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+--- Thread: David Clark - Therapy Thread (/Thread-David-Clark-Therapy-Thread)
RE: David Clark - Therapy Thread - Crimson Nape - 02-13-2022
Try turning the Smart Start off and see if that doesn't correct your problem. Like George Jetson, you will now have to press the button. (Ahh, memories!)
RE: David Clark - Therapy Thread - David Clark - 02-14-2022
I've been having a fair amount of CA's which my sleep study did not show. I was thinking the highish pressure 20 then I turned it down to 18 but still had them was causing it. Two days ago I turned the pressure down to 12 and I'm not showing many CA's now. The same two days ago I started using a DreamWear nasal cushion mask so I'm getting some leaking because I'm not keeping my mouth shut. I was also hoping the lower pressure might not force my mouth open but I guess not. I may have to resort to a chin strap. Are there any adjustments to pressures you see that I might need to make?
Thanks
Dave
RE: David Clark - Therapy Thread - David Clark - 02-18-2022
I got a little tired of fighting with mouth leaks so last night I gave the Dreamwear nasal a break and tried out my
F&P Vitera. Overall it doesn't look like it was a bad night but I have no idea what was going on for that hour.
RE: David Clark - Therapy Thread - Sleeprider - 02-19-2022
Looks like for about 1/2-hour your mask was ajar and leaked near the large leak threshold. Flow limits during that leak are not necessarily accurate. On the whole, the night looks pretty good.
RE: David Clark - Therapy Thread - David Clark - 02-20-2022
Overall it doesn't look too bad I don't think. Are there any setting suggestions you have that would help with the flow limitations?
Thanks
Dave
RE: David Clark - Therapy Thread - Sleeprider - 02-20-2022
If you want to try getting after the flow limitations, increase IPAP by 1-2 cm and increase PS from 5 to 6. You are already using a relatively high pressure support, and you should consider this move to be somewhat experimental to see if it makes a difference. We want to evaluate for effectiveness and comfort, and may decide to reduce PS to a more comfortable level. I don't know the source of your FL but it may be anywhere in the upper airway from nasal to near the soft palate or pharyngeal. Some people get lower flow limits with direct pressure to the nose using nasal pillows, but tolerance for nasal therapy is an individual thing.
RE: David Clark - Therapy Thread - David Clark - 02-20-2022
Thank you. I'll try the setting adjustments and see how it goes tonight. I have Dreamwear pillows and well as nasal cushion. I like them both but when I use them the mouth leak comes into play. The chin strap I have doesn't really work that well unless it's uncomfortably tight. There's probably better straps out there. The last two graphs I've posted where the AHI was lower and leaks were low are after I switched to the Vitera.
RE: David Clark - Therapy Thread - Sleeprider - 02-20-2022
Be aware that many chin-straps pull the jaw back and can directely increase flow limitation. The Knightsbridge dual strap pulls upward and seems to be a bit less of a problem, but is a full head cover. I actually prefer to see people try soft cervical collars to support the jaw from below and behind, than to use a chin-strap that wraps the chin or jaw and pulls toward the crown of the head.
RE: David Clark - Therapy Thread - David Clark - 02-20-2022
I did buy this one but I haven't tried it yet. I think maybe I saw it mentioned here somewhere.
RE: David Clark - Therapy Thread - Crimson Nape - 02-20-2022
Good choice! Especially when the summer months arrive. The material is a lot cooler than the normal covering material used.