nicchamilton - Therapy Thread

[G. Szabo]

Try EPR 1.

The higher your EPR setting, the better the chance to have CAs

[PeaceLoveAndPizza]

A few things…

When you have a feeling of not enough air, that is typically a result of not having enough pressure. Even though you may have a good AHI at lower pressures, it does not mean that is a good therapy pressure as you feel air-starved.

Please post the entire night or a few nights. Read the link in my signature for “Organise your OSCAR charts”. Do not post zoomed in shots until after posting the entire evening. Things need to be seen in context. 

Per the chart, you have EPR set to ramp only, is that what you meant to do? Also, the chart is only for ~2:40 of therapy, but covers the entire night. I assume you took off the mask, stopped the machine, then put it back on towards morning? That would explain the gap.

When you start the nights therapy, there are a few clusters of leaks. I can’t tell if they are mouth leaks or from faffing around with the mask. Once they settle down things look good, but we need to see the entire evening.

I suggest giving this a go…

Min pressure 9
Max pressure 15
EPR 3 full-time
No ramp (unless absolutely necessary)

The goal is to get enough pressure for comfort when asleep with a bit of EPR to make exhale easier and manage flow limitations. We can tweak settings from there after a few nights.

[HalfAsleep]

Try turning smart start off. It's been messing with newbie pressures and their sleep. My DME even recommends it be turned off because it's not working right.

If smart start is on but doing it's weird thing, it will look like the unit is off when you look at Oscar, 'cos in fact, there's no pressure. The unit sounds sort of on and has a kind of feeble spurt of air, but it's not on. This is likely to make you crazy, 'cos you'll swear it was on and you were plugged in all night. Aaaaand.....IME you will feel like you can't breathe, because, actually, you can't: you're breathing with a mask on your face, no forced air.

[SarcasticDave94]

My turn...

EPR 3 is showing as ramp only according to the OSCAR info dated April 25.

Ramp is locking you down to 7 for 15 minutes every time you start CPAP.

I would consider removing Ramp and if EPR is Ramp only, turn this to full time.

[nicchamilton]

I just got prescribed CPAP for UARS. Doctor put it on 8-15 with epr 3. didnt do an in lab titration. I changed it to 9-12 with epr 3. Ramp off. tried it twice so far with no result. im using a nasal pillow. 

I can lay down comfortably and attempt to sleep with the cpap on. However when I start to doze off I then wake up and end up having to gasp for air. Its very uncomfortable. Its almost like im forgetting to breathe. ill do this several times till i just take the mask off completely. 

For context when Im sleeping without the cpap- when i start to doze off my breathing gets deeper. So im thinking maybe i need to turn up the pressure on my cpap to react with my deep breathing?

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additional oscar data

[OpalRose]

I've combined three threads you started all relating to the same issue.  Please use this thread going forward.

Reading through your posts, I get the feeling that you're in a panic mode.  Realize that it takes time to adapt to the use of Cpap and having a mask on your face.  

I don't think you've posted a full night of sleep yet.  The charts posted thus far are very short periods of time and make it hard to advise you properly.

I'd like to suggest that you use your machine a couple hours with your mask on before bedtime.  Maybe sitting up reading or watching TV.  This may help you acclimate to the feel of the pressure.  

Once you do go to bed, try to breathe normally and trust the machine to do its thing.

If you start to doze off and wake up, try to keep calm and not remove your mask.  Get comfortable and try again.  

I'd like to see a chart with more than 2 hrs.

Also, when you repost, please follow the links in my signature line on organizing your chart. For starters, we only need to see the following graphs: Events, Flow Rate, Pressure, Leak Rate and Flow Limitation and the entire left side bar. You should be able to post that in one chart.

[nicchamilton]

Ok. I do sit and watch tv. I’ve probably done that for a total of 3 hours so far. I didn’t use it this past weekend really bc I was out of town. It does feel comfortable sitting and watching tv.  But I will try again tonight and stay calm