Please help with treatment review

[DaveL]

Dave & nightgagger, sorry. I forgot to add the scans...they're on now....

night gagger I was taped last night I hope well enough.

Night before, I was not taped. Simply mask by itself until I got up the last time. I put the cervical collar on, put the mask back on with the smaller--medium--inserts. Nose hurt from the large ones...

I may have overtightened the mask frame to prevent leaks. The Respironics fitting I ordered should be delivered today according to amazon.

[sheepless]

I haven't done any kind of analysis but think you had better charts including fewer leaks, maybe fewer ca, at lower min pressure. in the latest screenshot pressure barely went over your current min of 14, suggesting it may be higher than necessary.

[DaveL]

Ok Thanks, I appreciate it.

[SarcasticDave94]

January 15 chart looks like a long mouth leak. That was maybe the night with no tape. The other January 14, segment 1 within the 3 was some mask spikey leaking.

[DaveL]

Dave that really helps a lot. Except Jan 15 I taped. Jan 14th I didn't. Clearly I need to tape differently. Thanks!

Dates are wrong. I'm a day ahead. Must be living in Australia. Not Canada


I've been taping with a single piece of tape, vertical. Two inches wide. I had the tape covering my mouth completely from the right side towards the left. So there was a gap on th left side

I will try a longer piece of tape and cover corner to corner and beyond.

[SarcasticDave94]

Let's see what you get next.

[DaveL]

What a night.

AHI through the roof.

I might as well turn the apap off.
P30i trial .  Oh my.

Dave

1. Mouth fully taped. One piece of tape fully across my mouth. 
2. Soft cervical collar on
3. Respironics attachment for head gear wasn't received from Amazon, so not used
4. P30i mask with the medium inserts
5. Video on. I haven't looked at it.

Feeling....awful.

[DaveL]

What a night.

No. I don't have CSR.  But I sure had a rough night.

[sheepless]

well that was a wreck.

pressure could've gone to 19 but maxed at 14.2 so hard to figure reducing pressure was the reason. otoh, epap reduced to a max of 11.2 might explain some of the oa (but I lean toward probably not, considering your results at various settings). you could try raising that a bit by bumping min to 13 or reducing epr to 2 again.

personally, when I feel things coming apart, I go back to basics. I'd re-titrate myself with a single fixed pressure. once you find the setting that best treats your oa, you can reintroduce epr & then maybe a range between min & max. meanwhile, keep looking for a vauto or asv. maybe vauto's timing controls will help stabilize your breathing.

leaks were great for the first 3 hours & a 40 minute stretch after 4am. otherwise, your mask gave you problems the rest of the night. if you can figure out why the difference, you might be home free. any insight from video?

could be something else entirely going on, not pap related, but finding a good mask is obviously pivotal.

sleep labs routinely try out a number of masks on people in for titration. i wonder if you or you doc could persuade one to let you take your machine in between titration patients to let you run through their mask inventory. or maybe a dme provider would let you try their masks with your your machine in their facility.

I have mixed feelings about suggesting this but maybe you should take your charts & list of complaints to your doctor. or a reputable sleep doc. the trick will be to be persistent & not let them off the hook. insist on monthly appointments, for example, until problems are clearly resolved.

I hope others have ideas because I'm fresh out.

[Ratchick]

At what settings have your results been at their best, with all the recent changes? It looks like 14-19 with EPR 3 was working well, so maybe go back to that? And then work on the mask fit.