EETX - Therapy Thread

[EETX]

Hi all.  46, M, 6'2", 255lb

I was recently diagnosed with Severe OSA (AHI - 47.3) and Mild CA (10.3).   
O2 sat <90% (4.3% of test), <88 (2.1%) <85 (0.1%) - min of 82%

Dr wrote the Rx for CPAP or BiPAP and I chose the BiPap.   Model is Resmed Aircurve 10 Vauto.

I opted for a full face mask since I often sleep with my mouth open and have difficulty breathing through my nose regularly due to allergies.
Mask is a Resmed F30i.

I've slept with the setup 2 nights now.  I'm definitely still getting adjusted to sleeping with it, but haven't had too much trouble other than a sore septum the first night, occasionally swallowing air, and some air leakage when I toss/turn or the pressure really ramps up and wakes me.

Both nights my AHI was around 25 +/- (better than without, but not great).  I woke up feeling more exhausted than without it.  OSCAR charts show quite a few CAs and OAs to a lesser extent.  Several event last close to a minute.

Existing settings are (Min EPAP-4.0, Max-IPAP-25.0, PS-4, Trigger sensitivity - Med, Ramp is ON @ 20mins, Ti_max -2.00s, Ti_min - 0.3s,  Humidifier - 4)

Any suggestions on how to improve these charts (and mostly my sleep)?

   
   
   

[EETX]

Another night.  AHI went down a bit to 18.35.  Slept better the 1st few hours, but still felt about the same this morning.  Haven't made any changes to settings.  


   
   

[Sleeprider]

You need some more stable settings, but the main problem is positional apnea where your head and neck are misaligned causing obstruction. There is a lot we can do with settings to resolve obstruction and even the centrals, but you really need to read this wiki first, and maybe look into a soft cervical collar.
Positional apnea https://www.apneaboard.com/wiki/index.ph...onal_Apnea
Soft cervical collar: https://www.apneaboard.com/wiki/index.ph...cal_Collar

For settings, let's start by setting EPAP min to 7.0, Max Pressure 15.0, PS 4.0 and change trigger sensitivity to high. I think even the CA events are obstructive and part of the obstructive apnea being flagged. It's really important for you to ditch extra or tall pillows and get your sleep position right, and I'm pretty sure you're a candidate for the soft cervical collar. You're not alone and have lots of company.

[EETX]

Thanks.  I'll try those settings tonight and read up on the collar.   Amazon takes a week to deliver where I'm at, so I won't be able to try one for a bit.

[TechieHippie]

You can get a partial effect of the collar until it arrives by tucking a small pillow or stuffed animal under your chin.

[EETX]

Been a few days since my last post.   Ordered a couple of collars to try.  Still waiting on those.   AHI has dropped a bit with the new settings (>15).  The lower peak pressure has reduced the number of times I'm awakened in the middle of the night by rushing air/leaks.   I think I'll hold these settings until the collar comes in to see if they stabilize or drop further before trying the collar.   I've been sleeping with a very thin pillow and using a firm pillow pulled up to my chin to try to prevent chin tucking.   Seems like it's helped a bit.

Woke up extremely tired today, but I think I have a cold coming on.   That's going to be an interesting addition to the treatment.     
I'll update once I've had a choice to try to collar.  Thanks y'all!   




   
   
   

[CPAPfriend]

Data and leaks look better with most recent settings. Keep posting. I'm interested.

[Sleeprider]

Results are significantly improved at 50% of previous levels, but the collar is going to be a game changer for you.

[EETX]

Hi all,

It's been a few weeks since my last post.   I came down with a cold that lasted a few days which messed with therapy a bit, but I did some experimentation.

The first thing I tried was 3 different cervical collars.  I was surprised to find that none of them really seemed to make much difference.

During my cold, I was having issues with the higher pressures, so I dropped the max IPAP down from 15 to 12 for a night, then bumped back up to 13.  I also tried bumping up my PS to 4.2 from 4.0.   That made things markedly worse, so I went the opposite direction down to 3.0, but bumped my EPAP up to 7.6 (from 7.0).  That improved things quite a bit.   

It's much more comfortable with a lower PS for me.  At 4.0, it felt like the machine was forcing me to over-inhale for lack of a better description.    PS @ 3.0 feels much more natural.   I then turned up the sensitivity to "Very High" and it feels like the machine follows my natural breathing pattern much better.  Since those changes, my AHI dropped below 5 and have generally stayed there.

I've noticed I wake up now mostly when my mask starts leaking.   This happens either when I'm lying on my side and it pushes the mask off-center or when the pressure goes up higher.   Last night I tried dropping the max pressure a bit to 12.6 to help with the latter.   From looking at several charts, I'll still have events even if the pressure goes way up, so it doesn't seem like letting the pressure rise is really helping anything.

Last night's AHI was one of the better nights at 2.57.


   

   

[Jay51]

Here are some tips to help deal with leaks.  Mask Primer

It may take a little time to get optimized.  Just stick with Sleeprider's suggestions.  

And with cervical collars, the right size is imperative.  Measure the distance from the chin to the sternum in inches (and 1/2 inches).