jarrod1893 - Therapy Thread

[jarrod1893]

Hi all, I started CPAP therapy a few months ago. I've had a mask that works for me since February and I have no problems sleeping through the night on my side but I've seen little to no improvement. I would love any advice as my next step is to search for another underlying issue. 

- Machine: Airsense 10
- Mask: Full mask (Airfit N20)
- Pressure Range: 6-15
- Ramp settings: Auto
- Sleeping: I generally sleep on my side

I'm happy to post any other details needed, including the full data files if it's helpful. 

[nh00]

Hey jarrod, I see you were inspired by my post format, haha. I would suggest you post a few nights of data, you can follow this guide to get useful screenshots: https://www.apneaboard.com/wiki/index.ph...ganization. I'm in the same boat as you. Wishing you the best of luck

[jarrod1893]

It was less inspiration and more so total theft  You seem to have a similar situation and thanks for the advice. Best of luck to you too!

[jarrod1893]

Here are my past three nights of data:

[Dormeo]

Could you describe exactly what it is that isn't improving? A sense that you wake up a lot during the night? Feeling during parts of the day that you'd like to take a nap? Feeling mentally fuzzy, irritable, or gloomy? Feeling fatigued, with greater fatigue upon exertion? Feeling weak? Or ... ?

Most of your events are CAs. These probably arise from arousal breathing, and it's really the arousals, rather than the CAs themselves, that are potentially problematic.

You are also having a fair amount of flow limitation. Is your nose stuffy? If that's the FL problem, there's nothing much the machine can do about it; instead, you should try to treat the stuffiness. But if your nose is OK, the FLs might be arising from further down in your airway.

So to try to get your night as peaceful as possible, please try the following changes. Raise your EPR to 3, which might help with the FLs. Raise your minimum to 7 so that you can get the full benefit of the EPR at all times. (EPR drops your pressure when you exhale, and the lowest the machine can go is 4.) Finally, also set your maximum to 7. This will eliminate pressure changes, which might conceivably be disturbing your sleep.

This is an experiment; it might not help you at all, or you might benefit from these changes. At the very least, there will be some additional data to help with any future tweaking of your settings.

When you post your next chart, please include the FL graph. To fit it in, grab the gray bars between the graphs and push up on them to make room.

[jarrod1893]

I feel like i've dialed in the settings and my AHI is very low consistently but I feel no better after about four months. Is there anything that stands out from my data to anyone? It's fairly consistent.

[Sleeptechmaster]

Your leak value is too high and it's coinciding with your breathing events. 
Try increasing your EPR which can help with leaks but you need to fix the mask or mouth leak issue which could he interrupting your REM. (Jaw can fall open during REM plus the increased events causing the machine to ramp up pressure would wake you up so you might be getting very minimal REM recovery.) Your AHI value shows low but most of your events could be during REM which are not seen due to waking. 
That's a really high respiratory rate I'm not sure if that's accurate so all that breathing effort can exhaust your energy. 
If there's minimal breathing events outside of those REM leak arousals then you could do well with a lower minimum pressure like 5 or 6 which would also reduce breathing energy used. The mask/mouth leak looks like the main problem.

[HalfAsleep]

For any kind of settings advice, I’d recommend going with board monitors or administrators for guidance (sometimes, advisers can be good at this too: not me, however). These folks are handpicked for reliability and know-how. They personally use xPAP’s. I would venture to bet someone with those titles will be along soon.

I do notice, from the percentage number for “large leak”, your leaks are not that significant. Perhaps you scratch your nose in the night? When mine are momentary like yours, I’ve generally smacked my mask thinking it’s leaking (my mask sounds like it’s leaking when it’s not), jostled the mask when I move my head slightly, or, yep, got an itchy nose.

Is your mask seriously an F10? I had one of those back in the day, but I thought it went out of production a while ago.

Could you write the exact model and brand of your equipment in your avatar? It should be on the front of your unit. I find that xPAP units are named like cars: a name that sounds like a lot of other names and then a bunch of letters and numbers. So, it’s helpful if you specify the unit in your avatar, so readers can get an idea quickly. Same with the mask name.

[Sleeptechmaster]

If the 99% leak is 20 that is fairly high as anything over 25 being the absolute maximum where at that time the machine is no longer able to sense and adjust itself properly. A value of 12 or below is recommended.

[Crimson Nape]

The 99.5 is a percentile and not percent. Based on the complete sleep session of 8 hours 52 minutes, this equates to 2 minutes 45 seconds at this leak rate.

I suggest that you read the links in my signature to learn about OSCAR.
- Red