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New patient - Mach9 - 12-06-2023
I was diagnosed the week before Thanksgiving. AHI 42.Received my Resmed 10 Autoset the day before Thanksgiving. I will be posting some files in a few days. But for now I have a question. Today I was reading the Wiki instructions for OSCAR and when I got the Tidal Volume section, I read this: "High tidal volumes also decrease venous return and reduce cardiac output." Is this to say that high tidal volume could circulation, in the legs for example? My tidal volume the first night peaked several times at around 1900. The next morning, I had a swollen right ankle/foot. I didn't think about it being related to the CPAP at the time. Assumed it was diabetes related or the result of a minor tumble I took on a motorcycle a week earlier. Is it possible that it could be related to the CPAP and some of my settings? Or am I completely misunderstanding the term " venous return"? Scrolling through my reports, it looks like my tidal volume has been as high as 2200 or so. BTW, AHI is always below 3.0 now. Any suggestions? I will post some reports soon. I want to get them formatted the way you guys like. Thanks. Great group here I can tell already.
RE: New patient - PeaceLoveAndPizza - 12-06-2023
Anything is possible. Probable is a different question.
We need data in the form of OSCAR charts to be able to speak with any authority.
As the good Mr. Holmes so famously said…
“When you have eliminated all which is impossible, then whatever remains, however improbable, must be the truth.”
RE: New patient - staceyburke - 12-06-2023
The charts we need is in my signature at the bottom of the post - chart organization
RE: New patient - CPAPfriend - 12-06-2023
A lot of patients will have a few moments of high tidal volume throughout the night, so it's not uncommon, but ultimately your question is beyond my purview.
RE: New patient - Mach9 - 12-07-2023
Ok, hope I did this right. Here are a few report screenshots. One is from my first night and the other two are recent. I think I did them according to the instructions. Let me know if I didn't.
I should also mention that, since starting the therapy, I do feel less sleepy during the day. But, my chronic, CHRONIC fatigue is no better whatsoever. Also, that tidal flow I mentioned has peaked as high as 2,100 or so. I don't know what normal is. Thanks in advance for any advice.
RE: New patient - PeaceLoveAndPizza - 12-07-2023
Thanks, you did fine. Lots going on in there.
First and foremost. Leaks. I do not know what kind of mask you are using, but if it is a nasal mask or pillows, you are likely mouth leaking. If a full-face then there may be a fit problem, either incorrectly adjusted headgear or the wrong size cushion. You need to get this under control as it must be uncomfortable and affecting sleep quality. There are many good YouTube videos on fitting a mask that may help if you need it.
Second. Good job finding a working pressure! A lot of wild pressure swings caused by flow limitations. More on that below.
Third. Tidal volume looks fine to me. As CF said it is not unusual to have big spikes that show up in the 95% and 99.5% percentile. Your median is in a very good range.
My suggestions would be to try a pressure range of 8-12 with EPR 2 full-time. That should reduce the flow limitations and stop quite a bit of the pressure changes. Should hopefully be more comfortable as well. If you are using ramp, turn it off. Ponder what it will take to stop the leaks as well.
We can take it from there to fine-tune things. Hopefully it will help get you a better quality nights sleep. Give it a go and post some charts for review. Folks here are most helpful.
RE: New patient - Mach9 - 12-07-2023
Thanks so much for the encouragement and advice! Yes, i have a leak problem. Using a nasal pillow so I know I'm mouth leaking some, but also having the nasal pillow get out of position slight when I roll to one side. I tried a borrowed full face one night, but hated it. Tried taping a couple of times but was freaking out sometimes and gave it up temporarily. I will put in your recommended settings tonight and see how it goes and continue to work on the leak deal. I do have to get up 1 to 4 times per night to take a leak and also to let my diabetic dog out to pee. So I know that's not helping. Thanks again. A great group of folks on here!!!
RE: New patient - Mach9 - 12-12-2023
Last 3 nights. Tell me what you think. For the record, I feel miserable. If anything, worse than before I started. I had been feeling much less sleepy during the day. But that problem has returned in the last few days. Thanks for taking the time to help me.