New member with a question

[super7pilot]

I have the chart list in my signature (bottom of the message) that you need.  The only thing I would change for now is the min pressure.

min pressure is the lowest the machine will go.  Your is set to 4 and that is the absolute lowest the machine can go and that setting is for children.  An adult will need more so they do not feel air starved.

Set your min to 8

You will not need a ramp.  You will not get any therapy during ramp and your starting Min of 8 is in inhale pressure while the exhale pressure will be 5 and again the lowest it could go is 4 and you will not notice the difference.


Thank you for the chart wiki. That will help a bunch.

So set to 8cm min & 20cm max with the EPR at 3 full time and no ramp.

[super7pilot]

Well last night was a frustrating one. I'm beginning to wonder what my goals are or should be. My Dr's say that as I'm on three BP meds. That points to apneas causing the high BP.

Yet my BP at 67 yrs old is 130's/80's and even into the 120's/70's which the doc says is great. ?????

And I have to say that I have been more tired and feel much worse than I ever have prior to being on APAP therapy.


At the end of the first session. My nose started to clog up. Was off the mask for a while and put it back on. Removed it again. then about 7:30 AM brought the pressure down to 6 from 8. In the next 30min or so. I had 0 OSA's and 17 CSA's on my machines screen.

I'm about ready to return this infernal torture device.


Here is my chart from last night.  

[super7pilot]

Finally heard from my sleep Dr. My sleep lab showed 22 events per hour. Just plain old Apnea, Centrals weren't an issue. So all those at first were treatment emergent centrals. So that's good news and a big relief.

As of late my numbers have improved dramatically. Still a little tired but not the full on zombie I was a few weeks ago. I have had my pressures at 10-15 APAP with EPR of 1 and my AHI is below 1 90% of the time and 2 at the most the rest of the time. Nearly zero Apneas a few hypopneas and 1-2 centrals in total all week.

The typical max mask pressure has been an occasional 12.8-13.5 when my nose goes stuffy on my P30i pillows. But hovers around 10-10.5 average.

Now to work on masks and bug my ENT for more nasal solutions. I'm on Flonase & Nevage nasal rinse every night an hour before bed.

[SeePak]

Hi superpilot.

Glad you appear to be feeling better and getting on with your therapy.

I am curious about how your original charts are showing the machine keeping the pressures less than 7 cm all the time?

But you have much higher pressures now in your last post.

Could you post a few of these charts that are current, with the higher pressures?

[super7pilot]

Hi superpilot.

Glad you appear to be feeling better and getting on with your therapy.

I am curious about how your original charts are showing the machine keeping the pressures less than 7 cm all the time?

But you have much higher pressures now in your last post.

Could you post a few of these charts that are current, with the higher pressures?

I'll post last nights chart. I had only 3 Hypopnea events over 6:52. I used my 30i mask with the nose cradle and a ruby style chin strap. and my nose actually cooperated last night. YAY!!

What I had noticed as I learned more was that the very wide range of pressures that most Doctors set our machines at. (4-20 APAP) Can be bothersome. But they seem to like to take the easy route (for them) and just let the machine sort it out and end user be damned.

After a career in the Air Force working on Nuclear weapon system electronics (Minuteman II missiles)  I'm not a just let the machine figure it out type. I have to dig deeper.

So I found via the fine folks here that:
1, The 4cm was too low a pressure and had me breathing too deeply to catch my breath and that was washing out the CO2 and causing the central apneas.

2, Going from such low a pressure with EPR3 to the higher pressure needed for therapy creates sleep disturbances beyond ones Apnea. That had me sleeping but not sleeping deeply and restfully and had me in zombie mode and very unhappy/frustrated.

So, What I saw was that as I raised my minimum pressures closer to my therapeutic pressures a bit over time.  My central Apneas very quickly disappeared.

 However, my sleep doc requested that I raise my max pressure from just above to well above my therapeutic level to allow for a bad apnea night. So I upped it to 15cm but it has yet to hit that pressure

It was strange to me that all along my OSA's were actually quite low. It was those CSA's that were confounding to me. And they were also effecting me mentally. As in my layperson head. Centrals ARE RESPIRATORY FAILURE. I was quite afraid I would stop breathing and die.

Another nice statement from my sleep doc was that she said my lungs are in superb condition. As she said my blood O2 recovered very, very quickly after an OSA. I have never smoked in all my years.

anyway, Hope the charts are useful.

[SeePak]

superpilot, looks great!

Hopefully CA events stay away.

There is some narrowing going on in the flowrate, but nothing crazy like some charts.

For me, when i look to see what pressure you need, and since you use EPR, i look at the EVAP column and that pressure determines how I would be setting you up.

I see that you need probably 9 cm constant pressure , assuming nothing else changes, to keep flowrate good without narrowing on the chart.

So if you use say 11 cm, with EPR2, that for me would be same as above, 9cm constant.

If you were to not use EPR for whatever reason in the future, you will probably end up with about 9cm min to 10 cm max. pressure. Anything extra is just moving air i think.

Others disagree and have experience here for sure.

But i really never see anyone actually try it and leave it for awhile to see how it would work.

Glad you are back in the saddle again!

Straight ahead my friend!

[super7pilot]

SeePak. I have had the EPR at 1 at 10cm for a while. But I did kick it up to 2 last night with 10cm. And I was a lot more comfortable and my mask vent port was a bunch quieter as well. And as we can see, The Apneas stayed away.

It was a three fold endeavor.
1, A lot of experimentation based on the advice from my fellow sleepy heads on the forum.
2, Keeping my eyes on the OSCAR charts. As well as learning about those confusing numbers. Esp the flow limitations. Which seem to be based on internal Resmed data that they don't talk about. And even my sleep Dr. said ignore the flow limitations unless you are on Bi-pap.
3, And how I felt.

The last effort is the mask mystery and further effort to get my ENT to perhaps get more aggressive in clearing my sinus. I have a deviated septum on the right nostril. Which is the most clogged side of my schnoz.