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New CPAP User, Trying to Reduce CA's
#11
RE: New CPAP User, Trying to Reduce CA's
(08-09-2021, 05:35 PM)SarcasticDave94 Wrote: Mouth breathing via that F30i full face gives the advantage to compensate through mouth breathing when you need that. It does mean you might get dry mouth. But with full face, mouth breathing isn't breaking your PAP circuit, but mouth breathing combined with nasal or pillows masks will break circuit.

Thanks for the info. I just attached 2 images of some semi zoomed in leak rates. Are these showing mouth leak? They seem fairly flat, but they're in the 8-16 L/min range so they don't hit the large leak threshold.


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#12
RE: New CPAP User, Trying to Reduce CA's
I think mouth breathing is a possiblity. My take on the leak rate, hopefully I'm correct, long & wide or rounded leak traces I suspect mouth leaks. Kind of like these here. The other spikey leaks I consider mask leaks.

Another tell on mouth leaks can be dry mouth due to airflow. If you do have dry mouth, consider Xylimelts or Biotene or similar to help that if it's an issue.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
RE: New CPAP User, Trying to Reduce CA's
(08-09-2021, 09:55 PM)SarcasticDave94 Wrote: I think mouth breathing is a possiblity. My take on the leak rate, hopefully I'm correct, long & wide or rounded leak traces I suspect mouth leaks. Kind of like these here. The other spikey leaks I consider mask leaks.

Another tell on mouth leaks can be dry mouth due to airflow. If you do have dry mouth, consider Xylimelts or Biotene or similar to help that if it's an issue.

Thanks again for responding.

I'm trying to discern if my mouth leaks are something I should be looking to rectify and if it would be a source of my CA's at all. I increased my min pressure to 7.4 to try and reduce OA and H and it helped, but made my CA's worse, AHI just over 5.

Attached last nights data with some zooms of the leaks.


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#14
RE: New CPAP User, Trying to Reduce CA's
Increasing pressure will almost always increase CA. Sorry I've forgotten, ramp and EPR are off or minimal? These tend to increase CA but EPR tends to decrease the other Obstructive events. You're on the event teeter-totter.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#15
RE: New CPAP User, Trying to Reduce CA's
Your therapy would likely be best with ASV (adaptive servo ventilator) which is a PAP machine that actively treats central apnea, periodic breathing and hypopnea, while also treating obstructive sleep apnea. It would be very interesting to see the results of your sleep study to see if CPAP was actually the best choice, or was the expedient choice for insurance purposes. Either way, we may be able to optimize your current therapy and reduce the event rate, but if you are better served by ASV, that may not be the best choice. Let's go for comfort and take a look at your sleep study results, then decide if setting changes are your best choice, or if you should be looking forward to y our next progression on the therapy ladder.
Sleeprider
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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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#16
RE: New CPAP User, Trying to Reduce CA's
(08-11-2021, 07:48 PM)SarcasticDave94 Wrote: Increasing pressure will almost always increase CA. Sorry I've forgotten, ramp and EPR are off or minimal? These tend to increase CA but EPR tends to decrease the other Obstructive events. You're on the event teeter-totter.

All good, I have ramp off and epr is 2 currently.

I bumped my pressure from 7 to 7.4 since my median pressure has been 7.3-7.5 the past week.

I have messed around with epr 2 and 1 and didn't notice much difference in reported events. Nor have I felt any better from treatment yet. 2 weeks in and only getting up once or twice a night for bathroom break(its more going because I'm up, rather than waking because I need to go).
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#17
RE: New CPAP User, Trying to Reduce CA's
(08-11-2021, 07:54 PM)Sleeprider Wrote: Your therapy would likely be best with ASV (adaptive servo ventilator) which is a PAP machine that actively treats central apnea, periodic breathing and hypopnea, while also treating obstructive sleep apnea.  It would be very interesting to see the results of your sleep study to see if CPAP was actually the best choice, or was the expedient choice for insurance purposes.  Either way, we may be able to optimize your current therapy and reduce the event rate, but if you are better served by ASV, that may not be the best choice.  Let's go for comfort and take a look at your sleep study results, then decide if setting changes are your best choice, or if you should be looking forward to y our next progression on the therapy ladder.

Great info thanks!

I'll get my hands on my sleep study results. It was an at home test only though. Where I had a chest strap, finger o2 monitor and then a nasal cannula all connected.

From what I recall of the results, most of the triggered events were hypopneas, then some OA and a couple CA, for an overall AHI of 12.8. Not sure if the home tests under or over report certain events on average.

Must say the whole experience has been odd. Not sure if this is unique to where I live or not (BC, Canada). But did a telehealth appointment with my GP doctor, who ordered the sleep test. But I guess that was sent to a place called SnoreMD where they do the testing (at home only), but also sell equipment and they're who I've been dealing with solely since the initial referral from my doctor. It feels like very few medical professionals have actually been a part of the process as the folks at SnoreMD are clinicians.

I guess if ASV actually is the solution, I would most likely have to talk to my doctor again and get her opinion vs. talking with SnoreMD.

Not sure if it changes anything, but also I'm in a 30 day free evaluation with the AirSense 10 and I haven't technically purchased it yet (at least for another 2 weeks).
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#18
RE: New CPAP User, Trying to Reduce CA's
Ok for now you may want to drop EPR to 1. View the OSCAR data, CA should diminish but the Obstructive Apnea and Hypopnea events will likely increase. Welcome to the PAP treatment teeter-totter. Acting to diminish CA makes OA go up and vice versa.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#19
RE: New CPAP User, Trying to Reduce CA's
(08-11-2021, 09:42 PM)SarcasticDave94 Wrote: Ok for now you may want to drop EPR to 1. View the OSCAR data, CA should diminish but the Obstructive Apnea and Hypopnea events will likely increase. Welcome to the PAP treatment teeter-totter. Acting to diminish CA makes OA go up and vice versa.

About to hit the sack so I'll give it a go, thanks again.
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#20
RE: New CPAP User, Trying to Reduce CA's
PS so I don't forget. You mention the at home study included a chest effort belt. This is important as that piece of info means the CA that appear, if there were any, on the study would be real. The effort belt makes it capable of seeing CA, is what I'm trying to say. Again this is important for your situation regarding CA and ASV in future.

If you want clarification on what I'm saying, let us know.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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