have some BPAP therapy the first 3 or so hours, then major leaks the rest of the session.
I am not familiar with the new to you mask Fitlife. But as this was the one on extremely tight, it's going to fail to help.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Agree with Dave that until you find a mask that works, everything else is secondary. If you have a CPAP store near you, go in and have them try a few masks on you. If you use a DME and they are close, go do the same.
I DO NOT RECOMMEND the FitLife Total FFM for the average user. The large surface area of the FitLife Total FFM, means for a given pressure, you will have more lifting force than a smaller mask. Therefore potentially more leaks.
The original design of headgear is no longer available, the head gear available is a little large for my small head.
I ended up wearing a knit stocking hat, stuffed with 3 or 4 hot pads from the kitchen, under the supplied headgear..
However, if you did order it and plan on giving it a try, I suggest you go on Amazon and order some "Reusable Moldable Silicone Earplugs". Then you take one or two of those earplugs and shape a fat gummy worm long enough to bridge from mid eyebrow to mid eyebrow. Then take a heavy kitchen spatula and flatten that silicone gummy worm against your forehead, to fill in that void which forms there.
That was the only area, I had real problems sealing. There again maybe my strong DNA link to Neanderthals blessed me with a more pronounced brow ridge.
Now matter which mask you end up with, do refer to the Mask Primerand follow the information down to Jeffy1958. His information puts all of the information you learned up to that point in to practical application. That really worked for me!
I don’t have the new mask yet as I had to order using my insurance but I will switch back to the large Resmed full face as I have been using the medium the last couple of weeks. Will see if that helps with the leaks.
