The Journey Begins - clearairways Therapy Thread

[clearairways]

Hi All,

New joiner and wanted to introduce myself !

I got diagnosed a few weeks back, 31AHI / 32 Hyp - Severe SA with Severe Snoring.  Suspect this for years, but I am where I am.

Because of where I live in Asia, the local machine cost is excessive due to crazy markup and cartel like controls, and I'm not covered by insurance so it's all self pay. Any savings matter to me.

I got my prescription for a BiPap from my ENT, and I've bought a ResMed AirCurve 10 with a few masks ( I went with the N30 and the Swift FX so I could try out two different types of nose mask.)  It all arrives here to me tomorrow afternoon.

I haven't had any pressure recommended and my ENT told me I'd need to deal with all that myself if I didn't go via the approved vendor and the approved device here and make a purchase with them - I'm not comfortable being manipulated into spending an extra $1500-$2000 via the local cartel route which is what I've saved going the route I went and buying myself.

I'm quite technically minded, and so I'm planning on starting off with low pressure settings - something like 8/4 or 10/5 and bringing it up the next night if needed based on OSCAR analysis until my AHI is where I want it to be while then monitoring other metrics in the software to tweak it even further and dial it into a sweet spot.  Step 1 is to get to tolerate the device itself.

I'm cautiously optimistic about it all but looking forward to making some improvements and believe that the machine I chose will pay dividends in making it as comfortable and easy to adopt as possible.

Exciting stuff :-) 

Clear Airways !

[clearairways]

Hi All,

I'm a newbie, and have an AirCurve 10.  I'm considering starting treatment without having had pressure settings analysed/recommended yet but am not sure how best to approach.
Ultimately, I'm expecting that even with some recommended settings I'll need to tweak and play with it anyway, so i'm not shy to learn exactly how this machine works and I'm technically minded.

Anyone got any guidance on what way best to approach ?

Thanks !

[OpalRose]

Is this a new machine?  If it has prior usage, be sure to reset everything back to default.

Also, be sure you have a SD card inserted while you sleep.

Without a sleep study or knowing your history, set the machine to VAuto mode.
Set the Max IPAP at 20 for now.  It won't go that high if not needed.
Set the Min EPAP at 9cm.
Set PS (pressure support) at 4cm.

Expect some changes depending on what we see on charts.

Leave all other settings at default for now.

Order a Clinicians Manual here:
https://www.apneaboard.com/adjust-cpap-p...tup-manual

The clinicians manual will explain default settings.

When your ready to post a Screenshot of your data, use this as a guideline:
http://www.apneaboard.com/wiki/index.php...ganization

[Gideon]

If you VAuto (any CPAP) is used be sure to perform a factory reset to ensure all settings are at their default settings.

The bottom line is your starting values mean little because we Will suggest changes based on what results we see when you post.

[Uzupan]

I wish you well and there are peopling this forum that can and will help. I wish I could help but I am just starting this path myself. Just hang in there.

[Gideon]

Post your OSCAR daily charts here so we can tell you what we see and how we would respond to what we see.  You will learn fast.

[OpalRose]

Hi clearairways,
I have merged your two therapy threads in order to keep your history in one place.
Going forward, please keep your charts and therapy questions to this thread.

Thanks!

[Dormeo]

Great machine, and the time spent zeroing in on optimal settings will be a good investment.

When you get the machine and mask, I strongly recommend that you ease into using them. Set the pressures as recommend above, and then set the machine up somewhere outside your bedroom, in a place where you can read or watch TV or do something else distracting. Try using the machine for several hours at a time this way. This will really help you get used to the novel sensations. I'd recommend doing this every day for at least three or four days before you try using the machine at night.

Before you use the machine at night, lie down in your bed, put your mask on, and turn the machine on. Then adjust your mask for your best fit. Try changing positions in whatever way you normally do at night. Adjust again if needed.

When you start using the machine at night, I hope all will go very smoothly for you, but if you find you don't go all night with it right away, don't worry. You'll get there.

There are lots of people here ready to help you, so remember you're not alone with all of this!

[clearairways]

Thanks Opal - will keep things here and get that manual request in today.



Super Dizzy First Experience:
Yesterday evening, I set the machine up and spent 22 minutes just wearing it while sitting at the kitchen table with the N30 mask on. 

Had the machine set at 12 max IPAP, PS 4, and it went through a 20 min ramp cycle.

About 10 mins in while just sitting there I was feeling super super dizzy. 

Readings on the machine were going between 4-8 throughout the 20 min

By the time I was finished, I nearly fell over when I walked away from the table. Was feeling super spacy for about 20 minutes afterwards aswell even after I got into bed.

Not sure if that's normal or not, but I was freaking out a bit towards the end of it as I was quite disorientated.

Side note, that didn't record any data as I went to read it and it hadn't created any data files as part of the dataset. I assume this is because the ramp had only finished and therapy hadn't actuall started ? 


Starting Settings - Setting max IPAP to 20 on vauto:
I was watching a vid on youtube where it explaned how the EPAP ramps up with the actual IPAP with the PS difference - eg, at PS 4, 10/6, 11/7, 12/8.
I also saw that this can induce Central Apnea as if the EPAP goes up to 15-20 region, then that would put the IPAP at 15/11, or 20/16.
Do I need to worry about this or should I just let it rip and start getting data ?
I want to minimise any downsides as much as possible as I really want this to be successful.

Thanks !

[OpalRose]

I don't remember you saying if you had a sleep study or not.... if you did, do you have those results to post here? Did the results show Clear Airways?

And no, it's not normal to feel dizzy just using the machine 20 minutes sitting up.
Do you monitor your oxygen level?

So to set up your VAuto for tonight, you can take the settings lower. Ignore my earlier recommendations. Nothing is set in stone, we can always adjust.

Try these settings:

Set Max IPAP at 15cm instead of 20.
Set EPAP at 7cm
Set PS at 3

EPAP + PS = Insp.

And turn off the ramp feature if you are able.

Try this tonight and post a chart tomorrow.