Dapal's Therapy Thread.

[dapal]

Hello. Newbie here, I am trying to keep things in same topic and hope that I had not interrupted any one. Had you squeezed your elbows yet? It won’t be because of my CPAP machine but my limited of English -.
I used ambient for sleep, 3-4 night a week. I was recently  given  Resmed Sense 10 Auto by Doctor. My prescription of pressure is 8 -18, start ramping of 4. Struggling after 3 first night , I followed  advice from you tube and found this forum. The advice is " The first thing you do is adjust your machine to it's lowest pressure setting...  After the first night, record you apnea for that night.  The next night, you will need to increase the pressure by 0.2.  This is negligible amount you will not notice.  Again record your apnea events for the night.   You will continue this process every night for a month or two ... "
The night before last night I did not use the pill, slept 3 hours or so. I have been following advice, increased the maximum pressure started of 5.
[attachment=25336]
 Last night, I was trying not to use the pill, start using my machine with Pressure setting from 4 to 5.6. But later I had to use a pill starting at 2:30 Am
[attachment=25337]
Please take a look at attached pictures of mine using Oscar software. I am looking for help. Am I doing the right thing of getting to used it by following the link advised on you tube? Please explain mine things in picture meaning?


Thank you very much.

[Dormeo]

Hello, Dapal, and welcome!  It will be best if you start a new thread so people will be able to see easily that there's an additional person seeking advice.  You could call it something like "Newbie Dapal seeking advice."  

I have some thoughts about your charts but think it will be best to offer them once you've got a new thread going.  Just copy and paste this same message.  One thing you might do differently: arrange your charts per the advice here before you attach them in your new thread:

http://www.apneaboard.com/wiki/index.php...ganization

[dapal]

  I was really struggling , just want to return the machine and continue use ambient and let it go. I will continue to note and take F12 screen shot, waiting for answer.

[Dormeo]

Great, here we are in your new thread -- a thank-you to Opal Rose for taking care of that!

Your AHI is good, but I can see that you are struggling. The advice you got from YouTube is not very good. Most adults feel air-starved with pressure settings as low as yours are. Also, your machine wants to go higher than your maximum, probably in response to flow limitations.

So I'd like to suggest some initial changes to your settings. Please turn off the ramp, set your minimum to 6 and your maximum to 10, and set EPR to 2. The EPR of 2 will drop your pressure by 2 when you exhale. You will probably find this more comfortable, and it may help with your flow limitations.

After a night with these settings, please post another chart so we can see what happened. Please also tell us how you felt during the night, and how rested (or not) you feel during the day. That will guide further changes.

But before you post another chart, I'd like you to make some changes to the layout.

*Please turn off the calendar (click on the little triangle next to today's date) so we can see more of the information on the left panel.

* Please stack your graphs this way:

Events
Flow rate
Pressure
Leaks
Flow limitations
Snores.

* Please fit all six of those graphs into one screenshot. You can squeeze them in by grabbing the gray horizontal bars that separate them and pushing the bars up a little.

About Ambien: sometimes it's what we need when we face a special challenge (e.g., changing time-zones), but it is definitely not a drug to be taking long-term. So you are smart to want to make CPAP work for you. That's the real solution.

[Sleeprider]

Let's get your therapy on-track for success. Please try the following settings:

Mode: Autoset
Minimum Pressure: 7.0 cm
Maximum Presure: 12.0 cm
EPR: On full-time
EPR setting: 3

This is going to be much more comfortable and effective for you. The pressure is still low and with EPR your starting exhale pressure remains 4.0 cm, but with the higher inhale pressure, you will not experience the flow limitation, respiratory effort related arousals and hypopnea that you have now. This is going to feel very good.

[dapal]

Last Night, I tried again sleep without ambient. I went to bed at midnight wake up at 3:30 Am  because of heavy noise I heard. I stopped the machine once and re-started again. It was very hard for me to close my eyes, breathing in and out by nose only but I was like  practicing yoga, counting 4,5 in out by nose to 4,5.. until 7:30 Am in the morning. Ya know kind of like you sleep but not sleep at all. cause you know what was going on in the house.

Here was my chart of last night. I hope that I took a green shot as per your instruction right.
[attachment=25358]

I will set my machine as in your post tonite and I will post tomorrow.
Thanks a lot.

[dapal]

Here is my correct screen shot per your instruction of last night.
   
Thanks again with your patience of a non natural English speaking .

[Gideon]

The chart is not quite right. The Stats on the left are important. Enough so that I'll ask if you have any breathing or heart issues other than 'simple' Apnea.
Your Tidal Volume and Minute Vent seem low and your inspiration time and expiration time are equal which is OK but expiration times are usually notably longer than inspiration.

See the triangle/ inverted V by the selected date? Click that to remove the calendar.

[dapal]

    here is the right one 

[Gideon]

Turn the ramp off! at these pressures, all it is doing is hiding events that occur during the 45-minute ramp.  
ROT Min Pressure should be Machine Min (4) + EPR (2) = 6 currently
with the settings Sleeprider recommended

Mode: Autoset
Minimum Pressure: 7.0 cm
Maximum Presure: 12.0 cm
EPR: On full-time
EPR setting: 3

Min pressure = 4 + 3 = 7