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+--- Thread: [Treatment] Brand new to this, not sure how to optimize treatment (/Thread-Treatment-Brand-new-to-this-not-sure-how-to-optimize-treatment)
Brand new to this, not sure how to optimize treatment - tinimay - 12-02-2022
So I know things on this machine are not optimized. Did diagnostics with Lofta and it just seems like they are sales people that identify sleep apnea and mail out a machine with sub-par settings to get you to call back and pay for them to adjust them. Just my early take, I had a very weird start with them.
My sleep study was the best night's sleep I'd had in a year.
RDI: 16.1
RDI total events: 112
AHI 7.0
Total AHI events: 49
O2 minimum: 89
O2 average: 94
I got the Airsense 10 and an F30 mask to start.
I left out the screenshot of OSCAR data for the first night on cpap, lots of issues with leaks and I was recovering from Covid and coughing made a mess of the data from what I could tell. I'm still coughing a little, but I feel like I'm having problems with leaks and my AHI still seems high.
ANY assistance you can provide with optimizing settings or getting this treatment to be more effective would be greatly appreciated! I am anxious to learn how to manage this data and adjust things on my own. Lofta just doesn't have my confidence.
RE: Brand new to this, not sure how to optimize treatment - tinimay - 12-02-2022
Additional info: I don't have health insurance. I am also Autistic and a woman, and seem to get walked all over by doctors. They don't listen to me. So my confidence in health care providers, in general, is minimal. I just quit my primary care physician after explaining I was certain I have sleep apnea, my cardiologist (who I DO trust) was seeing atrial fibrillation and high blood pressure and was convinced untreated apnea was the cause. My smart watch had my O2 as low as 81% when I wear it at night. My primary physician took one look at me, said you don't have sleep apnea, those watches are faulty, and refused to call out a sleep study or send me to a specialist. So I used Lofta.
I've known had sleep apnea for years. It runs in the family. I was just really resistant to using a CPAP. My experience with CPAP machines was from the 90's watching my dad and little sister use theirs and that ancient tech was really distressing to me. Constant pressure you have to fight to exhale. I didn't know how far they had come with the tech in recent years.
Now, with the health issues popping up, I am fully on board with CPAP treatment. Love this machine, I just want to get it to work better and I'm hoping to adjust and treat on my own as much as possible.
I adjusted the clinical settings the first night, as they gave it to me set to 4.0-20.0 and I was starving for air.
RE: Brand new to this, not sure how to optimize treatment - DaveL - 12-02-2022
Welcome to the forum!
I don't have the skill to assist you.
You have started well--finding the forum, sending OSCAR charts. I'm sure that others with more knowledge will help you optimizing your settings, and getting good care.
DaveL
RE: Brand new to this, not sure how to optimize treatment - Sleeprider - 12-02-2022
Tinimay, your Airsense 10 Autoset CPAP has been set up with a minimum pressure of 7.0, maximum pressure of 20.0 and EPR (exhale pressure relief) full-time at a setting of 2. This means that when you start therapy, the inhale/exhale pressures are 7.0/5.0, and your pressure actually got to nearly 18/16. Looking at your charts, the clustering of obstructive events is an indication that your head and neck position may be contributing to obstruction of your airway. We have a Wiki article that discusses this problem, some simple self-tests and suggestions on limiting pillows or supporting the head and neck with a soft cervical collar. http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea
Other than the clusters of apnea, things are pretty good, and we can try to narrow your pressure range and improve comfort. I'm going to suggest an increase in minimum pressure to make room for a little more EPR and a reduction of the maximum pressure in hopes you will control the obstruction by being aware of positional issues and chin-tucking. The recommendation for now is minimum pressure 8.0, maximum pressure of 14.0 and increase the EPR setting from 2 to 3. Be sure to give us feedback on both AHI and comfort.
RE: Brand new to this, not sure how to optimize treatment - tinimay - 12-02-2022
(12-02-2022, 09:28 AM)Sleeprider Wrote: Tinimay, your Airsense 10 Autoset CPAP has been set up with a minimum pressure of 7.0, maximum pressure of 20.0 and EPR (exhale pressure relief) full-time at a setting of 2. This means that when you start therapy, the inhale/exhale pressures are 7.0/5.0, and your pressure actually got to nearly 18/16. Looking at your charts, the clustering of obstructive events is an indication that your head and neck position may be contributing to obstruction of your airway. We have a Wiki article that discusses this problem, some simple self-tests and suggestions on limiting pillows or supporting the head and neck with a soft cervical collar.
Other than the clusters of apnea, things are pretty good, and we can try to narrow your pressure range and improve comfort. I'm going to suggest an increase in minimum pressure to make room for a little more EPR and a reduction of the maximum pressure in hopes you will control the obstruction by being aware of positional issues and chin-tucking. The recommendation for now is minimum pressure 8.0, maximum pressure of 14.0 and increase the EPR setting from 2 to 3. Be sure to give us feedback on both AHI and comfort.
Thank you! Will give this positional info a read and adjust the settings!
RE: Brand new to this, not sure how to optimize treatment - tinimay - 12-09-2022
[attachment=46266]Update: Added a soft cervical collar and switched from a hybrid F30 to a p10 for her. The f30 mask had a lot of leaks and flapping once pressure got up to 14. Determined my face was too narrow for the face mask on the sides without tightening WAY too much. Drinking water is a big thing for me in the night, too. Very happy so far with the nasal pillows.
I have a new problem of pulling the pillows off in the middle of the night to take a break and falling asleep before I put it back on, which is why there's an hour break in the middle of the night. Very happy with AHI. And WOW so rested this morning. Been up since 7:30 when normally I sleep 2 more hours.
Close up screen of a patch of events I had early this morning. [attachment=46267]
RE: Brand new to this, not sure how to optimize treatment - Sleeprider - 12-09-2022
Well congratulations on the significant improvement in your results. Hopefully the comfort and feel for therapy will similarly continue to improve. That is a pretty dramatic difference, so your actions made a big difference. I think you can increase minimum pressure to 9.0, and we will eventually hope to see the positional issues improve even further.
RE: Brand new to this, not sure how to optimize treatment - mesenteria - 12-09-2022
I am pleased that you are determined to get this puppy under control and that you are open to suggestions and willing to keep tweaking your therapy and how you get it until it actually works. Unfortunately, too many come here and say they're ready to give up, and eventually do...or so they threaten. Those who persist, keep open minds, and who are willing to go to the efforts needed to dial in their therapy almost always have better sleep and actually feel more rested...and healthy.
Very few of us have an easy time finding out more about how to sleep better with PAP therapy of any kind. Masks don't fit, hoses keep getting in the way, or they fill with condensate, or the mask does, or their morning reports don't show much improvement. With perseverance, almost all of us eventually win.