MadFox - Therapy Help Thread

[MadFox]

Easy enough to try. I reduced the top end pressure because of the blow-over on the mask making my eyes dry so upping the min. pressure shouldn't hurt that. EPR is currently 2, so also won't hurt to go up a tad to 3.

My pulmonologist has not responded but only sent this a.m. My feeling is I don't have CSR it's positional and/or when leaks occur. However, I had a few at the 9 to 15 setting as well. The best thing for me to do is lose the weight with more exercise and now that i'm off steroids.

Do have to say that the dev. septum surgery with a doc saying "as bad as i've seen" has been truly amazing difference. 

** For any readers who have a dev. septum and not had the corrective surgery (covered by medicare and most insurances)... am telling you totally different, wish had been done 30 years ago. having it also made it where i could tolerate the CPAP

[MadFox]

   

Thanks to several regulars here:  @SarcasticDave94  @PeaceLoveAndPizza  and @Jay51 

Below is results after a few nights of experimenting plus a sinus infection clearing after day 4 on anti-biotics.

So, would this appear to be a good set-up?

[PeaceLoveAndPizza]

My opinion is you do not have enough pressure. Even if you have to use a fixed pressure, the min suggested is 8 and you can set the max to 10.

Something like:

Mode APAP
Min pressure 8
Max pressure 10
EPR 2 full-time
No ramp

Or even

Mode CPAP
Pressure 8 (or 9 or 10)
EPR 2 full-time
No ramp

A bit more on the minimum should help with the remaining arousals.

[MadFox]

Good morning.

Saw a new pulmonologist. New sleep study, without CPAP was still a "train wreck."

Had some open mouth nights where eyes and mouth dry (teeth hurt too). So, got a chin strap from resmed dealer store.

Have adjusted to levels recommended in June threads here. With chin strap now, past 2 weeks my AHI is 1.0 on average. Sometimes as low as .4-ish. Rarely above 2.0. Without chin strap was 2 to 4 AHI, and dry and mouth plus air swallowing issues.

Issues would like feedback:

1. Burping and stomach/bowel air. The pressure is NOT going over the max setting of 11, yet seems much worse now. Any solutions to this issue?
2. Saw opthamologist for annual and he said did have dry eyes not too bad. Recommended using refresh as much as possible vs. Rx but said no damage. Is dry eye a potential issue. Is CPAP bad for older folks eye health? Anyone had significant problems?
3. Any one using the mouthguards to open throat vs. a chin strap?. i.e. the mouthguards on TV and social media for snoring? Am mostly a side sleeper.

[Crimson Nape]

MadFox - I have merged your 3 threads that relate to your CPAP journey.  It makes it easier for those that offer advice to see your history in one thread. To provide a more inclusive title, I have renamed it to "MadFox - Therapy Help Thread". Please use this thread for all your therapy related posts.
- Red

[MadFox]

Okay. I was unsure what happened. Thanks.... I think!? ??

[OpalRose]

Issues would like feedback:

1. Burping and stomach/bowel air. The pressure is NOT going over the max setting of 11, yet seems much worse now. Any solutions to this issue?
2. Saw opthamologist for annual and he said did have dry eyes not too bad. Recommended using refresh as much as possible vs. Rx but said no damage. Is dry eye a potential issue. Is CPAP bad for older folks eye health? Anyone had significant problems?
3. Any one using the mouthguards to open throat vs. a chin strap?. i.e. the mouthguards on TV and social media for snoring? Am mostly a side sleeper.

I'll attempt to address your concerns....

1.  It's called Aerophagia, the swallowing of air.  Assuming you're using the pressure settings recommended in June...
..... to address Aerophagia, go to CPAP Mode and set your pressure to 8 with EPR set at 2.  Watch for a couple days, then if no Aerophagia, move the pressure to 8.6, EPR 2, watch for a couple more days, then move pressure to 9.  Continue this and as long as there is no Aerophagia until you find that "sweet spot" that still gives you low AHI readings.  

2.  Yes, dry eye is an issue.  I suffer with the same and need to be careful of air blowing over my face and in my eyes.
I see my Ophthalmologist every 3-4 months to check eye pressure.  
Another good brand of eye drops is Systane.  I use Systane Gel drops during the day and their nighttime eye ointment right before bed.  You can also wear an eye mask for extra protection.

3.  I don't use a mouthguard or chinstrap as I don't snore, but do use mouth tape for occasional mouth leaking.

[MadFox]

I'll attempt to address your concerns....

1.  It's called Aerophagia, the swallowing of air.  Assuming you're using the pressure settings recommended in June...
..... to address Aerophagia, go to CPAP Mode and set your pressure to 8 with EPR set at 2.  Watch for a couple days, then if no Aerophagia, move the pressure to 8.6, EPR 2, watch for a couple more days, then move pressure to 9.  Continue this and as long as there is no Aerophagia until you find that "sweet spot" that still gives you low AHI readings.  

Thanks for reply @opalrose Yes, aware of it being called Aerophagia. I tried a lower min. pressure in both CPAP and APAP modes. So, have adjusted a great bit. Current Settings are: (Copy/Paste from Oscar)  The air/belching in the a.m. is pretty annoying.


Mode: APAP     Pressure Min: 9.80 cmH2O  Pressure Max: 11.40 cmH2O   Antibacterial Filter No   Climate Control Auto  EPR Full Time  EPR Level 2 cmH2O  Essentials On
Humidifier Status On Humidity Level 4  Mask Pillows Ramp Off Response Standard  Smart Start Off   Temperature 27 ºC  Temperature Enable Auto

2.  Yes, dry eye is an issue.  I suffer with the same and need to be careful of air blowing over my face and in my eyes.
I see my Ophthalmologist every 3-4 months to check eye pressure.  
Another good brand of eye drops is Systane.  I use Systane Gel drops during the day and their nighttime eye ointment right before bed.  You can also wear an eye mask for extra protection.

Did not have this issue at first. Better with chin strap but still dry eye, not sure it is from leakage, think it is more the higher pressure of air into sinuses, mouth, and thus tear ducts, etc. Wear contacts so do not do well with gels and thicker viscosity drops. so refresh seems best right now. last thing I want is more things on my head like an eye mask. HA.

3.  I don't use a mouthguard or chinstrap as I don't snore, but do use mouth tape for occasional mouth leaking.

Really do not snore either, as mostly sleep on my side. Left side, being predominant (better for heart and reflux) got chin strap for open mouth on occassion when roll to back and even on side some it appears, also thinking might help eyes. but only marginally better so far. 

???   The question for others is does anyone use the assorted advertised mouth pieces that claim help with snoring as a way to avoid chinstrap and tape, etc.

So, still wonder if anyone uses any of the advertised mouth guards as assist to CPAP
And also, any other folks had significant dry eye and have suggestions?