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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 mask tube
Interestingly thought about the diet. I have gluten sensitivity issues myself and definitely sleep better when I don’t cheat with too much gluten. I have not thought about how it affects sinuses, so now I have another rabbit hole to chase down.
On humidity, use what works for you. I personally prefer to use auto temp and humidity, but there is no gold standard. If it works for you, Bob’s your uncle.
Regarding pressure, I think you are close to as good as you can get with your current machine. Using EPR of 3 gets you the best flow limitation and AHI numbers we have seen, but triggers those recurring centrals. I do not believe they are true central sleep apnoea events, rather are caused by the pressure support differential and may abate a bit over time.
I do not think going down in pressure will do much, at least nothing lower than 7 with an EPR of 3. Increasing pressure by around 0.2 cmH2O or such nightly may help for a short period, but long-term you need to consider options like moving to a bilevel which allows for trigger control to manage the CA’s. If you feel good where things are, then no reason to move to a new machine. You show the same pattern as many of us with increasing CA’s in the latter part of the night as you enter deeper sleep stages, which is why I expect a more sensitive trigger setting will clear that up.
One important thing is don’t faff around changing things nightly unless it has gone sideways. Give any change a few nights to settle in.
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 mask tube
I have to get another sleep study done because they don't have my original anymore and that will be my first step to seeing if I will qualify for a new bi-level machine.
I have the feeling in my throat which I had forgotten about from years past whereby it feels like something stuck in my throat nose area and it definitely affects my breathing.
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 mask tube
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 mask tube
I do not think you can do more with your current machine. We can continue to faff around with the pressures, but I do not think there is going to be much improvement.
BTW, the last chart is an anomaly to others, don’t get too worried about it as something was wonky. Also, turn off ramp as it is doing nothing at these low pressures.
For now the best results we have seen are in the range of fixed pressure 7 EPR 2 and 8 EPR 3. Anything above that and things go off the rails. Any lower and the pressure support is of no real value.
My suggestion is to show some of the OSCAR charts to your sleep doc. I think you can make the case for needing a bilevel to have extra pressure support to manage the flow limitations as well as the ability to manage the trigger sensitivity.
For now, stick with one of those pressures and remember some nights just are bad nights.
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 mask tube
******Finally got my results from sleep study couple weeks ago.******
******I can post if interested? *******
They do NOT suggest Bi-Level machine unfortunately, but....
I am sending email tomorrow to say that i get much longer exhale times when i use EPR2 and 3.
But with my airsense 10 elite, and the low pressure i need to use, puts me below snoring and some OA, i think.
So pretty sure with bilevel i can have the 5 cm +3cm pressure support as/if req'd when i am a bit more plugged up in nose.
I have been doing breathing exercises, tongue and cheek exercises, watching my diet, good sleep hygiene and finally making progress getting some rest and some consistency.
For me, low pressure and NO EPR seems to work, as long as i am NOT plugged in nose.
And, that is now much better with keeping my mouth closed BOTH day and night !! ( mouth tape, cervical collar, chin strap sometimes during the day when i notice i am gaping my mouth open.
Huge difference in my saliva in mouth and clearer in my nose due to, i believe, breathing exercises AND mouth shut !