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Started APAP one month ago. Tried N30i, F30i, N20 masks. Tried each one for about a week, and kept them on for the insurance-mandated 4 hours, but never slept well. One week ago I started with Bleep Dreamports, and having more success. At same time I also started mouth taping. Less leaking and able to sleep for several hours with Dreamports on.
With all of these masks I have a lot of trouble with "chipmunk cheeks". My initial prescription for pressure was 5 - 15 (as is usual), but after a week I changed it, trying to reduce the chipmunk cheeks (but so far without much success). I am considering trying the VCOM. However, the VCOM promotional material emphasizes that the VCOM is to improve "comfort", and it's not clear to me whether it would help much with the cheek puffing. I wonder if I should stay with APAP for a while more and experiment with different pressure settings?
The VCOM website says I should change my machine to CPAP settings, and maybe increase the pressure because the VCOM reduces flow somewhat. I am uneasy about making these changes because I don't fully understand all the implications of changing pressures up or down.
Any advice about current settings, or advice about trying VCOM?
10-22-2024, 07:12 PM (This post was last modified: 10-22-2024, 07:16 PM by Deborah K.. Edited 1 time in total.)
RE: New user, one month in, settings advice?
I don't advise the Vcom. Only a few people seem to benefit from it at all, and I don't think it does anything for puffed up cheeks.
I suggest that you set your pressure range differently. I think you need 8 to 13.
Also, you would do well to turn on EPR full time, set at 3. That will make your breathing more comfortable and will lower your flow limits, which are very high.
Deborah K, Thanks very much! I used your suggestions last night and it felt good. Breathing was comfortable and I slept for most of 8 hours without having to get up at all. Still some cheek puffing, but maybe a little less. Unfortunately I don't have Oscar data. I got the dreaded plain white screen with the notation: "There is no data to graph. Graphs switched off." I assume either I didn't have the SD card pushed into the machine completely, or I interrupted the SD card prep routine. But I'll continue for a couple more nights and record data.
Events per hour were up a little, to 5.5, but unfortunately I don't have any detailed data. More to follow. Thanks again,
I'm glad you felt better! That's so important. Post another Oscar when you can, and we can see if additional changes would be beneficial.
This is secondary, but it would be helpful if you posted your Oscar a little differently. To copy the page, touch F12 if your computer is Microsoft and F12 plus fn if you use Apple. That will give you the basic setup. Then check it to make sure we can read to the very bottom of the flow limits.
Thanks again for your interest. Last night was very similar to the night before. Breathing felt comfortable and I slept for most of the 7 hours. Some cheek puffing, but not as bothersome as it used to be. I will appreciate any advice for adjustments.
Update: As mentioned above, on Oct 23 I changed pressure settings and EPR as suggested by Deborah K and overall breathing and sleep duration was improved. I had been using the Dreamports mask for about 10 days at that point. Three days ago I switched to the Bleep Halo mask, just to try it, because the magnetic connection system is supposed to be a little easier than the plastic ports.
Subjectively my sleep experience seems to be about the same with either the Dreamports or the Halos. But the AHI numbers have been a little higher over the past three days with the Halo (7, 8.2, and 5.6). For the previous three days with Dreamports at the same pressure settings the AHI numbers were: 5.2, 5.5, 5).
I think, as other Bleep users have commented, the metal connections with Halo at the nose make that point a bit more stiff than with the plastic Dreamports and there seems to be more torque against the nose when I move around, and therefore more possibility to create leaks in the adhesives. I may try some small extra tape strips around the nasal discs to avoid leakage. I plan to continue with the Halos for a while.
Any advice for changes to reduce the AHI?
Thank you
I love Bleep, but I had no success with the Halos, so I went back to the Dreamports. The halos stuck out too far from my nose and tore the tape, causing leaks. I also did not like the extra weight. Some do great with them, but not me. Same for my husband, but he went back to his nasal mask, as he had never used the Dreamports and is happy with his mask.
I think you need to change your pressure range to 10 to 16. This is because your median pressure is 10.7 and you are bumping up against the 13 too often. Give it a try. I think you'll feel better.
Also, I think you are using 2 EPR. If so, raise it to 3. Your flow limits are high and we like to get them down when we can.
Deborah K, I changed the pressures to 10 and 16 as you suggested. The EPR has been set to 3 for the past week (since you first suggested that.). (Jut curious, what made you think it might not be three? I'm just asking so that it might help me better understand how to interpret all this data.)
My subjective comfort level continues to be OK.
The OSCAR data shows frequent low leaks. I was aware of a possible leak near the edge of one nostril where the halo ring was not centered exactly over the nostril. I probably should have replaced it, but I wasn't completely sure it would leak. Now I know.
