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Muggzy's Therapy Thread - My quest for relief
#1
Muggzy's Therapy Thread - My quest for relief
Greetings, and thanks for what looks like a wonderful and helpful community! For the first time in way too long, I feel hopeful that I can make a significant positive change in my life (after lurking on the forums for the last week, lol).

I am a morbidly obese 50+ year old white male who was diagnosed with OSA more than twenty years ago.

I have had two sleep studies, neither of them recent, and was never given any data (nor really much information at all, really) from the studies, but was told at the time that I had mild sleep apnea. 

I was prescribed a no-frills brick CPAP machine that could only be configured by the physician or technician, and the experience of using it with their chosen settings made me feel so claustrophobic that I gave up after about a month or two of inconsistent use both times.

In the time since, I've gained a ton of weight and been diagnosed with COPD as well. My health and energy had been slowly but steadily declining until 2020, when I caught COVID twice, and has been going downhill even faster since.

I recently purchased an "overnight" pulse oximeter with data logging, which showed that my saturation was dropping as low as 85% while sleeping, with a high number of ODI3 / ODI4 events each hour, which freaked me out enough to schedule an appointment with a new sleep doc.

The new doctor quite reasonably wants me to have another sleep study done, but the insurance company will only pay for an in-lab study and those are apparently in high demand with none being available for months. I will be scheduling one at the earliest possible opportunity.

Given that, and being in possession of a nearly unused ResMed AirSense 10 Autoset, I would like to see if it's possible to treat my sleep apnea to some degree myself in the interim, because I've never felt worse and the idea of waiting for months just to get started is unbearable. I'm not expecting miracles from going this route, but I would be incredibly thankful for any improvement at all.

So my question to all of you fine folks is this: given that I don't have a recent sleep study to provide guidance on a good set of initial parameters, is there a good set of generic parameters that I could use as a starting point?

Any suggestions would be greatly appreciated, thank you!
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#2
RE: Muggzy's Therapy Thread - My quest for relief
Welcome to the forum. You can find instructions for adjusting the settings here https://www.apneaboard.com/resmed-airsen...setup-info
A good starting point would be a minimum pressure of 7 and a maximum pressure of 15 with EPR full time at 3. I'm assuming that since you have OSCAR you have an SD card in your machine to collect data. It's very important that we see your datat as soon as possible so we can recommend adjustments from the starting settings. See the links below for instructions for organizing and posting data.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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: Muggzy's Therapy Thread - My quest for relief
Yup, I already have OSCAR installed and a compatible USB SD card adapter on my computer and an SD card on the CPAP.

I'll try those settings and report back.

Thank you for taking the time to respond, I appreciate it.
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#4
RE: Muggzy's Therapy Thread - My quest for relief
Let's get that Autoset out of the closet, and get started. Your new settings are:
Minimum pressure 10
Maximum pressure 18
EPR On Full-Time
EPR Setting 3

This is a limited bilevel suite of settings that should help you to improve ventilation volume. I suspect following a sleep test you will receive a full bilevel device with more pressure support than the 3-cm the Autoset offers. I think Melman's settings are well-considered, but your history makes me inclined to start with the minimum pressure of 10.0 and exhale at 7.0 rather than the 7.0//4.0 pressure which is at the bottom of the pressure scale. Show us some results in Oscar and we can try to optimize.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Optimizing Therapy
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How To Deal With Equipment Supplier


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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#5
RE: Muggzy's Therapy Thread - My quest for relief
Go with Sleeprider. His experience and expertise are much greater than mine. His advice to me 6 years ago got me on the right path.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#6
RE: Muggzy's Therapy Thread - My quest for relief
I plan on trying SleepRider's suggestion tonight.

I took Melman's suggestion last night, but unfortunately had issues with mask fit that resulted in not obtaining any meaningful data.

I hope to have those issues resolved tonight.

Is it weird that I'm looking forward to this test, despite knowing that CPAP has always caused me tremendous anxiety? Heh.
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#7
RE: Muggzy's Therapy Thread - My quest for relief
What is the significance of this breathing pattern, if any? This has been happening every night for at least the last two months, perhaps a little longer. It typically happens a few times per night and lasts from between five and thirty minutes at a time, usually terminated by an arousal. 

I am using a ResMed AirFit F30i "full face" mask, and as shown below there is no significant leak during this period. Minor changes to EPAP (± 2 cmH2O) doesn't seem to have any effect, nor does changing the EPR.
[Image: kJs959p.jpg]
To me it looks like examples I've seen here on the forum of palatal prolapse, and that's definitely something I've experienced during the liminal state between waking and sleeping (feels like a check valve snapping shut) but I'd like to see what people here think before I bring it up during my next appointment with my pulmonologist.
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