Please help with treatment review

[SleepyCPAP]

You are on the “Overview” tab (see at the top of your screen). The Statistics tab (last one on the right) is what shows the “Changes to Machine Settings”. Scroll down to that part and it will show a list of times you’ve adjusted your “prescription” (pressure), mode or EPR. That’s the part to take a screenshot.

[DaveL]

To everyone that has helped...

I am so grateful that you shared, for your skill and your patience.

Thank you!

[DaveL]

Here's the screenshot that was requested....

"Post a screenshot of your statistics page showing the section "Changes to Prescription Settings". "

[Geer1]

Can't stop spinning the knobs can you.

Hard seeing a real correlation in the data but some of that is because of how it is known that some masks and other affects other than settings have more of an effect on your data. I thought you were using EPR of 3 more but seems that was only in recent testing when getting poorer results, 1 or 2 does seem better which makes sense as your primary issue appears to be central apnea. Higher pressure seems to be a bit better than lower pressure too which would indicate obstructive as well.

Back ending in last Nov you had 156 days averaging 0.6 AHI with pressure of 13.4 to 19 cm range, 1 EPR. Last night you used similar settings with 12-17 cm, 1 EPR and similar results (0.55 AHI). Lets leave things as is (12-17, 1 EPR) for a few nights to see if things stabilize.

In your case stabilized will mean the odd night of higher AHI, if your average AHI is under 2 imo you are doing great and getitng as good of results as you ever will out of this basic machine.

The only thing I would consider playing around with is trying a lower max pressure (say 12-14) but I would wait at least a few more days (or even a week) to see if things stabilize. If it fails to stabilize that might indicate that your apnea is changing for some reason but I don't know why that would be and am just going to assume the bad days recently were because of trying all sorts of new settings, masks etc.

[DaveL]

Thanks Geer1!

I need to recover from this train wreck I caused. And I need to return the two loaner masks.

Dave

[DaveL]

Can't stop spinning the knobs can you.

Thanks you made me laugh.

I worked in a marina on the Rideau Canal.  The mechanic there was wise.   A customer would bring a motor in for service/tune up.  After the customer left, Bill would make a two word comment.  "Knob Twister".  Interesting place. Interesting man. I earned minimum wage.  75 cents an hour.

Later I bought my first motorcycle.  Learned quickly.  "if it ain't broke, don't fix it".  
Put lots of miles on that little bike.  Called it "The Tin Twin".


Dave

[Sleeprider]

Dave, we worked long and hard a couple years back to get your pressures optimized at 13.5 minimum, 19.0 maximum and EPR 2 in Autoset Standard mode. You can see this back around page 33 of this thread, however the charts are gone now. You disciplined yourself to not make setting changes until April, 2021 and your therapy was never as good. It's hard not to see that since that time you have been "dial-winging" and making frequent setting changes as well as changes to masks, sleep aids. We have repeated many times that therapy optimization means getting close to optimum settings, and observing trends, not individual nights, then making strategic changes ONLY when we have a plan for what we are trying to accomplish. Unless something major has happened, I really think you need to revisit the work we invested into your therapy starting here on page 31-37 and take another look at what you accomplished here and how you got it done. http://www.apneaboard.com/forums/Thread-...ew?page=31 We have to get you back to effective settings and out of the clinical menu.

[DaveL]

Thanks Sleeprider. I'll do that.

I was having troubles with my N20 medium mask. I bought a new one. Full mask. I had severe problems with it. Thought I would need to find a new mask--a different style.
my only resource was the reviews here. My DME supplier has procedures with C19 that I couldn't get help picking a mask or seeing what they have available.

Frankly mask selection is a pain in a tender spot. It's never easy. Summary==I hate choosing a new mask with a passion.


Charts have gone because I've far exceeded my allotment.
I'm reaching that point again. So I'll soon have to delete a bunch more if I am going to post here.

Thanks for your guidance.

I truly appreciate your comments. I wasn't criticizing anyone here; I was criticizing myself.

Medical treatment of OSA is totally flawed. My only hope is to participate here.

[Geer1]

Regarding the masks it is quite interesting how it appears that you responded to them with elevated centrals. I wouldn't be opposed to trialing them again to make sure it was the mask that was creating the issue but first you need to stabilize results. The problem with changing a mask one day, pressure the next, EPR the next is you lose track of what is causing the problem.

Since you do have a central aspect and it varies night to night you should stick to one change per week so that you get multiple days of data after the change and can easily tell if it is helping or making things worse.

[DaveL]

Thanks Geer1

I'm sticking with this for now. Watch and see how it goes.

edit: Started with problems with my mask a ResMed N20. Felt bad; numbers were high and climbing over a period of weeks. I took a brand new insert out of a box and put it in. Results were worse. Used it several nights. Figured that was proof I needed a new mask; I contacted my DME Supplier and got two on trial. Full face (F30i) and P30i and ordered the Respironics headgear that lowers the strap on back of my head. 2 day delivery, became 2 weeks! Started taking video to see how often I move. Horrendous. Those masks will cost me $350 Canadian each so I'm returning them to the DME Supplier.

Fast forward to last night. I scoured an insert for my N20 with Zeiss wipes. Put on tape. Put on my old under chin home-made pad because it's more comfortable. Score was excellent. Results were excellent. Felt good even though I got less sleep. No problem with leakage.

I'm Saying that the wrong mask affects sleep comfort. However, I don't have huge central problems with the right mask. I do with the wrong mask. And the P30i is wrong even though it was modified.

The F30i best feature was that I could wear it all night. I have never worn a ffm more than 2 hours. But AHI for this mask was 15 for the night.

And P30i power nap with mask alone was AHI=43

Proof! I don't have CSR. I don't have centrals with the right mask. Conclusion. Therefore there's no need for an ASV machine.