I'm loosing the battle

[DannyG]

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I'm really loosing it! Close to two months on therapy and it's going down hill. Last couple of weeks I can't stand wearing the mask, it's to tight, leaks and I can only use it a few hours at best.

My DME is no help and my doc is out of the country with no backup. I'm out of options. I'm in Texas on a trip around the country with no support.

I have tried to turn down the pressure and live with the centrals. I tried my new mask. I figure some help is better than none but it doesn't appear I can lower the pressure in the clinical menu.

[OpalRose]

DannyG,
First, you will need to turn on Flags for the Event Graph.

Look at your screenshot, bottom left under pressure graph. There is a drop down box, click on the Flags and turn them from Red/black to Green/black, so that the events will show in the graph. Please include, Events graph, Flow graph, Leak Graph, Pressure Graph.
Then repost your data.

Also, your mask should not be so tight that it's uncomfortable.

I noticed that SleepRider was previously advising you on pressure settings in another thread. Try to revisit and read your previous threads.

Hopefully, someone will be along that will be able to advise with ASV settings, as I'm sure it's a matter of tweaking your pressure.

[0rangebear]

[img][/img]

I'm really loosing it! Close to two months on therapy and it's going down hill. Last couple of weeks I can't stand wearing the mask, it's to tight, leaks and I can only use it a few hours at best.

My DME is no help and my doc is out of the country with no backup. I'm out of options. I'm in Texas on a trip around the country with no support.

I have tried to turn down the pressure and live with the centrals. I tried my new mask. I figure some help is better than none but it doesn't appear I can lower the pressure in the clinical menu.

DannyG

Most people take from a few weeks to several months to adjust to positive airway pressure therapy; don't give up. Please follow Opal Roses advice and post more data so the folks in the forum can help. There is a lot of good advice coming you way but more data is needed.For now try and use it a little more each night. It is hard to base anything on two hours of data.

Nevertheless, my initial observation is that your high pressure setting is not compatible with the mask type you are using. Typically the Amera vei leaks at higher pressures (above 15). 

Hopefully some more Amara View users will comment on this, but my experience is the mask works better when it is a little loser; especially with the upward pressure under the nose. When the mask is too tight leaks more. However, I do not see a high leak rate in the data you posted.

OB

[Gideon]

Too tight a mask is a common problem. Please read the Mask Primer

[Sleeprider]

I'm a little confused. The Humidaire humidifier went with the old S8 series machines. The Aircurve 10 is simply the Resmed built in humidifier. Assuming you are using the Resmed Aircurve 10 ASV, I'd like you to try some different settings as I outlined in another thread. Sswitch to ASV auto mode, then use an EPAP range of 8.0-11.0 with a minimum PS of 0 and maximum PS of 11.0. That would give you a pressure as low as 8.0/8.0 which for most people reduces CA. If you need pressure support for comfort, a minimum PS of 3 would still result in lower pressures. however you still need a maximum PS of 11.0. The ASV auto mode will increase EPAP pressure automatically if obstructive events occurred, but only if needed.

There is a lot you could do for your comfort, but you need to get a better understanding of this machine and the settings you are using. Please be sure to Order the Clinical Manualand consider reading this Resmed Titration Protocol how a patient would be ideally titrated by reading this focusing on pages 27 and 41 (ASV and VPAP Adapt).

[DannyG]

I'm a little confused. The Humidaire humidifier went with the old S8 series machines. The Aircurve 10 is simply the Resmed built in humidifier. Assuming you are using the Resmed Aircurve 10 ASV, I'd like you to try some different settings as I outlined in another thread. Sswitch to ASV auto mode, then use an EPAP range of 8.0-11.0 with a minimum PS of 0 and maximum PS of 11.0. That would give you a pressure as low as 8.0/8.0 which for most people reduces CA. If you need pressure support for comfort, a minimum PS of 3 would still result in lower pressures. however you still need a maximum PS of 11.0. The ASV auto mode will increase EPAP pressure automatically if obstructive events occurred, but only if needed.

There is a lot you could do for your comfort, but you need to get a better understanding of this machine and the settings you are using. Please be sure to Order the Clinical Manualand consider reading this Resmed Titration Protocol how a patient would be ideally titrated by reading this focusing on pages 27 and 41 (ASV and VPAP Adapt).

I'll try it tonight, just tested and seems like it might work. Have to check my AHI. Thanks

[DannyG]

Rep from my DME called today and we talked about my settings. She said they looked a little high and wondered if some thing had changed in my life. I told her yes I can no longer sleep at night with cpap.

She said she upped my ramp to 45 min. I told her I had changed the setting and they worked well last night. She said I can't do that without the doctor orders and I responded I had no choice as he is out of the country with no backup. Hope I have another good night tonight.

I need to take some time and read the clinical manuals so I can understand how the pressure setting effect each other. I other thing, had a build up of water in my hoses so I turned the humid back to level 4.

[Sleeprider]

Be sure to keep the machine lower than the hose leaving it so any water drains back. I suspend my hose from the headboard so it travels up quite a way before decending to where I am wearing the mask. You can always put the machine at floor level, but don't allow a loop of hose to be lower than the machine such that water can accumulate. As far as adjusting your own settings, you can do that. Read the first section of the CPAP Manuals article http://www.apneaboard.com/adjust-cpap-pr...tup-manual

The advise you have received here is all good practice based on standard ASV titration protocols. Your doctor is MIA, don't get bullied by a DME technician.