If the CPAP works for you, what is your expected AHI?

[tommyngo]

[quote pid='270023' dateline='1535463823']

Congrats on the success the collar gave you. Best wishes the positive results make a nice trend from here forward.  

Thanks SarcasticDave94... Well I am still working on some air leak problem with the nasal mask . Last night, my AHI increaesed to 2.8  with frequent wakinng-up due to "puffing"  (i.e. air escaping from the mouth ) . I am an occasional mouth breather and in the past 2 years, I used a full face mask + mouth taping . I have no idea why and when the mouth breathing starts !
The CPAP pressure range is currently set at : 10-16 cm H2O .  Should I lower this pressure range ?

I wonder how others deal with "puffing" when using nasal mask ?  I might try mouth taping again and see...  Please comment & advise . Thanks .

[sheepless]

it's possible you might adapt in time. my problems with leaks, aerophagia and puffy cheeks occur most often on my back. if you can identify a positional issue, that'll give you one way to try to minimize the cheek thing. in the meantime, you've probably read all about the pros and cons of a soft cervical collar. try it, if you haven't already. I use a nasal pillow mask but don't know mask type makes much of a difference with respect to whether the collar works for each individual. anyway, I don't much like it but that's what works for me against mouth and lip flutter leaks, chipmunk cheeks and clusters of events. that and a buckwheat pillow. I said I don't much like it but have to say I'd prefer it over taping and chin strap. I think finding a ffm to work with my facial hair might be difficult too so I'm really happy the collar works well.

[tommyngo]

Thanks for your comment . I am using a soft cervicall support and it does make a big difference in my AHI reading ! However, it not as effective in preventing "puffing" im my case yet .  . BTW, I  just switched to nasal face mask & soft cervical support at the time  3 days ago, so perhaps it might take more time to adapt  ??

[sheepless]

sorry, I should have re-read the previous posts in this thread before commenting. it seems you've had some significant success with the collar but continue to leak. I may have misunderstood puffing to mean chipmunk cheeks but maybe you mean the intermittent escape of air from between the lips, pfft, pfft, pfft. chipmunk cheeks might be undesirable but are really only problematic when air escapes. the machine manages despite small leaks but leaks above the red line have to be tamed.

many people have to use more than one technique. you've probably already read about them. most have been mentioned in this thread. you'll have to experiment with those and various masks. finding the right mask and taming leaks are the most difficult aspects of this treatment for most of us. it can be a slog but virtually everyone that perseveres finds a way. not much help but that's the way it is.

in addition to the other techniques, you might try a different type of collar, especially if your neck is particularly tall or short. pillow type might make a difference (I find buckwheat works best for me). try some kind of pacifier. stay off your back or side if leaks tend to occur in those positions. maybe the simplest thing you could do is lower your pressure in hope of finding a setting that doesn't leak as much, then slowly raise it again in small increments to try to adapt. until you find a workable solution, you might have to compromise between leaks and ahi.

[tommyngo]

.............. maybe the simplest thing you could do is lower your pressure in hope of finding a setting that doesn't leak as much, then slowly raise it again in small increments to try to adapt.  until you find a workable solution, you might have to compromise between leaks and ahi.

Indeed, I might have misused the word "puffin"   to indicate intermittent air leakage from the mouth . I really appreciate your helphul suggestions . I come this far after 2 years ...Another 2 years playing around with the CPAP machine still seems acceptable to me . Thanks, sleepless  .

[SarcasticDave94]

Why did I just think fish when seeing ahi in an above post? guess that was a squirrel over there...g'night people...

[sheepless]

ahi. yes, and isn't puffin a fish too?

[chrysos]

I’ve been following this thread and wondering where the “EPR” setting is. What does it do? I am in the clinical menu, the comfort section, I don’t have an EPR setting. There are couple of flex settings.

[OpalRose]

chrysos,
Expiratory Pressure Relief (EPR) is a ResMed specific term.

EPR settings:
Exhalation pressure relief is a CPAP feature that lowers the pressure on a CPAP machine when the patient exhales in an effort to make breathing more comfortable. Exhalation pressure relief offers three settings: 1, 2 or 3, with each number signifying the degree of pressure reduction. (A setting of 1 provides the least pressure relief; a setting of 3 provides the greatest relief).


Philips-Respironics uses the term A-Flex for its APAP machines, Bi-Flex for its BiPAP machines, and C-Flex for its CPAP machines.

Flex settings:
You can receive up to 2cm pressure relief, but is flow based.
• C-Flex – Provides pressure relief upon exhalation.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation.

[Sleeprider]

Just to add to what OpalRose said (and I think I posted it earlier in this thread); Flex is not the same as EPR and does not provide the "bilevel" benefits of EPR. Mainly this is because the pressure change is not sustained throughout inspiration or expiration, but instead returns to CPAP pressure before expiration ends. It does not follow the spontaneous respiratory cues of the user, and because of this can really be a problem when the machine "guesses" wrong at the timing of inspiration and expiration.