RE: First Night - ResMed AirSense 10 AutoSet
Another thing to watch is raising the max pressure may cause more Clear Airways.
RE: First Night - ResMed AirSense 10 AutoSet
(04-08-2018, 11:36 AM)Walla Walla Wrote: The Cervical collar also helps prevent mouth leaks by gently nudging the jaw closed.
OK. Last night I had my mouth taped shut with the paper medical tape that you suggested. It certainly stopped the major leaks.
RE: First Night - ResMed AirSense 10 AutoSet
(04-08-2018, 11:43 AM)OpalRose Wrote: Another thing to watch is raising the max pressure may cause more Clear Airways.
Yes, I think you are correct in that. It is happening already. Just my theory, but I don't think it is due to the pressure itself, but more due to the classification that ResMed puts on the event. I sense it will convert CA's to OA's, and in the short term I'm OK with that. My personal theory is that the main initiating event is a waxing and waning of the strength of the breath. Sometimes those precursor events end in an OA and other times as a CA. However, with higher pressure the odds increase that they will end in an CA. My understanding is that the body is essentially over reacting to CO2 levels in the blood, and the control system in basic terms is going unstable. My hope is that with a month or two of treatment with minimal OA events, my body will adjust to the lower CO2 levels and start controlling better. If not, a different machine may have to be the final solution.
Here is an example of what is leading me to this conclusion in the screen shot. There is a CA, then OA, then UA, and finally CA. I kind of think they are all the result of the same waxing and waning, but the terminating event can differ, and the event can be classed one way, or the other, or undecided. Just my thoughts...
RE: First Night - ResMed AirSense 10 AutoSet
So last night is finally showing some potential with an AHI of 2.2. That is the best I have achieved with the AirSense 10 machine. And it matches the best I achieved with the F&P SleepStyle. It may represent about the limit of what I can do given the high component of centrals that I have. The hope would be that my body adapts and does a better job of maintaining breathing rate as it adjusts to the higher O2 and lower CO2 levels.
My chin strap and medical tape over the mouth solution to the mouth leaks does not seem to be a permanent one, although it seems quite effective. I think I will try the chin strap only tonight and see how much of a difference that makes. It may be a tolerable long term solution. From there I will go on to try the option of a lower minimum pressure and no EPR.
RE: First Night - ResMed AirSense 10 AutoSet
Well I am still going nowhere fast with my CPAP treatment. AHI's are still all over the place, and my diversion to try the Mirage Quattro full face mask has been a failure. It just leaks too much with the pressure setting I have.
So I am going to try what I considered as Option #1 a while back, the no EPR option. I will leave max pressure at 15 cm and reset minimum to 8.5 cm with no EPR. I know Walla Walla thinks that will help. I'll first try it using the pillow mask and chinstrap. If it looks promising I will try the Mirage Quattro again. I suspect part of my issue with that mask was the EPR. The pressure fluctuation with each breath causes a lot of flex in the mask, and I think promoted leaks forming. Will see what happens tonight.
RE: First Night - ResMed AirSense 10 AutoSet
Just as an update I now have a fairly good history of results with two different options for machine setup; EPR @ 3 and higher pressures, and EPR @ 0 with lower pressures. The winner appears to be EPR @ 0 and lower pressures. Here is a summary of the outcomes:
High EPR and Higher Pressure
CA index - 2.5
OA index - 1.8
0 EPR and Lower Pressure
CA index - 1.7 (32% reduction)
OA index - 0.6 (68% reduction)
So far I have to conclude that 0 EPR is effective in reducing both central and obstructive apnea in me. May not apply to others, but if you have mixed apnea it may be worth a try. With the AirSense 10 you can set EPR to act in Ramp only, and that is what I do for comfort. It is off during the therapy hours during sleep. Now if I can only solve my mask leak issues...
RE: First Night - ResMed AirSense 10 AutoSet
You are kind of borderline for "mixed apnea", but there is a lot of good thought behind your experiments and the results make sense. Everyone seems to have their own unique response to PAP therapy permutations, and EPR is a tool that seems to make a lot of difference for some people. As you know, when we're trying to resolve hypopnea and flow limitations it can work to our benefit, but when CA is present, EPR can sometimes be the difference between good and mediocre results. There are no rules, and it's always worth a try. Looks like you have found a better solution for now.
RE: First Night - ResMed AirSense 10 AutoSet
(04-18-2018, 04:08 PM)Sleeprider Wrote: You are kind of borderline for "mixed apnea", but there is a lot of good thought behind your experiments and the results make sense. Everyone seems to have their own unique response to PAP therapy permutations, and EPR is a tool that seems to make a lot of difference for some people. As you know, when we're trying to resolve hypopnea and flow limitations it can work to our benefit, but when CA is present, EPR can sometimes be the difference between good and mediocre results. There are no rules, and it's always worth a try. Looks like you have found a better solution for now.
I have been trying what worked for me, with my wife's setup. It looks like the reverse is true for her. The No EPR method is not working that well although the difference is less. Higher pressure and EPR at 2 has given her results averaging just under 1.0 over two weeks. With 3 days of No EPR she has been averaging about 1.18. Possibly not statistically valid yet, but it does suggest what works for one, does not work for her. She has very few central apnea events, and perhaps that is the difference.
RE: First Night - ResMed AirSense 10 AutoSet
(04-18-2018, 06:13 PM)Ron AKA Wrote: (04-18-2018, 04:08 PM)Sleeprider Wrote: You are kind of borderline for "mixed apnea", but there is a lot of good thought behind your experiments and the results make sense. Everyone seems to have their own unique response to PAP therapy permutations, and EPR is a tool that seems to make a lot of difference for some people. As you know, when we're trying to resolve hypopnea and flow limitations it can work to our benefit, but when CA is present, EPR can sometimes be the difference between good and mediocre results. There are no rules, and it's always worth a try. Looks like you have found a better solution for now.
I have been trying what worked for me, with my wife's setup. It looks like the reverse is true for her. The No EPR method is not working that well although the difference is less. Higher pressure and EPR at 2 has given her results averaging just under 1.0 over two weeks. With 3 days of No EPR she has been averaging about 1.18. Possibly not statistically valid yet, but it does suggest what works for one, does not work for her. She has very few central apnea events, and perhaps that is the difference.
As you can see we are all individuals what works for one person may not work for another. We just have to try things and see where we end up,
|
