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Greetings,
I continue to have poor sleep quality. I've tried adjusting pressure +/- EPR, I tape my mouth at night, and wear a collar. I also mostly side sleep. At low pressure I experience mostly hypopnea and at higher pressure CAs + aerophagia. The aerophagia wakes me up and keeps me up all night. Pressure above 8 causes it. I' not sure what to do next. I have an appt with a pulmonologist at the end of the month but until then, want to dial in the settings for improvement. Any suggestions? Thanks!
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
When I first saw your charts I thought that you might have complex apnea (a combination of OSA and CSA). The best you can probably do right now is to try to optimize this current machine as best as possible and see if the results are good enough for you. You have tried many things already (great job).
If you get this machine optimized and it is not adequate therapy for you, there is a bilevel still to try; and even a machine like an ASV that is a bilevel and has a back up rate to combat both obstructive apnea and central apneas.
If anyone else sees any adjustments that could help, please post.
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10-07-2024, 12:10 PM (This post was last modified: 10-07-2024, 12:11 PM by SarcasticDave94.
Edit Reason: Edit
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RE: NoCaffAfter4 - Therapy assistance
Looks like there's some Positional Apnea clustering going on. You may want to read the wiki about it.
Flow limits chart has the shaggy grass look, so you will have to consider addressing via either by activating EPR or getting bilevel VAuto. The issue is this will likely increase CA.
If the CA were high during the sleep study, then maybe even ASV is a consideration.
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Machine: Resmed Air Sense 10 Elite Mask Type: Nasal pillows Mask Make & Model: Fisher & Paykel Nova Micro Humidifier: Resmed SX556-0204 CPAP Pressure: 6 to 7 cm CPAP Software: OSCAR
Other Comments: 35+ yrs on CPAP 98% compliance, now using VCOM at back of machine
I will start by saying your profile and charts mimic mine in a lot of ways, except for your high respiratory rate and i have never had auto CPAP.
I had sleep study that suggested 6 to 7 cm.
When i came to this site, everyone tried to get me higher pressure and EPR as well.
It did not work, and not anyones fault, it was just that for some reason, as yet to be determined, i just cannot get a repeatable chart from day to day like so many others on this website.
I suspect nocaff is similar.
My proposal is to keep low pressures for a few days.
Try 5 cm min. 7 cm max, NO EPR ( i would prefer a set pressure, which you did @ 7.4 cm i see in your charts, but maybe did not give that enough time OR that is too high.
There are a few things that i have read about where thinking differs here or there.
1) Need to get flow limit down, that has NOT been my experience, and from what i have seen, when that is the driving force in making adjustments, problems arise.
2) Auto CPAP finds your range. No way i agree with this!! And many others on the web agree. There is no feedback, really, for this type of control, so it goes high for some event then it sits there too long and causes other events. My and sleep clinic beliefs are that you need to get a set pressure first and see what that looks like.
3) dry mouth, from what i have learned about this it is mostly caused by mouth breathing, so we tape the mouth, but when you have an OA event, where does the pressure and air go? I think that is a bigger problem than breathing thru the mouth to relieve that pressure and i am experimenting with Myotape.
I am going to talk more about all these items in other threads, dont want to hijack NOCAFF thread, but i thought all this applied in this case so i mention it all.
Thanks, SeePak! I'm finding that I agree with your assessment and proposals. I find that 8-9cm is fairly decent, pressure higher that 9 results in aerophagia, causing arousals and disrupted sleep. Eight to 9 works pretty, but I experience a lot of hyponeas. I can see that it's a balance to dial in the settings. I'll try dropping the pressure a bit to see how it goes. FWIW - I was prescribed 5cm at my sleep study. I have an appt with a sleep doctor next week and will get his thoughts on a SVR. There's a lot of room for improvement.
Thanks again, I appreciate your thoughts and recommendations!
Machine: Resmed Air Sense 10 Elite Mask Type: Nasal pillows Mask Make & Model: Fisher & Paykel Nova Micro Humidifier: Resmed SX556-0204 CPAP Pressure: 6 to 7 cm CPAP Software: OSCAR
Other Comments: 35+ yrs on CPAP 98% compliance, now using VCOM at back of machine
Yes, nocaff, sleep study 5 cm, i was assuming that, you just never know what somone puts in that spot on the bio.
Thats why i suggested 5 - 7 cm,
I also was wondering how you felt after the night of 7.4 cm constant pressure?
I just had myself a crazy obstructive/clear airway event night , but i feel great today ! ( i do breathing exercises, i know that helps, cause i get the CO2 flowing, my O2 goes up and my head/body feels great !)
The chart dont always match the sleep i get, i'm sure others have the same thing.
Looking forward to see/hear how you make out......
