How to adjust the full mask usage

[luckydxx]

You can post more than one daily chart or you can post the Overview chart. The daily is preferred due to the detail.

Yes i will the post the chart. But the sleepyhead data show each day, not a summary, how am i able to let you see multiple days?

In the top left of the screen there is a set of tabs you can choose from; Welcome, Statistics, Daily, Overview,... The Statistics tab gives you a summary of numbers of various time periods. The Overview does similar but graphically. On it you can set the time period that you want displayed.

The Daily tab provides the most useful data display to determine pressure settings for optimization.

Excellent advice. Ditto the above.

And here are few others with extreme high AHI with short time usage. thank you

[Crimson Nape]

Other than the last chart, I'd speculate that the events are positional.  This could be from chin tucking or back sleeping.  Based on the last chart; Does your mom take any pain meds or changed any medication or med strength?

[Ron AKA]

please take a look the charts. These are past week my mom's report with some AHI higher than normal 5. I try to identity how much percent caused by Central Apnea, or anything can help API under control.As on the left side of chart i don't know which category it is. please advice. Thank you so much again.

Look in the top left of the page. You will see the different categories of apnea identified and the index (higher is worse) of each. They should all total up to the AHI. The good news is that the highest portion in almost all cases is the OA (obstructive apnea), and that can be addressed with a CPAP. In some cases the CA's (clear airway or central apnea) are evident, but not really that high. 

I see Smart Start is turned on which should be increasing pressure after sleep is detected. You can probably fine tune that better by also setting a Start Pressure of about 7 cm. I would also suggest trying a minimum pressure of 9 cm and a maximum of 14.5 cm. If the OA's are not reduced, you may have to go higher with the minimum than 9 cm.

[luckydxx]

Other than the last chart, I'd speculate that the events are positional.  This could be from chin tucking or back sleeping.  Based on the last chart; Does your mom take any pain meds or changed any medication or med strength?

She sometimes took sleep med before sleep.

[Crimson Nape]

That will do it.

[JesseLee]

The short amount of time that your mother is on the machine and the complicating factor of using sleep medication is giving a high AHI.
Narcotic sleep medicines and other sedative medications will cause for more central apnea events.
Your mom has sleep onset insomnia so she feels that it is necessary to take the sleep medication.
That leaves two issues we have to figure out. She needs to be on the machine longer and she needs to try avoiding the sleep medication.
There are alternative medicines that she can use. One that comes to my mind is an anti depressant that is effective as a sleep aid as well, its called trazadone. You will have to get a prescription from her doctor and make sure it is okay for her to take trazadone with any other medcine she may currently be taking.
Hopefully, with alternative medication she may be able to stay on the machine longer as well.
If she is not able to get an alternative sleep aid, there are sleep hygiene practices she may try. Having a dark and quiet environmwnt, sometimes white noise helps, setting a bedtime every night at the same time, waking every morning at the same time, no caffeine of stimulants 4-6 hours before bedtime. There are many practices to improve sleep and she will have to practice to see what works.

[luckydxx]

The short amount of time that your mother is on the machine and the complicating factor of using sleep medication is giving a high AHI.
Narcotic sleep medicines and other sedative medications will cause for more central apnea events.
Your mom has sleep onset insomnia so she feels that it is necessary to take the sleep medication.
That leaves two issues we have to figure out. She needs to be on the machine longer and she needs to try avoiding the sleep medication.
There are alternative medicines that she can use. One that comes to my mind is an anti depressant that is effective as a sleep aid as well, its called trazadone. You will have to get a prescription from her doctor and make sure it is okay for her to take trazadone with any other medcine she may currently be taking.
Hopefully, with alternative medication she may be able to stay on the machine longer as well.
If she is not able to get an alternative sleep aid, there are sleep hygiene practices she may try. Having a dark and quiet environmwnt, sometimes white noise helps, setting a bedtime every night at the same time, waking every morning at the same time, no caffeine of stimulants 4-6 hours before bedtime. There are many practices to improve sleep and she will have to practice to see what works.

thank you Jesse. I have been researched since last year about sleep insomnia, sleep med, sleep apnea.
She has been using sleep med on and off for years, to the point now sometimes sleep med doesn't even help.  Last year in March, she was diagnosed with sleep apnea. In Apr she started the device, and stopped in Aug, didn't use until Mar again.
The doctor prescribed Sertraline  25 mg as necessary last year, she tried from July to Sep last year. She said not so helpful. 

She also took Alprazolam 0.5mg, now she is using Estazolamum 1mg.  I did read about trazodone. But no doctor has prescribed me yet, since in US she has no insurance. And i am afraid it is the same side effect as other benzodiazepines and can only take in short period. Not sure will it lose effect like others she has been dependent on so long time.
Also this article i read
http://emedicine.medscape.com/article/292498-medication

Sedating antidepressants like trazodone and mirtazapine in low doses are often prescribed at bedtime for insomnia. Little scientific evidence supports efficacy in the treatment of insomnia without associated depression; their use in patients with insomnia without depression is not FDA approved and should be considered off-label use. Doxepin is the only antidepressant, which, at a very low dose, is FDA approved for insomnia.

 I am in a dilemma situation and helpless. I tried to avoid the sleep med but the problem is if she can't sleep there will be no life quality.

I also understand about sleep hygiene,  I think part of issue she has more like Psychiatry。

[luckydxx]

Based on the chart that you provided in an earlier post, you can make some adjustments. 95% of the time, your mom's pressure is at 12.4. Her max pressure is at 13.4. Her current settings are at 4-20 and that is a really broad range. Since she is not experiencing any significant central apnea, I would suggest that you set your min pressure at 8 and max pressure at 15. Although the machine is doing a good job at keeping her AHI low, these new settings may help to keep pressure rises from interrupting her sleep. Also, you may adjust EPR to a lower setting to see if the reduction in pressure change helps as well. It's all about getting her comfortable.

Ramp can be used if she feels uncomfortable with higher starting pressure. If you want to use ramp manually to see if it helps her, you might try a starting pressure of 5 for 5 minutes. If she doesn't feel like she's getting enough air, you may want to increase the ramp start pressure or disable ramp by turning ramp off.

If you haven't done so, there is a link at the top of this page "CPAP Setup Manuals". Request a copy of the Resmed Airsense 10 Autoset clinician manual for instructions on how to make adjustments in therapy settings.

Hang in there, gonna get this worked out.

Also, when you make adjustments to the settings, it is wise to let your mom use those settings for at least a few days. All changes take some getting used to, and making a lot of changes like you have done recently need to be tried out for a little while. Your mom will never get used to anything if big changes are made often.

Hi Jesse, 

I took my mom to clinic last week. Show them the report for last few weeks. Told them the issue about pressure mom felt when air came out. They set the min to max to 5-10. I asked them is max enough, they asked me to try and go back in two weeks.

These are the AHI numbers since then, i really concerned weather the pressure is right. What is your thought?

Tues: 11, Wes: 8.8, Thurs: 6, Fri:15.5, Sat: 35.5.

I don't know is it the pressure issue or something else not properly treated.

Please advice and thank you so much.

[luckydxx]

Based on the chart that you provided in an earlier post, you can make some adjustments. 95% of the time, your mom's pressure is at 12.4. Her max pressure is at 13.4. Her current settings are at 4-20 and that is a really broad range. Since she is not experiencing any significant central apnea, I would suggest that you set your min pressure at 8 and max pressure at 15. Although the machine is doing a good job at keeping her AHI low, these new settings may help to keep pressure rises from interrupting her sleep. Also, you may adjust EPR to a lower setting to see if the reduction in pressure change helps as well. It's all about getting her comfortable.

Ramp can be used if she feels uncomfortable with higher starting pressure. If you want to use ramp manually to see if it helps her, you might try a starting pressure of 5 for 5 minutes. If she doesn't feel like she's getting enough air, you may want to increase the ramp start pressure or disable ramp by turning ramp off.

If you haven't done so, there is a link at the top of this page "CPAP Setup Manuals". Request a copy of the Resmed Airsense 10 Autoset clinician manual for instructions on how to make adjustments in therapy settings.

Hang in there, gonna get this worked out.

Also, when you make adjustments to the settings, it is wise to let your mom use those settings for at least a few days. All changes take some getting used to, and making a lot of changes like you have done recently need to be tried out for a little while. Your mom will never get used to anything if big changes are made often.

She said nose and mouth breath at the same time inside the mask when she almost fall into sleep make her uncomfortable and keep her awakening.

[luckydxx]

Please see last few days data after change pressure to 5-10