David Results - Request Feedback

[parkdj808]

Hi all,

I have completed 3 nights with my new machine:

Night 1: EPR 3, had some CA events
Night 2: EPR 1, lowered CA events
Night 3: EPR 1, AHI and CA events rose

Resmed Airsense 10 Autoset
Mask: Resmed AirFit N20 (nasal)

I have not felt strong benefits from the use of the machine yet.  I normally sleep around 9 hours but have been aware of the mask and noise which makes it harder for me to stay asleep. Hopefully I continue to get more and more used to the equipment where I am not conscious of it. 

Would love your feedback. Should I continue on with the same settings and get more data or??

Thanks!
David

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[CorruptAlligator]

Looks fine. You can raise the minimum to 7. And it sounds like your are aware of EPR and CA relationships.

Do you start sleeping on your back? If it possible to to start sleeping on your side? If you are sleeping on your back, sleeping on the side can lower the machine to react with such high pressure. Autoset reacts to flow limitations, and peaks the pressure accordingly.

And if you are having issues with leaks from the hose getting on your way, get something to hold your hope up in the air.

You can try to mask the noise with white noise.

[Gideon]

Welcome to the forum.
In Night 1 your effective EPR was all over the board because your min pressure was less than 7, the min for use with EPR=3, Look closely and you will see that you had more CA events at higher levels of EPR than at lower ones.

Night 3 I can see irregularities in the flow rate that often indicate an awake state, especially at the start and end of that night. Id have to see a 3-5 minute view but If you were awake those central were likely just you holding your breath while tossing and settling in making them SWJ or Sleep Wake Junk. This is very common.

[parkdj808]

Thank you both!

I will adjust minimum pressure to 7. Should I continue with an EPR of 1?

I think that I am getting mouth leaks.  Mouth is dry even with humidifier on 5. Maybe need a heated tube?

I think you're right Gideon about me possibly being in an awake state at beginning and end of night. I have attached some zoomed in views.  Not sure if this was the correct method to provide 3-5 minute views.  Please advise if there is a better way for me to provide this information. 

Thanks!

[Gideon]

Set your min to 7, and EPR=2
All of the zoomed views show heavily flow limited breathing, and at least some awake breathing in all 4. One of them shows typical CO2 apneic threshold breathing so you will be a balancing act. Based on these zooms and the flow limits I want you to use EPR of 3, but let's try EPR=2 for about a week first. I want your body to get used to, and compensate for, lower levels of CO2 in your blood.

The quick nutshell is that it is the need to remove CO2 that provides our drive to breathe, yours is on the low side with CPAP so we want to help you adjust. This is not a problem, just something we want to keep an eye on.

[parkdj808]

Ok I will adjust to min to 7 and EPR=2

Report back tomorrow with new daily result?

[parkdj808]

Hello all,

I adjusted my minimum pressure to 7 and EPR to 2.  
I also taped my mouth closed which I guess helped with the mouth leak?

But I felt really groggy when I woke up this morning.  

I guess this is a constant balancing act to get me to the right place. I appreciate anyone's time to read my charts and try to help me get to good sleep.  
Thank you Oscar Team and Friends!  

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[Gideon]

You are on a range where you need to subjectively see if current settings are better or worse than the night before. I don't want your numbers to on any way prejudice your answer either way. The answer should be of the form,. "the previous/current settings feel better because. Then you can look at your numbers. And post your results.

To improve how you feel increase your min pressure to 8, no other changes. Still want to go to EPR=3, but just not now.

[parkdj808]

The last two wake ups have not felt great but this morning was probably a little worse. But neither felt good. 

From leak rate data, assuming I am mouth breathing and that taping my mouth last night was helpful??

Will adjust to min pressure 8 and keep EPR at 2. 


Thanks!

[parkdj808]

Updated results with min pressure at 8 and EPR at 2.
I taped my mouth shut again to stop mouth leaks...any feedback regarding the leaks?
Love to hear your thoughts on my latest results and any suggestions. 

I have to say that I do not feel very rested still.  I tend to wake up very early in the morning due to being conscious of the machine and then go back to bed, when normally without the machine I would not wake up really early.

Thank you!

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