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+--- Thread: LuminousOne Therapy Thread (/Thread-LuminousOne-Therapy-Thread)
RE: LuminousOne Therapy Thread - LuminousOne - 07-26-2024
Thanks Jay! Your responses have either confirmed my suspicions or provided recommendations that will definitely help.
My leaks were decreased quite a bit last night, but could definitely improve. I suspect that my soft collar and my flatter pillow are coming into contact with my mask and/or straps and causing interference when I move. I am trying others which are better sized and sifter. I've been working on reducing the oil situation in conjunction with the mask. I should have tried mask liners long ago.
I suppose I need to calm down about the CA's. I'm only a month in and there is a reasonable chance they are transitional due to my periodic waking periods. I don't want to push for a switch to a bi-level (as recommended here) without more evidence that it's necessary.
I really appreciate your time and recommendations.
RE: LuminousOne Therapy Thread - LuminousOne - 08-03-2024
I finally ditched my original soft cervical collar and replaced it with a Caldera Releaf which fits much better and is more comfortable. The first two screenshots below are when I continued to position myself of my left side and ended up with my mask leaking due to pressure from the pillow - the second shot includes a full face-plant which I discovered upon waking.
I went back to my flatter pillow stacked over my fuller, softer pillow and was positioned on my back last night in hopes of increasing comfort, promoting fewer leaks, and reducing eye puffiness. I got out of bed for a while to listen to a guided meditation and it took about a while to get to sleep. I woke up at 8:45 am and tried to get more sleep, but was mostly awake for a while and did not return to a consistent sleep patter. I think the string of events appearing at this time is sleep-wake junk.
With all this in mind, would any pressure changes be in order according to the metrics? My original prescription was for 10-20 APAP with EPR 3. I have gradually modified it to 10-15.3 with EPR 2. Would a reduced lower limit setting be recommended?
Note: my flow limits don't vary a great deal. I'm wondering if my narrowed nasal passages are causing these numbers. I am a nose breather but switch over to mouth breathing if very congested.
Thanks for any recommendations.
[attachment=67859] [attachment=67860] [attachment=67861]
RE: LuminousOne Therapy Thread - LuminousOne - 08-05-2024
Finally had a much improved OSCAR report:
[attachment=67921]
arts
Unfortunately, I had trouble getting to sleep due to discomfort and experimentation with various pillow placements for comfort while not causing mask leaks. Once I was asleep, I slept better than usual. Leaks were way down and mostly occured during the wake time when I was experimenting. I didn't actually sleep until around 30 minutes after the "break". I was awake when the one OA was recorded and woke periodically after 6AM, so any of those events could be sleep-wake junk. I have a cpap pillow with cutouts for the mask arriving today.
Questions:
1. Would any pressure changes be in order according to my recent charts ? My original prescription was for 10-20 APAP with EPR 3. I have gradually modified it to 10-15.6 with EPR 2. Would a reduced lower limit setting be recommended?
2. My flow limits don't vary a great deal. I'm wondering if my narrowed nasal passages are causing these numbers. I am a nose breather but switch over to mouth breathing if congested. In this case is a reduction of flow limitations unlikely?
3. My current hybrid mask needs to be tightened enough to prevent leaks that my nose becomes compressed and I wake up with strap marks and a lot of eye puffiness on the side I lie on. Is there a style of mask that is better for side sleepers in relation to leaks?
Thanks for reading. I appreciate any help and recommendations!
RE: LuminousOne Therapy Thread - Jay51 - 08-05-2024
Good progress.
1. You can experiment with a reduced lower limit, but I would personally keep it the same (and maybe even a tad bit higher experiment). Try both and see what OSCAR reveals. You are EPR 2. You do have some CA's. Going to EPR 3 full time would most likely reduce your flow limitations ever further, but could cause more CA's. You can experiment here again if you like.
2. Your narrowed nasal passages could be contributing to your 0.07 95%tile flow limitations. They may not though. Only experiment here I can think of would be to try some breathe right strips (or equivalent) and possibly a nasal dilator and see if either of those help your numbers. Your choice if you want to try this experiment.
3. I have a F & P Vitera full face mask (and also a Quattro FX full face mask). I am not the most up to date on hybrid mask. From reading threads here, 2 top hybrids seems to be either the f40 hybrid or the evora hybrid full face mask. There are many reviews of these here in the Product Review Forums or even just doing a search on them. Also can see videos of these hybrids and more online. *I know you are currently using the Evora, (and you also have the f40 right?) but you might learn some tips on how to get a better seal on these also. If anyone else has a recommendation here for the best hybrid full face mask for side sleeping, please post.
RE: LuminousOne Therapy Thread - LuminousOne - 08-05-2024
Thanks Jay!
1. I will try a slightly higher low limit. I tolerate 10 fine. I've lost quite a bit of weight since this started and my upper limit requirements are steadily dropping. I'm guessing that the objective is to have as steady a continual pressure as possible, similar to CPAP to prevent arousals (?). I dropped EPR to 2 from the prescribed 3 hoping to decrease CA's. They seem to be lessening. I struggled with EPR of 1, but will re-evaluate.
2. I was thinking about dilators. I have a radiofrequency turbinate reduction a few days before I started on CPAP. I was hesitant to try dilators until I healed up. I still have a deviated septum and collapsed nostril valves. Your input answered this question
.3. I had even more trouble with the F40. According to some sources, it starts to lose it's grip with pressures of 14 and higher. The Evora has greater reinforcement but, for me, loses it's grip if it comes in contact with an unyielding object such as pillows. I can't wait to try my cpap pillow tonight.
I appreciate your advice. It is priceless to me.
RE: LuminousOne Therapy Thread - Jay51 - 08-06-2024
EPR is called expiratory pressure relief and is supposed to be for comfort only. But, it reduces flow limitations in a lot of cases and works therapeutically in that sense. The only downside to it is, as you have observed, a possible increase in CA's due to more CO2 washout from better breathing.
Some people like a consistent straight cpap pressure all night. Some like EPR. Your experiments are confirming what works best for you.
RE: LuminousOne Therapy Thread - LuminousOne - 08-28-2024
Hello All,
Please help. Primary MD providing no assistance. Sleep therapist at DME left. Don't see sleep MD until next week.
Situation: On APAP since June 18th. AHI and clear airways have steadily decreased. Have positional apnea which is being treated with soft cervical collar. Have had big problems with masks, especially with fit. Initially tired F40, then Evora FFM - had significant leak issues. Switched to pillows less than a week ago with great increase in comfort, but still having some leaks. One pillow tends to slip away from nostril, likely due to set up shifting during movement. Also have collapsed nasal valves which may allow more slipage. Going between using small and medium, with medium being more comfortable. Mouth opening is solved with tape and not a big issue anyway.
Questions:
1. I was initially prescribed pressure of 10-20. Currently at 10-15 from my own experimenting. Was using EPR of 2 mostly in hopes of reducing CA's, but returned to 3 last night in hopes of reducing flow limits. My need for pressure at the high limit has remained much lower than 15. Please advise what level would be best.
2. I would appreciare any recommondations relating to P10 mask usage. Sleeping on my back reduces mask shift, but increases AHI; sleeping on side creates more mask shift.
3. Should I be more concerned with CA's or flow limits?
First screen: Medium pillow, EPR 2.
Second screen: Small pillow, EPR 2.
Third screen: Medium pillow, EPR 3.
[attachment=68940] [attachment=68942] [attachment=68941]
Thanks to all of you!
RE: LuminousOne Therapy Thread - LuminousOne - 08-29-2024
Bump.
RE: LuminousOne Therapy Thread - Jay51 - 08-29-2024
In regards to question number one: experimenting is probably the best tool to use here. It is a balancing act getting the correct EPR setting for sure. Base it on how you feel in the morning (which settings combination works the best for you personally.
In regards to question number 3: tough question. Since a CA lasts over 10 seconds, it would probably be more severe than flow limitations. By definition a flow limitation can be anywhere from 1% to 50% disrupted flow. Even though it is not a full blown apnea, it could cause a lot of trouble with your sleep quality at night.
Question #2: hopefully someone with the P10 can give tips here.
Chart #1 looks the cleanest and quietest of the 3 charts that you posted.
RE: LuminousOne Therapy Thread - LuminousOne - 09-01-2024
Thanks Jay. I appreciate your knowledge and willingness to answer my questions.
I think I'm finally getting somewhere. The P10 - so far - has been a success. Comfortable to wear except for the break-in nasal soreness, doesn't leave marks on my face, AND my numbers are improving.
Drum roll........My AHI the night before last was 0.9 - lowest ever. Of course, I forgot to push the SD card in and don't have the full story, but I felt good afterwards and feel it's an accurate metric.
This is from last night. I'm using mouth tape, but showing leaks. I think it's from the pillows becoming dislodged when I press my face into the pillow. I have to find a remedy to keep my face away from the pillow. Also shows evidence of positional apnea even though I had a scc on loosely (probably too loosely). My OA's have been running less than 1 and these were an anomaly.
[attachment=69067]
Does anyone have any recommendations for pressure adjustments? My median is running gradually lower, around 10's to 11's so I lowered the bottom pressure to 9.6 and as my high pressures are in the 13's, I lowered my high limit to 14.6. I ran my EPR back up to 3 because my CA's have lowered.
Thanks and sleep well.