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Khavoqi - Therapy Thread
#1
Khavoqi - Therapy Thread
Hey everyone.

I have a ResMed AirSense 10 with nasal pillows. I'm a 19 year old male, 5'11, 165 lbs.


I've been struggling heavily with my CPAP machine. I don't know where else to go at this point. I've only had a good 2 nights on it, out of nearly an entire month of using it. Every day I wake up feeling like I got ran over by a truck; please help me sort out my settings.

Pressure: 5.8
Ramp Time: Off
EPR: Off
Humidity: 4

I tape my mouth each night to prevent mouth leaks, have a roll that prevents me from turning on to my back. It seems like I just randomly rip off the mask in the middle of the night without me even being aware of it; at least that's what I think it is. The weird part is that I apparently subconsciously put it back on or something. Please help me figure it out, I seriously don't know what I'm doing wrong. It feels like I've tried everything, all to no avail; those good night are as elusive as the wind.

Thanks.


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#2
RE: Please help I can't do this anymore
Hi Khavoqi!  -  Welcome

Sorry to hear about your problems.  Do you have a copy of your sleep test that you can post here?  It is recommended that you block out your personal data before posting it here.

Most adults will feel air starved until the pressure is at least 7-8 cm. This may be a consideration for you.

- Red
Crimson Nape
Apnea Board Moderator
Project Manager for OSCAR - Open Source CPAP Analysis Reporter
www.ApneaBoard.com
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Please help I can't do this anymore
Hi, thanks for the super quick response.

I didn't realize my pressure may have been too low; I'll try adjusting that and see what happens. However, since I'm at a healthy weight (and may have UARS from my research), would this still be the case?

Also, here is my sleep study: https://imgur.com/a/O6UT0um
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#4
RE: Please help I can't do this anymore
@Khavoqi

Hang in there, you are in good hands with Crimson Nape! 
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#5
RE: Please help I can't do this anymore
The min setting is the amount of pressure you are inhaling (or your fixed setting). I personally have to have at least 9 or I’m pulling off my mask.

I’m sure you need a higher pressure to get enough oxygen. I would try 8 for a night and see how that works for you. You could need higher.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: Please help I can't do this anymore
OK, I looked at your report. Your throat muscles may be relaxing to the extent that gravity is causing part of your problem. Avoid sleeping on your back as much as possible. The left or right sides or the prone are the preferred positions. Do you have any medical history or on any medications that you haven't mentioned? I'm guessing here, but your tossing and turning could be also caused from uncomfortable bedding or sleeping environment. Bedding includes both mattress and/or pillow. The sleeping environment includes noise, temperature, and light. Any problems with any of these?

- Red
Crimson Nape
Apnea Board Moderator
Project Manager for OSCAR - Open Source CPAP Analysis Reporter
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Please help I can't do this anymore
First of all, I really appreciate the help and dedication your showing to a complete stranger. Really means a lot to me.

To answer your question, nah, my sleeping environment is pretty good. Almost pitch black, not a lot of a noise, nice, cool temperature, etc. I do all the typical things for sleep hygiene, so I got that checked too.

And nah, I don't really have any medical history. I take Vitamin D supplements, but that's pretty much it. I guess I'll try and take a look at my sleep environment and see what could be causing the tossing and turning.
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#8
RE: Please help I can't do this anymore
OK! I was trying to cover all the bases. Still, stay off your back. We'll see how you progress for there.
- Red
Crimson Nape
Apnea Board Moderator
Project Manager for OSCAR - Open Source CPAP Analysis Reporter
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Please help I can't do this anymore
I'd like to take a different approach and see if we can get you to a more comfortable place by changing some settings, and especially by using the exhale pressure relief feature on your machine. I think your flow limitation is under-stated on your results because your inspiration time is actually longer than expiration time. This suggests your are having to use respiratory effort to suck in each breath past airway obstruction and without EPR you get no "assist" from the pressure support your machine is capable of. I'm going to give you suggested settings. Try them out and report back with a chart and comments on comfort.

Mode: Autoset Standard
Minimum Pressure: 7.0
Maximum Pressure : 10.0
EPR: On, Full-time
EPR Setting: 2

I will probably suggest we move up to 3 cm of EPR, but want to see if this affects CA events with a lower setting of 2 to start. You will need to access the clinical settings to implement these changes. This may help if you're not familiar. https://www.apneaboard.com/resmed-airsen...setup-info
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Please help I can't do this anymore
Hi, thanks for the suggestion.

Funnily enough, I actually tried turning on EPR to 2 last night, whilst increasing my pressure to 8.4; still doesn't seem to have made a difference on my overall sleepiness.

Attached are my results from last night.

Since I apparently have inspiratory effort, would that point to UARS, which would mean that a Bilevel would be ideal?

Thanks.

*Note: I went to sleep at around 5. Yes, I know it's really, really late, but there doesn't really seem to be any point in going to bed earlier when I'm gonna be tired regardless of how long I sleep.


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