Second night on a CPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Nathan C. Morales
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Second night on a CPAP

Post by Nathan C. Morales » Wed Jan 28, 2015 9:24 am

I seemed to have greater success on my second night. I used a different mask: Resmed Quatro FX Medium.

Here are my stats: http://imgur.com/UsbksB0

I think I'm going to try a nasal pillow next.

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Julie
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Re: Second night on a CPAP

Post by Julie » Wed Jan 28, 2015 9:29 am

It would be much better if you attached this note to your original thread so we can follow the sequence... don't remember what the story was now.

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Re: Second night on a CPAP

Post by Sleeprider » Wed Jan 28, 2015 9:45 am

Nathan C. Morales wrote:I seemed to have greater success on my second night. I used a different mask: Resmed Quatro FX Medium.

Here are my stats: http://imgur.com/UsbksB0

I think I'm going to try a nasal pillow next.
I also don't know about your last thread, but I see you are very obstructed with your current settings of 5 min, 10 max. The pressure is maxing out at 10cm and still not treating you. It looks like you need 10 minimum and max somewhere up around 15 and see what that does. Note your median, 95% and max pressure are all 10 cm. It has no place to go. Setting your minimum to 10 is the same pressure you have all night, but you need to open up the max pressure to treat your obstructive apnea. This will in turn reduce snores and flow limitations and RERAs. I presume that was not a very restful night?

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Nathan C. Morales
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Re: Second night on a CPAP

Post by Nathan C. Morales » Wed Jan 28, 2015 9:51 am

Here was my original thread: viewtopic/t103453/viewtopic.php?t=103442

At least my AHI is down from 28 to 4.

I'll try setting my auto to do 10-15 min/max and see what happens.

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Re: Second night on a CPAP

Post by Sleeprider » Wed Jan 28, 2015 10:08 am

Nathan, that is great progress. I think you'll see another significant reduction tonight. A lot of this ends up being trial and error, but the data points a clear path for you at this point. The increased pressure should be beneficial.

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Re: Second night on a CPAP

Post by grayghost4 » Wed Jan 28, 2015 10:11 am

looks like a great improvement.
read this post about the quatro mask .. it applies to any mask:

https://maskarrayed.wordpress.com/tamin ... e-quattro/
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

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palerider
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Re: Second night on a CPAP

Post by palerider » Wed Jan 28, 2015 11:38 am

Nathan C. Morales wrote:I seemed to have greater success on my second night. I used a different mask: Resmed Quatro FX Medium.
that's MUCH better. I agree that you need more pressure, as evidenced by the auto spending most of it's time at your set maximum pressure.

I'd suggest, instead of 10-15, setting it for 9-15, or even 9-20 and seeing what it wants to do. you're very much in a data gathering mode at this point.

also, please hit 'f10' to turn off the right sidebar when you do your next screenshot, and take a look at this neat page below for tips on how to make the screenshot look, and work better when you post it.

https://sleep.tnet.com/reference/tips/imgur

keep up the good work!

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Uncle_Bob
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Re: Second night on a CPAP

Post by Uncle_Bob » Thu Jan 29, 2015 12:26 pm

Nathan C. Morales wrote: I'll try setting my auto to do 10-15 min/max and see what happens.
What was your titrated pressure? You've got to make sure thats in the picture somewhere. I do well with my minimum pressure being set to 1cm below my titrated pressure and then plus 6cm for my maximum.

Full face masks are a dance with the devil, i tried 4 of them. I would definitely try and see if you can make a nasal type mask work.
Nasal masks, especially pillow type will be cheaper in the long run too and are easier to keep clean.

Good Luck
~UB

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palerider
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Re: Second night on a CPAP

Post by palerider » Thu Jan 29, 2015 1:23 pm

Uncle_Bob wrote:
Nathan C. Morales wrote: I'll try setting my auto to do 10-15 min/max and see what happens.
What was your titrated pressure? You've got to make sure thats in the picture somewhere.
I believe this is a self titration scenario.

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Uncle_Bob
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Re: Second night on a CPAP

Post by Uncle_Bob » Thu Jan 29, 2015 3:26 pm

palerider wrote:
Uncle_Bob wrote:
Nathan C. Morales wrote: I'll try setting my auto to do 10-15 min/max and see what happens.
What was your titrated pressure? You've got to make sure thats in the picture somewhere.
I believe this is a self titration scenario.
Self titration, then why not open her up to 20cm and let the algorithm do its work?

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palerider
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Re: Second night on a CPAP

Post by palerider » Thu Jan 29, 2015 5:56 pm

Uncle_Bob wrote:
palerider wrote:
Uncle_Bob wrote:
Nathan C. Morales wrote: I'll try setting my auto to do 10-15 min/max and see what happens.
What was your titrated pressure? You've got to make sure thats in the picture somewhere.
I believe this is a self titration scenario.
Self titration, then why not open her up to 20cm and let the algorithm do its work?
well, that's usually what I suggest, then after getting some data, narrow at least the bottom setting to where it's needed... I wasn't the one that suggested the initial setup, so I'm just advocating smaller changes

his main thing was getting the leaks under control, and higher pressures would just make that worse.

general interesting comment: while he needs more than 10cm pressure, that first night, the machine never raised pressure, because the leaks were so bad, it kept trying to reduce pressure to get the mask to seal. good evidence that machines DON'T increase pressure because of leaks.

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Nathan C. Morales
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Re: Second night on a CPAP

Post by Nathan C. Morales » Thu Jan 29, 2015 9:41 pm

Ugh. My third night was horrible.

Woke with a headache, lung ache, and feeling very zombie-like. It felt like one the worst sleep nights in many months. Here's my sleepyhead data:

Image

I don't know what happened or what all my stats mean. I had my auto pressure set from 7-15. I guess I can open it up to 7-20.

After last night I am scared to try this again.

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Uncle_Bob
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Re: Second night on a CPAP

Post by Uncle_Bob » Thu Jan 29, 2015 9:49 pm

as palerider rightly said you have a leak problem as a priority. Did you try a nasal pillow mask as you mentioned?

any of the other stats are not deemed to be accurate if your leak is above 25 as the machine is unable to compensate.

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Re: Second night on a CPAP

Post by Pugsy » Thu Jan 29, 2015 9:59 pm

It's your 7 cm minimum that is the problem..not the maximum. If your machine could go to 100 cm it still couldn't fix the problem.
You need more baseline pressure (that's the minimum) to help hold the airway open and prevent the airway collapse in the first place.
Right now with these settings the machine is in "fix it" mode instead of "prevent" mode and things work a whole lot better in prevent mode.

I don't know how much more than 7 cm minimum you might need...very likely the 10 cm that others have mentioned.
Also...past experience has shown me that often if the minimum pressure is more optimal then the upper ranges of the pressures will actually stabilize and sometimes actually reduce.

Your leak line last night...ugly but probably still within the machines ability to compensate but just barely. Part of that increase in leak is related to the pressure increasing itself. Remember that total leak line (the top leak line) means not only excess leak but also the mask's expected vent rate is included and more pressure means more vent rate. Your leak rate last night while a bit ugly....not enough to blame the other ugliness on.

You can use 15 cm max if you wish or 20 or anything in between but I bet if you use 10 cm minimum instead of 7 that there's a good chance you won't need those higher maxes nearly as much as you might think.
The pressure will stabilize and not roam around as much...leaks will be easier to control with less changes in the pressure and your snores and AHI should greatly improve.

I don't know if 9 or 10 minimum will get the job done. I doubt you will need more than 10 minimum.
Unsure about the maximum but I would set it to 20 and see what happens. The machine won't go where it doesn't think it has good reason to go and if the going there presents a problem then we deal with it if we need to.

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Re: Second night on a CPAP

Post by palerider » Thu Jan 29, 2015 10:07 pm

Nathan C. Morales wrote:I don't know what happened or what all my stats mean. I had my auto pressure set from 7-15. I guess I can open it up to 7-20.
like pugsy said, (and was suggested last night) raise the minimum pressure, so you're not getting into as bad a situation in the first place

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