Help - 1 year CPAP - not success - help very welcome!

[Macka]

Oh also, I don't think Oscar is reporting flow limits when softpap is off for either all or some Prisma models. So thinking they vanish with it off is misleading. I believe Prisma data is flagged more vigoruosly than Resmed and so can look alarming. Turn off all flags other than essentials and off the flow chart as well.

I think you could try apap 9-11 epr 2 and set the machine to dynamic mode so it is more responsive to rera and flow limits. Regardless what you try, you will get a better idea of the machine limits if you stick with settings for some time, till you become comfortable with them. Switching it up too regularly can send you into a bit of a spin.

Some other things I have found with the Prisma. A 22mm hose is what I believe they are designed to use. 22mm offers way softer delivery and gives an easier exhalation. So also if you add a Vcom. I believe the Prisma has a continuously spooled pump, bit like a turbo, so may explain why the flow can seem intense with a smaller hose and nasal masks. With Vcom attached you will still hit all target pressures, it is not just a straight drop in inspiratory pressure, but an easing into the beginning of it which is very comfortable. I definately would investigate whether you can get softpap3.

[leono85]

Hi! thanks for all the comments, tips, and help!

Sorry for the delay in updating my case, I was in a period very energy-drained. 

Last few days,  I could improved:
- Based on your comments I changed the pillow (also some days before I started supplementing with NAC as some studies report a benefit for people with sleep apnea). Thanks to that I could reduce my flow limitations events from around 140 to 40. So, I think both the pillow of the NAC help. It is true that with NAC alone I saw some improvement, but after the week and just 2 days with the new pillow, I could see the relevant improvement in the FL events reduction. Attached is a picture of that.

Before this recent change, when I was heavily struggling, the doctor agreed to change the machine. Today, I received it. It is a ResMed air curve 10. The current setting is set as automatic, (exhale) 6 to 14 (inhale). At least is that what I got explained by the technician.  He also explained me that I should tune by myself the Timin and Timax (or something like that) to make it more comfortable. Since this machine is new to me I am looking for information. As soon as I have data from this machine and updates I will share it with you . 

If you have any tip for someone starting with this specific machine, it is very welcome! I will be looking around the forum and other sources to get more familiar with this machine.

[leono85]

First night with the Resmed Accomplished.

This morning, after waking up and having breakfast, I went to the machine and extracted the SD card (as I used to do with the Lowenstein machine) and then put it on my computer. I used Oscar and surprisingly, the program says that I only used the Resmed machine for 13 minutes, while in the sleep report on the machine screen, it says I slept 9 hours and had around AHI 3. So I can't share the report today . I hope this was a time thing and tonight it will work fine. If there is something I should do, please let me know, to prevent not getting the data.

About my sleeping, I had several awakes, like one every 1.5 hours, I guess it is becoming used to the machine. During the day I will check my energy levels carefully to see if there was an improvement in that regard.

[WisNaeMe]

Your last Lowenstein chart looks like it was starting to go in the right direction for you, so hopefully with your move to Resmed Bilevel it can only get better and you’ll fell less disheartened by your therapy.

It will be interesting to hear how transitioning from Lowenstein to Resmed goes for you? …hopefully smoothly! But information on how the change went for you might help others who may follow in your path.

What is the exact model of your Aircurve 10 (S, ST, ST-A, Vauto, ASV?). It will help folks give more specific advice if they know the exact model you are using.

Also remember to update your Apnea Board profile to reflect your machine changes. Again, that should get more Aircurve users looking at and commenting on your thread.

I’m not in a position to comment on your OSCAR data issue, but I’m sure someone will be familiar with the problem you describe and be along shortly to offer advice.

But Good Luck with your new machine!

[leono85]

Thanks, WisNaeMe!

I could get the data from the machine. I just put the SD card back into the machine, waited a bit took it out put it in the PC, and could get the data.

I am attaching the first night with the machine. I went to sleep at around 21.00, but the record is from 16.00 since I tried it first with the technician for some minutes. The plots below the event flangs correspond to the period I was sleeping.

The machine is a Vauto. I will update that in my profile, thank you for pointing that out!

[leono85]

Thanks, WisNaeMe!

I could get the data from the machine. I just put the SD card back into the machine, waited a bit took it out put it in the PC, and could get the data.

I am attaching the first night with the machine. I went to sleep at around 21.00, but the record is from 16.00 since I tried it first with the technician for some minutes. The plots below the event flangs correspond to the period I was sleeping.

The machine is a Vauto. I will update that in my profile, thank you for pointing that out!

I could manage to have a better capture of Oscar report (attached) of last night's sleep.

[Sleeprider]

Most of the OA in this chart occurs as multiple events, which is typically positional. https://www.apneaboard.com/wiki/index.ph...onal_Apnea
Other than that, flow limits are generally low, except where positional issues increase resistance, and that also corresponds with the OA events. If adjustments to pillows or sleep position issues do not resolve this, then some increase in minimum EPAP to 8.0 may be able to prevent some OA events. If you're comfortable with the pressure you can give that a try.

[leono85]

Attached is my sleep from the last 2 nights. I changed the pillow, I bought new ones for neck support. Each relate graph relates to a different pillow. The one of last night, I noticed is that the OAs look sparse and not much clustered.

Also, just in case, I am a side sleeper. I don't sleep on my back nor on my stomach.

Any tip or suggestion is welcome!

[Sleeprider]

I think this is an improvement, however there are still clusters. On Feb 24, Your OA event rate is 1.70 per hour or a total of 13 events in 7.65 hours, yet we only see 11 events. That's because two of those flags are clusters of 2 apnea. On Feb 25 there are visibly clustered events, but not extremely tight. There is some room for improvement, but perfection is not needed if you're comfortable.

[Macka]

It looks to me like you need a minimum of between 7 & 8 epap to control those apneas. Nearly everytime the machine dropped your pressure towards your min of 6 it ended in apnea event.

Would be great to see your flow rate pinned as well.