Oscar CPAP Optimization Results-Awesome!?

[SeePak]

Thanx for the article, will re-read that.

Yes, i inspect at 3 min. chunks as well.
(Actually, every situation, for me with my brain, is different, sometimes i like having ALL parameters up, and can pick something out that way to investigate further.

But i dont have the knowledge yet, but wont take long.

What i was saying about the aspiration times, in the 3 min. chunk, i was finding that i was getting times where exhale was longer than inhale, and it always followed with large flow spike, possibly arousal, with a CA event. then settled out.
Also getting those footballs in the flow.

I'm sure we'll get to all that once we get dialed in with a good area for control, and keep the airways open, and my mouth shut!

[PeaceLoveAndPizza]

All good questions and comments. I think having a collar will help some, but how much is still TBD until you get a properly fitting one. See the attached for measurements. A collar will not only help keep your mouth closed but will also keep your neck more properly aligned and help with flow limitations. I use a FFM but also a collar as it makes a difference in AHI and sleep quality.


I have no experience with mouth tape, so hopefully someone who uses it will respond to help with that.

Higher pressure does add to the leaks, but in many cases is related to mask fit being wrong or headgear improperly adjusted. To me finding the right mask is a key element to effective treatment with CPAP. We can tilt at many windmills with tweaking pressure, EPR, response, triggers, etc, but often the proper mask can make a big difference.

Take a good look at your sleep hygiene as well. Even if you just focus on the basics like not eating within 3 hour of bedtime, turning off electronics an hour before bed, using relaxation techniques, using a flatter or CPAP pillow, and more, it can help as well.

Regarding tweaks to your machine, you can try going back to a pressure of 7, but use 2 cmH2O of EPR. We will have to figure out of the two variables, pressure and EPR, what combination gives the best nights sleep. We will also have to accept that treatment of flow limitations is going to be difficult with the current machine, so don’t get too concerned with that at the moment. Focus on sleep quality.

[SeePak]

   

Feel truly awesome this morning!  
7cm /EPR 2

Mouth taped shut.
Nasal strip.
Chin Strap
same under nose mask( this is worn, so leaks developed thru night )
Same CPAP pillow (may need new, or try another, will see)

FL is fantastic !

events very low.

I think if i get the leaks totally under control ( will try much newer ( Jan 2024)  Mirage Activa LT that i was using originally, and all along during my years of treatment )....

Will be headed for somewhere around 6.4 / EPR 1, and maybe even 6.0 / EPR 0   

Neck collar coming next week.
Getting some proper mouth tape as well.



Comments?

[SeePak]

   

I actually feel real good this  morning, in spite of the plethora of events!

6.6 cm / EPR 1

Taped mouth again, no problem.

Did NOT wear chin strap ( not sure if that affected anything, but definitely no leaks thru mouth all night. ) But ,

Maybe the strap was keeping jaw etc. in position to avoid some obstructions?

The mirage mask was mostly good, except for the 45 min leak in middle of night
Wow, when those masks leak it really adds up (surface area large)
I have a big bump on bridge of nose and these masks , in retrospect, are not working for me, so..
I will go back to the under nose that i used the other nights while testing. ( Phillips dreamware)
looking back i see it really was not a large factor, or leak amount., but i will get a new one for sure.

OA has come back, Snore as well, could be due to lower pressure, however, i suspect i was chin tucking again.
Collar will be here very soon this week.

With my new found knowledge of sleep apnea etc,, ALL from this site!, i am now laser focused on...

Neck collar to determine obstruction severity and degree of control i get from that

Mask type and seal

[SeePak]

Update on how i feel...

Not as good as i originally thought!

Feeling a bit nautious in my nose, head, throat upper chest area.

will monitor and update...

[SeePak]

Hey Pizza,

ok, back to 7 cm/EPR2  for tonite

Checked Overview, everything was best on April 13

New mask and hopefully collar coming tomorrow.....

BTW, i want to mention i have blue/purple large rings inset on my eyes.
I am assuming sinus issues.
Any relation to apneas, not sleeping lately etc.?

[tiredsleeper]

Would you mind linking the How to Optimize post?

[PeaceLoveAndPizza]

Lots to work through in your posts, no specific order to my responses.

The optimising link is in my signature below.

Regarding chinstraps. For many they help a bit but most force the jaw back, which is not helpful as it obstructs the airway. Mouth tape and/or soft cervical collars are a better choice for many. Mouth tape is a good choice for many, but some of us still chin-tuck, so the SCC helps correc that. There is an excellent wiki on this topic.

https://www.apneaboard.com/wiki/index.ph...cal_Collar

What kind of new mask are you getting? A full-face mask or another nasal pillow/mask? I think you said your current mask is a mirage nasal mask, so wondering if a full-face would be better. I am not a fan of fighting masks. If a specific make/model does not work after a fair go, then it gets put into the spares drawer. Use whatever works for you, which unfortunately is a trial-and-error process.

Check your hose management. Sometimes we can tug on the hose during the night which causes leaks. Some use a hose caddy which holds the hose above your head so it does not get tangled up in things as we flop around.

Hopefully the rings/nasal issues are just from a bad nights sleep or general allergies/congestion. If congested you can always try a spritz of generic Flonase or other nasal spray to see if it helps.

Let’s see how things go with the collar before considering more changes. I suggest staying with one pressure for now. You had good results and felt better with a pressure of 7 and EPR of 2. With your current machine that may be as good as it gets, but for now I think you should stay with it until there is a good reason to change.

[SeePak]

Hey Pizza. 

I will keep it simple! 

Mouth leaked with tape last night.
this hurts!

7cm/EPR2      (results similar wont waste server space with screenshot!)

I agree with ALL you say!

Bought new dreamware pillow mask.

Hopefully collar fixes mouth issues, yes!
I see all my current limitations now, for sure, as you suggest. (glad it did not take too long to accept them too!)

Full face or hybrid probably in the future, just want to see how the collar works out.

Will post when i get info.

*****I will provide my history/experiences in new thread to highlight how my recent contact with my DME has failed to help me!!***

You people are awesome!!   

[SeePak]

           

Hey Pizza,

Using Dreamware full face mask

Caldera neck collar

On the 19 th i smelled 'campfire', so i turned humidity to manual, 24 deg C. and humidity level 2
( read online of others having weird smells too)

On the 21st, last night, i had problems with seal, suspect higher pressure caused this, again.

I am thinking of 7cm, EPR3, what do u think?

BTW, Insurance Company employees on strike, but will be calling ASAP about new machine if possible, VAUTO bilevel.