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+--- Thread: Help please for a new Resmed user. (/Thread-Help-please-for-a-new-Resmed-user)
Help please for a new Resmed user. - Partner - 09-01-2019
Hello everyone.
My wife had a sleep study in June which came up with an AHI of 32.2/H with no central apneas. The longest OA was 72 seconds.
She was immediately prescribed a CPAP/APAP machine -a Resmed 10 autoset set to 5 -15 cm H2O in APAP mode.
This brought her AHI down to 7/H, but kept waking her up, due to the air pressure opening her lips with a resulting (noisy) gale.
Since then, the visiting technician has brought the pressure down to 4 - 6 in CPAP mode.
She now sleeps better, although her lips are still forced open from time to time (even when taped up) and her AHI varies between 1 and 3.5 / H. Which sounds good, but she has a lot of small apneas (<10 seconds) which aren't logged and then, typically, a packet of 20 -30 second apneas usually between 4 and 6 o'clock in the morning.
I've read some very interesting posts on the forum and have been trying to understand the results on ResScan and Oscar but some nights I can't make head or tail of them . . .
Could someone offer advice on how to proceed, please ?
PS she'll be 74 this year.
Thanks in advance.
RE: Help please for a new Resmed user. - Crimson Nape - 09-01-2019
It would be very helpful if you would post some daily screenshots. For information on chart orginization and how to post them, please see the links in my signature.
PS: I bet she doesn't know that you posted her age.
RE: Help please for a new Resmed user. - Sleeprider - 09-01-2019
Controlling mouth leaks can be challenging. The mechanism by which we exclude pressure from the mouth is the tongue, and it is effective as long as it is firmly sucked into the roof of the mouth behind the front teeth. If your wife's jaw tends to relax during sleep, then the tongue can fall and open a path for air to escape. We either learn to keep the tongue in place, or we can use something to support the jaw to keep it shut, or use a full face mask. Things to consider in supporting the jaw are a small C-shaped roll pillow, soft cervical collar, or even pulling a soft feather pillow between the shoulder and jaw. There is no single answer, and members have done many things from the "tongue suck technique" to taping.
The pressure range of 4 to 6 is very low,, and may not be the most effective approach to avoid leaks or optimize therapy. It also will make exhale pressure relief very limited or impossible. If you post a daily details chart from OSCAR we can give you some opinions on efficacy and perhaps comment on whether she should consider going the full-face mask route.
RE: Help please for a new Resmed user. - Partner - 09-01-2019
Thanks for your rapid replies
@ Crimson Nape, I shall try to post up a few charts - something that puzzles me however is that on ResScan, I only get 8 charts, whereas on Oscar I have 14. Is this normal ? (I did check the "all data" box when loading from the SD card).
And yes, Idid get permission from Mrs Partner for her age (although not in writing
).@ Sleeprider, The problem is definitely not her jaw dropping (which I suspected in the beginning) - at the higher pressure her cheeks were puffed out like a chipmunk and then out came the air. It's better now at the lower pressure, but still happens.
You're probaly right about the tongue-control, but I'm not sure what the solution is . . . The technician installed a humidifier to solve the problem, but she hasn't used it yet.
Just tried to post last night's results, but I need 4 posts !
RE: Help please for a new Resmed user. - Melman - 09-01-2019
I've never used Rescan but it is normal to have 14 charts in OSCAR. You don't need to post them all. The important ones are event flags, flow rate, pressure (not mask pressure), leak rate, and flow limits.
RE: Help please for a new Resmed user. - Crimson Nape - 09-01-2019
While ResScan and OSCAR theoretically provide the same data, the way OSCAR displays this information provides a better understanding of the data. OSCAR is the preferred program here on the forum. You will need at least 4 posts in order to attach the screenshots.
Looking forward to seeing the charts.
RE: Help please for a new Resmed user. - Partner - 09-01-2019
I've prepared the screenshots for last night, using Resscan, but I've only just realised that it's all in French
I'll re-do them with Oscar . . . which is in English !
RE: Help please for a new Resmed user. - Sleeprider - 09-01-2019
The use of the humidifier should help with comfort, and may help in sealing out leaks. First, thing you will notice is that the machine is much quieter with a humidifier. The more humid air can help keep the mouth and throat from drying,and of course our noses are very sensitive to unconditioned air. I think you should start using it tonight!.
OSCAR is available with French language (or English if you prefer), and we will know what we are looking at regardless of the labels. Instructions for posting charts are in my signature links.
RE: Help please for a new Resmed user. - Sleeprider - 09-01-2019
From DariaVader:
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
Place your tongue behind your front teeth on the roof of your mouth
let your tongue fill the space between the upper molars
gently suck to form a light vacuum
Practicing during the day can help you to keep it at night
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
RE: Help please for a new Resmed user. - Partner - 09-01-2019
We'll give the humidifier a try
Your suggestion of teaching Mrs Partner to lightly suck her tongue between her molars made me think of teaching Granny to suck eggs . . . (sorry).
Next post should be the charts . . .