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+--- Thread: [CPAP] Switched to FFM, need help on settings (/Thread-CPAP-Switched-to-FFM-need-help-on-settings)
Switched to FFM, need help on settings - Strange54 - 02-06-2024
Hi all,
I was diagnosed with UARS and was originally using nasal pillows for a month or so; however, as I increased my pressure to address flow limitations, I began to have significant leaks. I also just got too tired on chin strap and mouth tape. I have been using the FFM (AirFit F20) for about 5 days thus far and not really sure how to go about changing my settings. I have read some places that the pressure may need to be higher than that from nasal pillows. My leak rate improved at lower pressures but my AHI was very high. I had switched back to APAP for a couple nights to better identify what pressures I need but I'm not too sure how to change things. My last increase in pressure resulted in more leaks (however, I believe I didn't fasten the FFM as tightly since it had given me some red marks on my nose where I ended up breaking out with tiny pimples).
I seem to struggle with how to approach these situations. Should my first action be to address the leak issues before further changing pressure? If my body would have its way, I would mouth breathe (since my nose has practically been non-functional my whole life although I had extensive sinus surgery about 6 months ago). I have also read that nasal route is preferred for UARS so I was wondering if there is any utility in a chin strap. I have intermittently used a soft collar but I really can't tell if it is working since I haven't got my pressures and leaks figured out. Do my graphs look like there is clustering where this might be helpful? I think I've made too many changes at once so far. OSCAR shows no obstructive events and mostly just 'clear airway' events. Is this synonymous with central apneas? If I keep increasing my pressure, will the centrals get worse? Also I am not really sure what to do with EPR? I can tolerate expiration against higher pressures, so do I need it or is there some element of it that is intrinsically helpful for UARS.
Not sure if anyone can comment on this but my other question is in regards to medications and their effect on arousal threshold. I am on quite a few psychotropic medications. Mydayis (stimulant) 50mg qAM, bupropion 450mg qAM, vilazodone 40mg qAM, gabapentin 600mg qHS (for RLS), trazodone 50-150mg qHS PRNl; non-prescription: 100mg caffeine/200mg l-theanine qAM, a combo melatonin/l-theanine/herbal stuff gummy at night, and Thorne Elite Multivitamin AM/PM.
I realize that's a lot of questions but I really appreciate anyones help. I am currently taking FMLA because of how bad my depression has been and I really need my energy to improve so that I can have the will to be active and do things.
I have attached my last 3 days of using the FFM (don't have SD card data on like 1-2 days prior). I mainly increased the minimum pressure and did change EPR (doing too much at once I know). I may have to start tightening the mask more given increasing leak rate with higher pressures. Also not sure what to do with the humidity. I have woken up feeling moisture at the edge of the mask causing a leak. Not sure if this is just from humidifier or maybe some saliva.
Please let me know what further images I can provide (if you need me to zoom in on some section or whatever).
Thanks all!
RE: Switched to FFM, need help on settings - Deborah K. - 02-06-2024
Could you post a redacted copy of your sleep study? That would help a lot. You have mostly Clear Airway events. If they are treatment-emergent they will likely lessen or go away as you adjust to your therapy. If they were your primary apnea in your sleep study you will need different advice. Hopefully, others can give you advice on your other issues.