Intro

[Sleeprider]

Number one problem with therapy is leaks, and it would help to include that on your charts. It looks like you have positional issues that might need to be addressed by a soft cervical collar http://www.apneaboard.com/wiki/index.php...onal_Apnea
http://www.apneaboard.com/wiki/index.php...cal_Collar

[SarcasticDave94]

Others will chip in with far more detail than I, but let's get you started on the basics of an answer.

My first "red flag" that therapy is not as good as it needs to be is AHI. Your first screenshot says 5.4 or so. 5.0 is considered treated by medical terms. Your AHI is almost 5, but then you look at the Event area. You have the little event flags all over the entire session. This says to me your therapy is still in need of attention to make therapy and the CPAP machine do things better to gain comfort. The AHI goal is not necessarily 0.0, but below 5 and feeling better for use of the machine.

Another area of focus would be leak rate. This should be as low as you can keep it. If it goes high, that means the mask may not be sealing very good. It signals it needs attention if it's high. ResMed machines redline leak rates above 24 because that's the calculated rate it can work with to give you therapy. Higher than that, and it can't cope any longer; it doesn't have any more reserve power to compensate for leaks.

[Gooserider]

As the person trying    to sleep next to Mary-Anne, while we will certainly take a look at the leak data, I would say that it does not SOUND like she has major problems with leaks...  Occasionally, perhaps once every few nights, her mask slips a bit and I definitely hear a lot of noise, but she pretty consistently wakes up very quickly and adjusts it to the point where the noise goes away....  Most of the time I hear lots of noise from the O2 concentrater (Gads do they ever make a racket!! ) and a little from the CPAP machine, but not a lot of air-leakage type sounds....

ex-Gooserider

[Gooserider]

For what it's worth dept...  Mary-Anne has been having problems with her insurance in that they didn't want to keep paying for her O2 concentrator because the sleep study that put her on it was so long ago...  As a result the doctor ordered her a 'home sleep test' that was done WITHOUT her using the CPAP or concentrator - neither one of us slept much and I can certainly say that she was snoring LOUDLY and irregularly and seemed to frequently stop and then gasp a few times then start snoring again.  

We got a call a few days ago from the doctor that had ordered the study who said she had around 56 events per hour, and she thought that certainly it justified a new machine...  I'm all in favor of that, but we pointed out that she already had an Autosense 10 so it didn't seem absolutely necessary.  We asked about changes to her current settings and she indicated that she needed more info about what the machine was currently set at...  Mary-Anne sent her some of the OSCAR data from the last few days.

We got a call back this afternoon from the doctors who said she had run the data (which she said she had never seen formatted like that   - I told her a little bit about OSCAR) by one of her colleagues that was a sleep lab specialist who said her current results weren't that bad, but suggested a few tweaks that might relieve some of the gasisness that Mary-Anne has problems with....  Per the suggestions I walked her through the menus and made the following changes:
Mode - was Fixed @ 11, changed to Auto 6-11 (regular auto her machine apparently doesn't have the 'for-her' option )
Ramp - was off, changed to Auto, with a start pressure of 4 (the minimum)
EPR was set to on full time at 3 - we didn't change this but based on my understanding of the 'optimizing therapy' page of the wiki, I am wondering if that could be a problem as it left her with an effective EPAP of 8 - what do folks think?

I am thinking the plan now is to see how she feels and look at the data again in about a week to see what it shows -


ex-Gooserider

[Gideon]

I always give the benefit of the doubt to the doctor. Post the results after 1 night and we will see where things are.

[mgwmgw]

Ex-gooserider and I changed my CPAP from constant IPAP of 11 to autoset between 6 and 11.  Attached is the result. There is an overall view of one night and a couple of zooms into where there are more events.  I have not shown central apnea in OSCAR recently, but the doctor thought she saw some in the sleep test without CPAP. I seem to be going up to 11 pressure quite a bit. Ex-gooserider has suggested that since I have an EPR level of 3, we might consider lowering that to 1 or 2.

I am feeling less gassy but otherwise about the same.

           

[Gideon]

15 May is showing you what chin tucking is doing to you. This is a positional Apnea that no amount of pressure can correct. What you need is a Soft Cervical Collar (SCC) to maintain your cervical alignment. Please read the Cervical Collar linked in my signature. Do this, then repost and we can discuss where to go from there.

[trish6hundred]

Hi mgwmgw,
WELCOME! to the forum.!
Good luck in getting your CPAP therapy optimized.