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How'd you sleep the second half of the night? How do you feel this morning?
1. Are you taping your mouth or using a chin strap? You have a lot of room to improve in the leak area and are likely leaking from your mouth although less so on constant pressure. I'd target a 95% leak rate of 0.00 or as close to it as possible.
2. In APAP mode the machine was bumping up against 12cmH20 (your max) to try to control flow limits and could not - if I were you'd I'd jump 2cmH20 and try constant pressure mode at 11cmH20 because I think you're well below a therapeutic pressure.
Yesterday I crashed for a nap in the afternoon and was really sleepy at bedtime.
We will see what today brings!!
Getting the leak rate down close to zero may be a challenge, because I don't know what to change. But I will keep working on it. It was better last night.
So I had a constant pressure of 11 and had the EPR at 1.
Any complaints about comfort? Pressure feel okay with no issues breathing in or out?
You have a wee bit of leaking going on. Not too bad, but enough to cause sleep disturbance. As long as it is not waking you up don’t worry for now, let us focus on the therapy. If it gets much higher it wil have to be dealt with, but there are bigger windmills to tilt at for now.
Your tidal volume looks low, but it may be physiological. If you are on the smallish side it could be due to you being on the smaller side. TV is calculated based on various criteria e.g. height, weight, gender, etc. Nothing to worry about at the moment, but something we need to keep an eye on.
Flow limitations continue to dominate things and you need a bit more pressure to handle the hypopnoea's. Try using a pressure range of 11-14 EPR 3 or a fixed pressure of 12 with EPR 3. Use what feels best to you.
Ah, a wee lass. That explains the tidal volume. We’ll just keep an eye on it for now.
Your apnoeic events are causing and flow limitations are contributing to your tiredness. Raising your pressure a bit and adding some EPR will help.
Do you feel any mouth dryness in the morning? That is a clear sign of expelling air through your mouth. The leaks look to primarily be mouth leaks (look the leak chart at 21:45, 22:30, 00:15, 01:45, as examples. The duration tells me they are your mouth leaking air on expiration.
Longer term you may need to add a soft cervical collar or other method like mouth tape to control mouth leaks, but for now focus on the bigger issues.
For now, don’t worry about the leaks. Let us keep focused on the flow limitations and quality sleep.
I did wake in the night with dry mouth. I am using tape on my mouth that LeftyLanky recommended. Maybe I need to use a wider cut of it. I have been cutting it down some. It comes in big rolls.
Do you have an OSCAR screen shot of stats that comes from someone who has conquered all these problems? What are we aiming for? No rush on that. I am just curious.
