Good Result, but could it be better?

[wesozzzz]

Hi
Thank you ajack, DeepBreathing, bonjour,  and SleepRider for your suggestions,

So far I have taken off the ramp, set the EPR to 3cm.

I can tell the difference in the way my breathing is affected, its seems like an interference to my flow.
I think I will have to adjust to it.
My 95% pressure has come down 3 cm to 12.46.
I am feeling more energised, but thats a subjective thing, but I feel relatively  good.

My AHI are slightly up, last night was 3.49 but then i was wearing a different soft neck support after the dog tore a hole in the other one.

I will give it a few more nights at these settings then I will post some charts.

wesozzzz

[Sleeprider]

What kind of dog? Mine just drinks beer.

[wesozzzz]

Hi
Thought I would report back.

I bought a recording Oxiometer, but found it had minimal instructions,  very particular in how to set up to get it to record, not user friendly. I did manage to get 2x 90 minute recordings during   the first hours of sleep.
One  returned a min o2 of 91%, 7 events between 90 - 94%  with av duration 58 seconds. The other 94%,1, 49 seconds.. In both tests SO2 was other than these events above 94%.

I think that was  an ok result , much much better  than what was indicated during my sleep test of min SO2 of 75%  and av of 85%. From my Oscar charts I am getting a good tidal flow so my lungs  seem to be working ok despite my Lung Fibrosis condition.

I am still trying for  most comfortable sleep I can get.
I have changed  from my low pillow to a higher one to take the pressure off my shoulders when side sleeping, then trying to remember to shove the pillow aside when I change to prone position . Despite my wearing a soft collar I am very sensitive to any chin tucking triggering off sleep apneas.

Gas has become a problem but I have applied a EPR of 1 cm , so  I will see how that affects that problem.

Overall I am much brighter in my mind, now rarely sleep during the day and  colors look more intense.

I am attaching an image of my over all chart since I started CPAP. You can guess when I read on The Apnea Board about positional apneas and chin tucking, a dramatic change to my trial results.
Also included a typical daily charts
.
Question - Oscar Chart:

I have been getting on most nights an AHI of 2 to 3 but the Event Flags dont indicate any thing like this. Could anyone explain why this is so?

Question - Potential problem with mask use.


I have developed a sore spot/ rough skin on my nose in the area where the mask sits near the nose bridge. I think its going to lose skin in that area.
How can I avoid this? band aid? any skin preparation I can apply? Change my mask?
I currently use a F+P Simplus FF mask. The only other mask tried was Resmed F20 but I had large leaks at side edges of my lips. I am a mouth breather and nasal masks didnt work for me.

Thank you Apnea Board I am very grateful for your help and suggestions

[Crimson Nape]

Question - Oscar Chart:

I have been getting on most nights an AHI of 2 to 3 but the Event Flags dont indicate any thing like this. Could anyone explain why this is so?

You don't have the Hypopnea events turned on.  In the lower left side of the screen look in the dropbox and make sure all items are switched to green.

Question - Potential problem with mask use.

I have developed a sore spot/ rough skin on my nose in the area where the mask sits near the nose bridge. I think its going to lose skin in that area.
How can I avoid this? band aid? any skin preparation I can apply? Change my mask?
I currently use a F+P Simplus FF mask. The only other mask tried was Resmed F20 but I had large leaks at side edges of my lips. I am a mouth breather and nasal masks didnt work for me.

Just about any hand lotion or moisturizer should work.  I've had very good success using Blue Emu.

[Sleeprider]

At one time, we pointed out you have a lot of flow limitations and suggested a EPR of 3. I think rather than reducing that to 1, we need to limit the maximum pressure instead. You need EPR to treat the flow limits and hypopnea, and it can help with aerophagia (air swallowing). You are currently using 8.6 to 18 pressure with EPR 1. Let's try 9.0 to 15.0 with EPR back to 3 and see if that feels and works better. As mentioned by Crimpson Nape, we want to turn on the hypopnea events so we can track that. Your biggest problem right now is the flow limitation which means it is taking longer to inhale than normal. We really want to see EPR at 3 so you get more assist on inhale and an easier exhale.

[ajack]

For gas, I would also have epr3. You might also talk with your doctor about GURD or other issues with the stomach sphincter muscle, if it doesn't resolve, mine went by itself.
I think you are still obstructing and needing too high of a pressure. If your collar, or other positional changes isn't doing the job. I would see an ENT. If the need for high pressure isn't resolved, you might consider and talk with your doctor about a bilevel down the road
The titration guide would suggest you raise min pressure for all obstructive events including FL and snoring
https://www.resmed.com/us/dam/documents/...er_eng.pdf

[wesozzzz]

Thanks Sleeprider.

Re EPR, As I have a lot of stiff tissue in my lungs that area does get sore if my rib cage gets moved around. eg.  like doing repitious actions like shadow boxing.
So im taking this slowly, Im hoping it will be ok to raise the EPR and I wont get too much kick back.

As the difference widens between the EPAP and the IPAP , from the charts it looks though I need to raise the max pressure to th emachines max of 20 cm.
My Oscar results on auto are often on or near the current max setting of 18 cm, thought about raising it  but as my AHI have been ok have resisted because of gas and  increase risk of leaks.
But then an extra 2 cm of pressure isnt much of a change.
What do you think?

I have plenty of time so I will take this slowly.

Thanks again

[wesozzzz]

Last night I raised the max pressure from 18 cm to 20 cm  and it flat lined ( looking for more pressure  perhaps), a few times through the night..and the sky didnt fall in.
Im impressed that my mask hasnt shown any large leaks so far.

I note that my tidal flow has a big range, 100 to 780 ml ( with no leaks ) and 95% at 640 ml. is this a normal situation.?

Tonight I will raise the EPR to 2 cm for a few days and see my lungs take to it.

keep Breathing