[Equipment] DiabolikalDeux - Therapy Assistance

[DiabolikalDeux]

Can you attach a standard OSCAR screenshot? Also, what pressure settings are you using? 4-14 as listed in your profile? If so, that 4 is likely a problem, being too low for both therapy needs and hindering EPR 3 from working fully from the start. If using EPR 3 full time you need minimum to be 7.

Sure, here are the screenshots I took this morning, sorry it is so late, I've had a weird busy couple of days. Also, I put it at 4 for a bit of relief as even at a pressure like 9, it was hard to inhale softly, I have to breathe deep or just right, otherwise the pressure gets too high to breathe at all.

[SarcasticDave94]

What I would suggest is using 7 - 12 pressure, keeping EPR 3 full time, and leaving Ramp off as is now.

The combo of 7 minimum pressure plus EPR 3 equals the 4 you have now, with a differential of that 3 bumping to 7 on inhale. This is a bilevel action BTW. It may be easier on you than the current 4 that requires the machine to dial things up for events. At 4 minimum, EPR is cancelled until the pressure climbs to 7, because EPR (exhale pressure relief) cannot reduce anything below 4, the physical low threshold.

[Nightynite]

Congestion has always been something I just have to deal with as long as I have been on pap therapy. I have tried everything and nothing works 100 % for 100% of time used.

In a 7 night example, I may have one night of congestion that disrupts my sleep.

I also have the same symptoms and no matter what I have tried over the years the basic congestion has always showed up.

I'm now dealing with eye problems and not so sure that some of the nasal sprays I used daily haven't contributed to this problem.

Stay positive and continue the search. This is what successful hose heads do.

[DiabolikalDeux]

re SarcasticDave, I will try that tonight, see how it works. Thanks for the suggestion.

[SarcasticDave94]

You're welcome. Hope it helps.

[Sleeprider]

Have you ever tried Flonase (fluticosone propionate)? It can reduce inflammation in the nasal passages and allow freer breathing. Your typical CPAP night lasts less than 2-hours, and it's hard to know if you're ever falling asleep. Breathing should be effortless as when you don't use CPAP, and consciously taking deep breaths is not normal sleep breathing. There is certainly a lot of obstruction apparent in the breathing pattern, although we might see more with some zoomed shots of the flow rate. The settings suggested by Dave should help. In your chart, breathing is total chaos until about 23:55 when you finally fall asleep for about 30 minutes. You must be exhausted.

[Dormeo]

A few quick thoughts.

Do try Flonase, but be aware that it can take about two weeks to kick in.

And you might benefit from setting your machine up outside your bedroom and using during the day or evening while you read, watch TV, or use your devices. This could really help you get used to the experience of breathing comfortably with CPAP.

About Dave's excellent recommendation for pressure settings -- It's a little counterintuitive, but pressure that are too low can feel as though they're too high, just because you have to labor to get enough air.

I second Dave's recommendation about your pressure settings.

[DiabolikalDeux]

re SarcasticDave94, so I've tried it for the last two nights in a row, except that I realized that that Ramp is set at 15 minutes but was too tired last night to change it, only remembered this morning.  it's helped a little, I was finally able to fall asleep with it on but I guess only for two hours, and much as the MyAir app is unhelpful, it says that that mask seal needs adjusting, but it's a large, I don't know what I can do because otherwise it's like my face is just big. Including one OSCAR screenshot for reference, I only slept to about 2:40 in the morning or so.

[DiabolikalDeux]

re Sleeprider, I actually did try Flonase for months and did not help. Right now my ENT has me on Azelastine, Nasacort, and both Ayr saline and NeilMed daily saline sinus rinse, and I am supposed to go back next month to see if has helped at all with congestion or my inflamed turbinates and deviated septum.

Also for the record, my typical CPAP night lasts less than two hours specifically because I am not falling asleep. It's rare that I've actually been able to fall asleep, like I can't roll over, suddenly my mind goes into overdrive, my legs get twitchy and won't stay still, etc. There have been a few times where I used it win bed in the morning after waking up and found myself slightly better and more energized by focusing on staying awake in order to get the breathing in. (Also I did attach a screenshot for when I fell asleep lats night in a previous comment)

[Sleeprider]

If you feel CPAP is not delivering air in a way that makes breathing easier, and you have maximized EPR at 3 at a pressure that resolves most obstruction, then you should try a bilevel machine like the Resmed Aircurve 10 Vauto. It is not much different than CPAP but can provide pressure support during inspiration that makes breathing effortless. With your current settings of 7-12 cm with EPR 3, your realized pressures are 7/4 to 12/9 (inhale/exhale). With the bilevel you can add pressure support as needed to supplement the physical effort of inspiration. For example, with PS 4.0 your pressures would be 8/4 to 12/8, or with PS 5.0, 9/4 to 12/7. As PS rises, respiratory effort and inspiration time diminishes and ventilation (tidal volume) increases. As it is, you don't appear to tolerate CPAP leaving you mostly untreated. This may be sufficient to justify moving to bilevel.