[Diagnosis] cpap since 2 years .tired

[jeje]

           
   
I started my treatment two years ago to combat severe apnea (45/h, 25 seconds average duration).
I'm 49 years old, 1m90 108kg, smoker (sometimes I quit). my doctor prescribed me an airsense 10 with a minimum of 4 and a maximum of 12, with a basic nasal mask at first. I quickly changed to a nasal Phillips dreamwear. it fitted well but i was tired every morning.I started to complain to my doctor who offered me an operation on my mandibles which I refused (normal it's an ENT doctor). In my country the treatment is free as long as we use it, but I decide to take a dreamwear facial mask to test. lots of leaks (I think you need to have a flat face to wear this mask). After two years of telling them that I'm tired, they notice that I breathe through my mouth and prescribe me a Resmed AirFit F30 (wich is more confortable/ my face).I wake up with my head spinning, very tired and decide to switch to EPR level 3 mode, to loosen my mask and the night of the 10th is better than the other nights of the week. So I downloaded oscar and watched some explanatory videos, but I don't understand everything. I noticed that with the nasal mask there were big leaks probably due to opening my mouth during sleep, with the facial dreamwear there were mask leaks. on the other hand I don't really understand why I'm tired with the F30...

so I started writing notes on Oscar saying what I was doing: lowering the minimum pressure for the night of the 11th, the EPR level, etc.
for this evening the night of the 12th, I plan to raise the min pressure to 8.4 leaving the EPR. I would have liked to try to raise my max pressure to 14, but I'm afraid of doing something stupid. Because I don't understand from the Oscar graph, when the pressure is at 12 I have hypopneas or obstructive apneas when the machine should eradicate them..what do you think?

[PeaceLoveAndPizza]

Try these settings instead. 

Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
No ramp

That should help smooth out the pressure swings and be far more comfortable. Give it a go for a few days and post some charts. Folks can help fine-tune from there.

[jeje]

Try these settings instead. 

Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
No ramp

That should help smooth out the pressure swings and be far more comfortable. Give it a go for a few days and post some charts. Folks can help fine-tune from there.

thanx, i am gonna try.  I feel like I'm breathing badly, especially when exhaling. I also have the impression that the AirFit F30 is making me swallow CO2; I don't feel any air coming out when I exhale. I get up, less tired with 8.4 minimum than 5. thank you, I will try this evening with your data.

[jeje]

   
i've just download the datas with oscar of the 12st night (5.4 min to 8.4)

[Narcil]

Any particular reason you used 12 max instead of 15? As you can see the machine was maxed out for a significant portion of the night, and couldn't really deal with the leaks. massive flow limits remaining and some hypopneas. i recommend that you try max 15.

If you think you are rebreathing co2 the only way to make it better without changing mask is to increase the pressure, so more co2 is pushed out of the mask. how can no air come out of the vent when you exhale? that seems problematic.

[jeje]

hi, my doctor told me to max 12. i seems to be agree with the way to up to 15. ty
i don't feel air go out from the mask base when i put my hand on..

am gonna try this ty

[PeaceLoveAndPizza]

Your mask (ResMed F30) has a whisper quiet venting setup. It comes out on the elbow at point where it connects to your mask frame.

   

[jeje]

Hello,
yesterday, i was really tired; so i changed the max pression to 14 (sorry not 15 u were true). it seems to be better!!
I have a little pain in my neck, I don't know if it's due to the increase in pressure, but my apnea is almost gone (thank you friends). I therefore find myself with the minimum pressure at 8.4 and maximum at 14. according to the 3H graph I might have needed more pressure (15 or 16).
I breathe through my nose at first and I imagine breathing through my mouth when I sleep (based on the mouth leaks I had when I wore the nasal). do you think we should increase the pressure above 15? Is it also necessary to increase the minimum pressure to match the maximum pressure? I see 2 central apneas, weird???thanks

[Narcil]

hey. glad it's working out. i had pain in my neck when i started cpap but it was because i was crooking my neck in a weird way because of the mask.

i don't think you need more pressure, the machine only maxes out when you have leaks. it would be more comfortable to deal with the leaks first. they look like mouth leaks to me, but i've never used a ffm maybe your jaw drops under it or something? i've been trying to make a chin strap work for a month, not that easy.

2 CAs is really nothing to worry about. most ppl get some CAs starting out cpap and 2 is very low.

[jeje]

hi, ty. i bought this last time; never used. i am gonna try tonite. i tought, it wasn't good for me to close my mouth but if it prevents my chin from going in...
good night