[Therapy Tweaks] Dad's Turn

[dracus]

Ok, finally got dad into the sleep doctor. Turns out he has moderate sleep apnea and has a deviated septum as well.

The ENT suggested he utilize cpap and forgo treatment for the deviated septum as he's likely had it for years.

His pre-therapy numbers were 29 AHI with some central, hypnea, oa and even a bit of restless leg.

The tritation study recommend an APAP with 8-20 for the pressure. He was given a dreamstation set that way. He's using a wisp for a mask. His current challenge is that he's waking up in the middle of the night and can't breath through his nose. Under normal circumstances he can't really only breath through one nostril.

I have recommended he adjust the humidity/heat because I know from my experience as a user that cpap unclogs my nose.

He has a full santa beard and may need a full face mask (because of the deviated septum). He's not keen on the idea. He's happy with the wisp though and did like the dreamwear mask which was used in the studies. So far compliance and hours of use are good.

His numbers are staying on the higher side but are consistent. I'm at a loss in his case on how to improve these numbers.

Open to suggestions?

Here is a link to some charts:

https://imgur.com/a/LEtyn

[PaulaO2]

How long has he been on it?

My suggestion is to talk him into a full face mask. He's going to be more comfortable with that. It is possible to use one with a beard.

[Walla Walla]

I think if you bumped the minimum pressure to 10cm you'd see most of those events disappear.

[dracus]

Ok, officially bumped.. I'll work on the full face mask..

[trish6hundred]

Hi dracus,
I didn't think I could ever get used to a full-face mask. I thought it would be chlostrophobic for me; and while it was at first, after a while, I just got used to it. I also wasn't sure I could talk with air coming at me, but with little practice, I was able to overcome that fear.
I wish you much success with helping your dad through his CPAP therapy, and keep up posted on his progress.

[DoubtFire61]

I too have a deviated septumbas well as other blockages in the sinuses. A nasal solution was never an option.

Humidity cannot overcome a structural issue.

[Sleeprider]

Wishing he had gotten the Resmed Autoset. Post some charts. We can do a lot more from the data.

[dracus]

Me too sleep rider. Apparently, they get to bill for both the cpap and separate humidifier which is why Dme sells the inferior dreamstation.

Charts posted in first post. Link goes to 3/4 charts on imurgr.

I've upped minimum pressure to 10.

[ajack]

I wouldn't go the min above the 95% number 10, unless there is a reason. 9 may have been okay and give it some time to settle down. I can't see a Santa beard working with a FFM and it looks like the D/septum and mouth breathing may be giving some trouble. If the nose is still a problem in a few weeks, I'd tell him to suck it up and get an electric razor

[Sleeprider]

Dracus, have you considered outfitting him with a P10 instead of the Wisp? As you know, the pressure is applied in a way that can nullify a deviated septum. Since you're a P10 user, it should be pretty easy to lay your hands on an extra mask.

FWIW, a titration of 8-20 seems like a guess, not a titration. Get the study. Finally, your dad would do great on a BiPAP Auto. His problem is far more to do with hypopnea than OA. That problem responds to pressure support like a dream. I think with a starting EPAP pressure of 8 to 12 and PS of 3 to 5 cm, his results would be amazing at much increased level of comfort.