[Pressure] Newbee - 1st Evening Failure

[Snooks]

       
Hi Guys.

I did a sleep study test and was diagnosed OSA 72 events per hr.  I did a follow up Titration Study and they used a N20 mask WITHOUT a chinstrap despite my explaining that I mouth breathe and would like to try a FFM. So the first 2 hrs was wasted and then they woke me up and put a chin strap on me with the N20.

I then slept 5 hrs and woke up, there was no more time to test the FFM and they sent me home. Now i found the chin strap so tight and uncomfy and claustrophobic, more than the mask. They said i slept well and needed a pressure of 14.

So, first night at home i was trying the machine. I decided to trial a Resmed Airfit 20 FFM. I tried to remember everything i have read in here, changed a few things like EPR off, Ramp off, Starting pressure was supposed to be 6 but something isn't right. I did the Facemask Test and after fiddling a few times i got it to seal ok, even when it ramped right up. So when i laid down for the real thing the pressure was just like full on, impossible for me to handle. So obviously something is wrong.

I have attached an Oscar Report as correct as i can do it. I was on and off for 90 minutes overall, but i don't think Mask Fit Tests are indicated etc. The actual time of trying after mask fits etc was probably only 10 minutes. By then i was a ball of sweat, very scared, fed up and disheartened.

In addition, the humidity water container leaked all over so everything that could happen, seemed to happen and in all honesty i think that i made an excuse to give up. I found it so scary and claustrophobic and even worse than the chin strap in hospital. In hospital i felt safe, here at home, i felt all alone.

I'm a 59 year old, 6'3" 310lb ball of jelly : I would love opinions and advice. Thank you. (Sorry, i see that i posted the image twice and can't work out how to remove one. My apologies.)

[Cpapian]

I am a little bit confused by your message. It seems you mentioned your starting pressure should be 6 yet your OSCAR reports it is set at a fixed pressure of 14. You also mention it was too much. So if your pressure should be six, you should fix that. Tou weren't on long and had no events so we can't comment on changes at this point.

If you spilled your water, don't put so much in. There is a maximum line, but go lower than that until you get more comfortable.

Otherwise, relax. It's a lot to figure out in the beginning.

NB to adjust the pressure.... press both buttons simultaneously for a few seconds..... you will see the clinical menu. Scroll down to minimum and maximum pressures. Don't play with anything else for now.

[staceyburke]

WELCOME You have started on a journey that all of us have been on.  It does not end in one night.  I guarantee you that tonight will be a better night for you.  The setting you have would be very hard for anyone to use successfully.

I'm sorry but you have not data to analyze.  Your machine is set to CPAP which means that it is blowing the same amount all of the time.  You do not want that.  First change is to go to Auto.  That will allow the machine to make changes according to your events.  Next you need to set the min and max pressures.  Min=7 (EPAP)Max=14 (pressure) and EPR=2  Now that is just a start for tonight and changes will be made after we see tonight's charts.

Since you are new at this I will assume you do not know how to change these settings.  If you do you can ignore what I am about to write.

You need to be in the clinician menu.  You do that by turning on the machine by pressing the ROUND BUTTON.  The screen will light up.  Next hold down the round button and the home button on the front of the machine at the same time for about 3 seconds (not the top button).

Now you should be in the clinician menu.  At the top of the screen with be words about being in the clinician menu (I am not sure the exact wording).

You use the round button (turn it) to move up and down the menu.   Stop on the one you want to change and press the round button - now the options will be available, move through the options using the round button.  When you get the correct number press the round button - that changes the number- if you do not press it in your number will not have changed.

Do that for all the options I gave you.  When you are finished press the home button (on the front not the top) and you are out of the clinician menu and you are ready.  If you missed something just go back and start again.

I know this sounds hard but it is not and everyone here does this, that is what this site is about.

Good luck and I hope you have a good nights sleep.

[kappa]

There's only 3 minutes of data in your graphs... some issue with the data import? Maybe purge the data from OSCAR and redo the import from the SD card?

Having an autoset in CPAP mode with a fixed pressure of 14 seems curious and likely quite uncomfortable for a first time user. I'm sure others would have better suggestions but putting the system in auto mode with a 8-15 pressure range would seem much more likely to allow you to get to sleep and then the machine can titrate based on flow limitations and events as it's designed to.

[SarcasticDave94]

Yeah, I'd go for a redo on your settings. They're not doing you any favors on what you've got now. Change the Mode to Auto, make the pressure 7-15, and add EPR of either 2 or 3. Those red or green ghouls for your leak test are not very helpful. Rely on knowing if you have it adjusted by lying back and hold the mask to your face with the PAP running therapy not the evil mask fit thing. After feeling what the tension is by just holding the mask in place, now add the straps with a tension like what it was with your fingers holding it in place. You won't die due to PAP use; give it a new try with real settings that will be more comfortable.

[Snooks]

Thank you to everyone that posted, it is greatly appreciated.

I did actually change numerous settings myself so that starting pressure 04 14 is a mistake that i have made. Low light and poor eyesight combined with a huge amount of panic. I have been around here for 2 weeks and read so much in here and especially about Oscar and watching how people do minute changes day by day. Hence, i took the ramp off, the epr off, turned the humidity down and changed pressures, So yeh, that mistake was almost certainly mine.

The water tank leaking, i filled it just to the minimum line because it was turned off, the leak is some sort of issue connecting to the machine but i will check it again tonight before i start.

The CPAP setting, well i saw that and figured it would automatically be an auto and didn't touch that because of that reason.

I was also concerned that in Oscar it shows the Filter is missing. Is that a concern???

As i said, i appreciate any feedback and don't be worried about hurting my feelings, it is a helluva lot better than dying from heart issues caused by OSA.

Cheers from the Land Downunder.

[kappa]

The water should not leak if the unit is flat, particularly at a low water level... possibly a faulty seal between the metal base and the plastic body of the tank? Or a crack in the tank? Sounds like you might need to take it back and ask for a new tank...?

Try half filling the tank and ensure everything outside the tank is dry and run for a few minutes at pressure while wearing (e.g. using your current setting of 14 or a mask leak test) and see if you can find any water outside the tank afterwards...

[Snooks]

The water should not leak if the unit is flat, particularly at a low water level... possibly a faulty seal between the metal base and the plastic body of the tank? Or a crack in the tank? Sounds like you might need to take it back and ask for a new tank...?

Try half filling the tank and ensure everything outside the tank is dry and run for a few minutes at pressure while wearing (e.g. using your current setting of 14 or a mask leak test) and see if you can find any water outside the tank afterwards...

I'm certainly going to check that tonight and will sit it in a dish so if it does leak, it wont electrocute anyone.

It makes me wonder how well the machine has been serviced and cleaned, given C-19 and the fact that there is no air filter in it. That's odd, hopefully it can't hurt me.

Thanks for the advice

[Gideon]

Your Tidal Volume and Minute Vent seem way off and I don't know why.
Med Minute Vent = 27.38
Med Tidal Volume = 1460
Please give me 2 sets of charts (The one above is missing Flow Rate)

In OSCAR
click on View / Reset Graphs / Standard (Event Flags,Flow Rate,Pressure,Leak Rate,Flow Limit)
Take a screenshot (F12)
click on View / Reset Graphs / Advanced (Event Flags,Flow Rate,Mask Pressure,Tidal Volume,Minute Vent)
Take a screenshot (F12)

[Snooks]

Your Tidal Volume and Minute Vent seem way off and I don't know why.
Med Minute Vent = 27.38
Med Tidal Volume = 1460
Please give me 2 sets of charts (The one above is missing Flow Rate)

In OSCAR
click on View / Reset Graphs / Standard     (Event Flags,Flow Rate,Pressure,Leak Rate,Flow Limit)
Take a screenshot (F12)
click on View / Reset Graphs / Advanced    (Event Flags,Flow Rate,Mask Pressure,Tidal Volume,Minute Vent)
Take a screenshot (F12)

Hi Bonjur,

I'm afraid i have wiped the information of the sd card. Given it was such a short span i only posted it mainly for all the settings and  stuff so as i could get advice about them. I'm going to make the alterations that were suggested and given the settings will be lower and easier to breathe, hopefully i should be able to get some worthwhile information tonight and post it in the morning.

Bonjur, I have seen you on the forum a lot over the last two weeks and probably read a thousand comments that you have made. I just wanted to say thank you so much for helping as you do and I look forward to your comments when i post some decent stats in the morning. Having people like you makes the journey so much easier...but still scary (lol).

I appreciate your time and thank you again