How to overcome if you breath with mouth and nose same time when wear mask

[Walla Walla]

In that last hour it looks like those OA events were caused by position. Dropping the chin towards the chest can cut off the airway. Instead of trying to raise pressure it's sometimes better to use a soft cervical collar or small pillow to prevent the jaw from dropping. I've seen pressure increased all the way to 25cm and not budge an OA caused by the chin tucking in.

[Ron AKA]

thank you.

She was using device and full awake for first few hours. 

Is this the tube you get?

https://www.resmed.com/us/en/consumer/pr...e-air.html
Commercial Link Removed. Instead search Supplier #8, adapters and tubing.
about $40??

I did ask doctor before they don't think needed. and forum users suggest this. Also I am thinging take her to see ENT, but wont happen until early next month. I am afraid i am running out time. 

do you mean very few "CA events" (not OA events)??

also i have question above, curious
"do you all have pressure setting needed on your diagnosis report in North America? 
My mom did the sleep study in China, only show she is sleep apnea, and AHI,  SpO2  etc, no pressure needed shown. So how would you be able to determine that when purchase device?"

Yes, you need the "AirSense 10 ClimateLine Air Heated Tube"

That is if you want to run in auto climate control. 

Yes, I did mean very few CA events. That was an oops!

I had a hard time understanding that last question. Are you saying that she will not be using the ResMed AirSense 10 AutoSet in China? If you have to buy another machine there, I would just set it up as close as you can to the A10. I believe there are some Chinese designed and made machines, but I don't know much about them. They may be better priced or more available.

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[luckydxx]

thank you.

She was using device and full awake for first few hours. 

Is this the tube you get?

https://www.resmed.com/us/en/consumer/pr...e-air.html
Commercial Link Removed, Search Supplier #8, adapters and tubing.
about $40??

I did ask doctor before they don't think needed. and forum users suggest this. Also I am thinging take her to see ENT, but wont happen until early next month. I am afraid i am running out time. 

do you mean very few "CA events" (not OA events)??

also i have question above, curious
"do you all have pressure setting needed on your diagnosis report in North America? 
My mom did the sleep study in China, only show she is sleep apnea, and AHI,  SpO2  etc, no pressure needed shown. So how would you be able to determine that when purchase device?"

Yes, you need the "AirSense 10 ClimateLine Air Heated Tube"

That is if you want to run in auto climate control. 

Yes, I did mean very few CA events. That was an oops!

I had a hard time understanding that last question. Are you saying that she will not be using the ResMed AirSense 10 AutoSet in China? If you have to buy another machine there, I would just set it up as close as you can to the A10. I believe there are some Chinese designed and made machines, but I don't know much about them. They may be better priced or more available.

so once you change to heat tube, the climate control will change to auto from manual, correct?


I mean: when you diagnosis with sleep apnea, does the report also provide you the pressure you need to be treated? As i don't know the process here. If some poeple use cpap, they must have a number so the device can set up.

Right now i am doing trial and error without any pressure in the doctor report shown me how much she needs. i try to understand how works here in US.

-----
Moderator Action: Link Removed

To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites. This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

-----

[luckydxx]

In that last hour it looks like those OA events were caused by position. Dropping the chin towards the chest can cut off the airway. Instead of trying to raise pressure it's sometimes better to use a soft cervical collar or small pillow to prevent the jaw from dropping. I've seen pressure increased all the way to 25cm and not budge an OA caused by the chin tucking in.

thank you for the tip, how would you tell could be positional reason?
I did try to get the collar, i tried the collar myself at walgreen yesterday, it feel very stiff.   

where would you put small pillow, under chin in the front ? she did use some airplane pillow over neck behind to sleep, i don't know this would worse the situation. Also she toss around on bed.

 mom is very hard to please and convince, I am afraid too many things at the same time irritate her and more confusion.

[Ron AKA]

so once you change to heat tube, the climate control will change to auto from manual, correct?

I mean: when you diagnosis with sleep apnea, does the report also provide you the pressure you need to be treated? As i don't know the process here. If some poeple use cpap, they must have a number so the device can set up.

Right now i am doing trial and error without any pressure in the doctor report shown me how much she needs. i try to understand how works here in US.

If you have it set at manual now, it may not switch to auto when you connect the Climate Control hose. You may have to switch it manually. 

I am still not quite understanding your question on pressure. If you have to use a CPAP, fixed pressure machine, then yes there is a pressure you need to at least get started. However, if you have an Auto CPAP like the AirSense 10 in your profile, it is not critical what that magic pressure is. You let the machine find the pressure it wants. That red line in your SleepyHead charts is that the machine is deciding on for pressure. It changes during the night.

[luckydxx]

1. what is the difference between resmed cpap mode, autoset mode and autoset for her mode (sorry I try to understand them correctly).

2. Also with all the graph detail, which are the primary stats  you pay attention to and you would reorder them together to get a better look.

3. And what would you suggest to let mom use the device longer hours at night (she does need to go bathroom couple times at night)? 

1. CPAP mode is a fixed pressure mode. You would have to choose one single pressure to use rather than a range of 8 to 15. I would advise against using it. Once things are settled out a bit and you see what you are getting with the revised pressure settings, which I believe you now have correct, you could try the Autoset Mode instead of the Autoset for Her mode. Hard to predict if it will be better or worse. Just try it and see. The difference could be subtle, but some of your previous posted screen shots indicate there may be some benefit in using the Autset mode. 

2. I posted my daily detail screenshot below. These are the variables that I like to look at with the AirSense 10. The Mask Pressure and Flow Rate look like garbage, but have some interesting detail when you expand out the time scale. To maximize the detail that is visible make sure you maximize SleepyHead to full screen when you are setting up the graphs to show, and before you do the F12 screen capture.

3. I think the first thing is to get the pressures right so she feels more comfortable. Next you might want to think about alternatives for a mask. But one step at a time.

Hi Ron, on your chart, i don't see your climate control is auto, how can tell you are using heated tube from the graph?

So on the device, do you use auto on climate control , would you let me know your setting? 

so does this need set together with humidity level, i mean fine tuning all these?

I am considering get one. 

thank you

[luckydxx]

so once you change to heat tube, the climate control will change to auto from manual, correct?

I mean: when you diagnosis with sleep apnea, does the report also provide you the pressure you need to be treated? As i don't know the process here. If some poeple use cpap, they must have a number so the device can set up.

Right now i am doing trial and error without any pressure in the doctor report shown me how much she needs. i try to understand how works here in US.

If you have it set at manual now, it may not switch to auto when you connect the Climate Control hose. You may have to switch it manually. 

I am still not quite understanding your question on pressure. If you have to use a CPAP, fixed pressure machine, then yes there is a pressure you need to at least get started. However, if you have an Auto CPAP like the AirSense 10 in your profile, it is not critical what that magic pressure is. You let the machine find the pressure it wants. That red line in your SleepyHead charts is that the machine is deciding on for pressure. It changes during the night.

thanks Ron. Sorry for the confusion. I am not referring my situation. Just in general way, as some patients don't use auto cpap, they use fixed pressure cpap. So i just curious how would they get the pressure from? From diagnosis report, or from other study.

[Ron AKA]

Hi Ron, on your chart, i don't see your climate control is auto, how can tell you are using heated tube from the graph?

So on the device, do you use auto on climate control , would you let me know your setting? 

so does this need set together with humidity level, i mean fine tuning all these?

I am considering get one. 

See page 16 of the Clinical Guide pdf. There is a set up called Climate Ctrl. If the heated air tube is connected there will be an option to set it in Auto. If not, then only manual. 

SleepyHead seems to have a bug in how it reports the Climate option. I definitely have it set in Auto on the machine.

I think you could probably get a setup that would work in manual without the heated hose. However as room temperatures change, humidity changes, and nobody adjusting it from day to day, it probably would be better to go with the heated hose and just set it in Auto.

[luckydxx]

I would have mom's settings at 8.0 to 20.0 because the 10 maximum pressure is not sufficient to treat the obstructive apnea.  I would also look for a soft cervical collar to prevent positional apnea that is the likely culprit with the clusters of obstructive apnea.  My guess is that she is tucking her chin to her chest, or her pillow puts her in that position, and she cannot breath when the airway is closed off by that position.  A soft cervical collar is made of foam and ranges form 2-1/2 to 3-1/2 inches in height and should be sized to comfortably be worn (an inch or two greater than her neck circumference).  By keeping the airway straight, she will not have the clusters of OA, and the pressure range will probably settle in between 8 and 14 cm.

Simultaneously breathing nasally and orally is not a big trick, and many people do it.  I would not worry too much about that since the leak rates are acceptable.

Hi Sleeprider, where would you recommend get the soft one? I went to walgreen last night and try myself, feels pretty stiff. it cover the whole neck area. I want to find one for my mom who is 5 feet tall 132 lb.

thanks

[Walla Walla]

Look on Amazon for a collar. They have all different sizes.