New User Needing Some Help
Hello.
Thankful to have found this board since my doc has been no help at all in working out the settings for therapy. I'm using an AirSense 10 with full face mask and have been fighting with inconsistent nights and lousy sleep. The main problem that started a few months ago is that now I'm having problems getting to sleep when wearing the mask. Put it on, hit the hay, try to get comfortable - waste an hour or two - take off the mask after some cussing and snarling a bit. Once the mask is off I'm out like a light. No idea what's going on, but on the nights I can get to sleep with the mask on the sleep apnea is still there. Screen shots attached.
RE: New User Needing Some Help
You might want to try the following setting to reduce your Hs:
Min/Max pressure 15/20 cm.
EPR=3, full time.
RE: New User Needing Some Help
Thank you.
I will give that a try tonight.
RE: New User Needing Some Help
Following up from my original post. The 15/20 settings didn't seem to help much and were pretty uncomfortable due to the higher pressure so I backed it off a bit and am considering dialing down the EPR (currently at 3) as see how that affects things. Lowest AHI so far so that's a good thing. I'm considering trying the current settings for awhile and see how things go. Any suggestions welcome.
Last two nights data:
RE: New User Needing Some Help
Your apneas are clustered, which is an indication of positional apnea. Positional apnea cannot be treated with pressure adjustments. You should not bend your neck forward. You can try a cervical collar. Also, use a thinner pillow. And it's better to sleep on your side.
As for the pressure adjustments, you are hitting the 18 cm max, so your maximum pressure should be increased.
You want to reduce the EPR. It is not advised because it helps you tolerate high pressure and reduce your flow limit, which is still high.
Hence, it would be best if you kept EPR=3.
09-28-2024, 10:10 PM
(This post was last modified: 09-28-2024, 10:28 PM by Phaleronic.)
RE: New User Needing Some Help
Hello DraftZebra,
With EPR at 3 (max) you're losing apnea control and since you need higher pressure (99.5 percent pressure is what your max pressure is set to, either 18cm or 20cm), I strongly suggest turning EPR OFF. Your flow limits are spiking because EPR is lagging behind in inspiration pressure delivery and the airway is closing and the FLs are happening.
You are a primary person for bilevel therapy, in the meantime I believe you will feel and breathe easier if you set the machine to cpap mode @ 15cm and use EPR to help you with exhalation pressure relief if you absolutely need it, if you do, turn it up 1 level at a time.
Test this tonight please for 30 minutes to see how it feels.
RE: New User Needing Some Help
I'll give that a try. Thank you!
RE: New User Needing Some Help
(09-28-2024, 10:10 PM)Phaleronic Wrote: ... I strongly suggest turning EPR OFF. ...
You are a primary person for bilevel therapy, in the meantime I believe you will feel and breathe easier if you set the machine to cpap mode @ 15cm and use EPR to help you with exhalation pressure relief if you absolutely need it, if you do, turn it up 1 level at a time.
I agree that a bilevel would help because of the high number of OAs and Hs and the high pressure needed. Therefore, there is a conflict between the above statements. One of the significant advances of Bilevel is its capability to deliver higher than 3 EPR. (Simultaneously, the trigger setting will not substantially impact the AHI in this case.)
So, if a bilevel is suggested for this member, then the EPR =3 with the current instrument is a must.
09-29-2024, 02:35 PM
(This post was last modified: 09-29-2024, 02:38 PM by DraftZebra.)
RE: New User Needing Some Help
Gave the CPAP mode at 15 cm a try last night and EPR off wasn't that uncomfortable - my back had other ideas though and that's what gave me the data gap last night not the therapy. Some nights are okay and others can be hell like that.
Anyway, there's a couple questions from the above replies:
When you refer "bi-level", does that indicate the use of a BIPAP rather than a APAP/CPAP machine?
How does that affect the position related apnea or does it? I'm going to pick up a soft collar and see if that helps with the clusters any.
Including a couple of screenshots from last night which include the O2 Ring data:
RE: New User Needing Some Help
(09-29-2024, 02:35 PM)DraftZebra Wrote: When you refer "bi-level", does that indicate the use of a BIPAP rather than a APAP/CPAP machine?
How does that affect the position related apnea or does it? Yes, bi-level above means BIPAP. See, for instance, my device.
Positional apnea cannot be addressed by pressure treatment, not even with bi-level.
BDW, your flow limit on the posted chart is still too high.
|
