How much effort should be really going into each breath?

[DiabolikalDeux]

So, I have an AirSense 11 with a CimateLine tube and an F20 cushion, I recently got a cover for the tube to retain heat, and have been trying to get the settings right together more air going. I have a deviated septum and inflamed turbinates, been trying to Currently I think it is set at 15 minute ramp, 84 degrees for the temperature, 6 for the humidity, 3 EPR, I'll turn it back on to get more settings and info if need be. But something that hit me the other night, is simply that that after months of using it, I always seem to stay awake by needing to consciously take as deep breaths as possible. Through my nose or my mouth, even with a higher pressure, it just feels like I have to in order to get more air than without the machine going and having to take a deep breath every three seconds. Is this typical, should there be this much effort, or is it not and is there anything that can be done to fix it? (I am seeing an ENT about the septum and will see them next month after seeing if nasal rinse and allergy prescription sprays do anything to decrease the turbinates)

[SarcasticDave94]

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.

[greatunclebill]

deviated septum is a physical condition that you're not going to medicate away. the ent may want to cut to fix it. it may or may not help you long term. you should be looking at full face mask for best results.

[DiabolikalDeux]

deviated septum is a physical condition that you're not going to medicate away. the ent may want to cut to fix it. it may or may not help you long term. you should be looking at full face mask for best results.

Sorry for the very late response, I'm already using am F20 with a foam cushion since the silicone felt like it was cutting into my skin, but it still seems to not be helpful in getting air up my nose. I also tried an F40 but it kept pushing up the nose, a bit like the Three Stooges when Moe would pull one of the others up with a hammer in the nostrils, that's the best way I could put it.

[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.