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[Diagnosis] 2.5 years trying to figure this out.
#11
RE: 2.5 years trying to figure this out.
Stacyburk, thanks for taking a look and the recommendation of trying a high setting for the trigger.
I should have joined this group a few years ago.

Staceyburk, thanks for taking a look and chiming in on the trigger recommendation.
I should have joined this group years ago.
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#12
RE: 2.5 years trying to figure this out.
Let me know if you need me to go another night or two at these settings. 
Last night I woke up after 5 1/2 hours and could not get back to sleep. 
I try to stay on my side but catch myself on my back quite a few times during the night. 
The AHI ( if it means anything) is higher than ever. 
This full face mask is definitely doing much better on the leak rate. I have always had massive leaks with the nasal pillow mask and taping. 

Thanks again for your help and time!


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#13
RE: 2.5 years trying to figure this out.
Unfortunately woke up again after only 5.5 hrs again and could not get back to sleep ( 2nd night in a row). I also tried my F30i and had masive leaks so I'm going back to the F20 tonight.
Hopefully I can get you a better report tomorrow.


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#14
RE: 2.5 years trying to figure this out.
First things first, please read the link in my signature “Formatting OSCAR Charts”. It will be helpful to have everything on one screen. We don’t need to see the calendar or pie chart, but the complete left-hand table is important as well as the main charts listed in the link. 

I see a few things going on. First is the clear airways, which as Stacey suggested you can reduce by increasing the trigger sensitivity. I prefer not to increase it right away as sometimes finding the right pressure can help reduce them. In your case I would set trigger to high.

For the new settings I suggest as a starting point

Mode APAP
EPAPmin 9
IPAPmax 15
PS 4
No ramp
Trigger high

One other option is increasing pressure support, but one thing at a time. If you want to try more PS, go up in 0.2 increments. A little bit goes a long way.


Regarding sleeping position, ending up on your back is not terrible if you are getting a good nights rest. I have to use a shoulder wedge pillow and frequently end up on my back, but because of the wedge it does not seem to create any problems.

For the mask, stick with the F20 for now. The F30i works well for some, but I never could get it to work for me. I currently use an F&P Evora full-face mask and also am experimenting with the ResMed F40. With a full beard both seem to work well, though I do get occasional leaks. I don’t worry about them as they are not waking me up and I am not going to shave, so I just ignore the occasional large leak.

I have tried nasal pillows and Bleep dreamports/eclipse, but I am a mouth breather at times and I never liked taping and find soft cervical collars uncomfortable if used too much. If you want to find out more about nasal pillows and taping, create a new thread and folks will jump in with advise.
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#15
RE: 2.5 years trying to figure this out.
Happy Halloween!
Let me know if I need to do anything different on the Oscar format but I think I got it corrected. 

I'm confused on the mode. You said to move to APAP. I just see S mode on the Aircurve but I think my other machine Airsense 10 as apap.

I think most if not all of my centrals are caused by being awake or rolling over to my other side. I can send more zoomed in screen shots if you would like.

Definitely staying with the FFM F20 for now unless I start swallowing air and getting stomach aches but everything is good now in that category. 

I thought the bleep was going to be worth the trouble but between taping my mouth with three pieces and the putting on the halos; that's what drove me back to the FFM and it has been really nice to just jump in bed and slip on the FFM. 

So yeah, just wondering on the mode (APAP) and if for sure we should try the high trigger if I have a hunch the centrals are not all centrals. I am sending a screenshot of an obstructive that has some flattened breaths before it happened. I think  Dont-know for me there is a big difference if I role on my back and probably need more pressure if I do that but I don't know. 


Thanks!


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#16
RE: 2.5 years trying to figure this out.
Sorry, that was a typo. Still mentally recovering from being unwell. 

Mode VPAPauto
EPAPmin 9
IPAPmax 15
PS 4
No ramp
Trigger high
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#17
RE: 2.5 years trying to figure this out.
Happy day after Halloween,

You probably want to see a few days at the new settings but I thought I would post this Oscar from last night with the min at 9 and the trigger set on high. 
This is the 3rd or 4th day in a row that I have been waking up after only 5 or 5.5 hours and can't get back to sleep which is unusual for me. Probably not cpap related but I thought I would mention it. 
 
Have a great day


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#18
RE: 2.5 years trying to figure this out.
Any issues with the pressure you did not mention? I ask because I think we need to increase the pressure a bit to deal with the OA/H events. I don't want to push you into problems with aerophagia or other discomforts.

To wit, try the following.

Mode VPAPauto
EPAPmin 10
IPAPmax 16
PS 4
No ramp
Trigger high

If you are fine with the higher pressure, then we can continue down this path for a bit. If there are any issues we can try something completely different.

I am hoping over time we can reduce the pressure a bit as you get used to things. But we need to find the balance point first.
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#19
RE: 2.5 years trying to figure this out.
No problem with aerophagia yet.

I do need to tighten the mask more so this morning I had a pretty good red mark on the nose between the eyes. 
I'm going to place a small piece of tape over that area every night and hopefully that will prevent that from happening again.

I don't like the idea of wearing something else but do you think there would be any benefit to trying a soft cervical collar to keep my neck straight while sleeping for better air flow down the windpipe?


I will try those new setting tonight and let you know how she goes.

Thanks for hanging in there with me. 
Really appreciate the help.
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#20
RE: 2.5 years trying to figure this out.
Well, on a positive note the tape between my eyes saved my nose from the F20.

I woke up again and was hoping it was morning but (once again) it was only two or three in the morning. Hope I can break this cycle tonight. 
Last night's Oscar probably will not help anything but I will drop it on here just in case. 
Have a good weekend!


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