Need Some Advice Please

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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AcedDublB
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Re: Need Some Advice Please

Post by AcedDublB » Sun Nov 08, 2015 4:18 pm

This CPAP is a loaner including SD card so there is previous data there.

I started on or about October 9, 2015.

Last night's sleep was best I have had in over a month as I never felt I awoke at any point. As noted I took one 1 mg Lorazepam to assist me in getting to sleep which it did amazingly well. I don't normally take this medication but felt I was getting so little proper sleep over past few weeks that I needed to try a different approach and I will likely repeat again tonight.

I do try and sleep on my back most of time with mask but I can sleep on either side if that is recommended position.

If you need further detail from Sleepyhead I can post now that you have given me the required help.

I really want to succeed at this with your help and others.

The clinic and equipment supplier really don't give you the guidance to be successful in my opinion. Thank goodness for Google and devoted people like yourself.

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Pugsy
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Re: Need Some Advice Please

Post by Pugsy » Sun Nov 08, 2015 4:41 pm

For some reason your pressure is sufficient to hold the airway open at least part of the night but not all of the night. The 2 most common reasons for increased pressure need are supine sleeping or REM stage sleep.
Your really ugly time frame starting at 2 AM approx is way too long for it to be REM stage sleep unless you have some really weird REM staging going on.

Most likely it is related so the supine sleeping. I am of the opinion that people shouldn't try to sleep in positions that they aren't used to sleeping in...I tend to think it's just best to let people sleep however they can sleep the best and let the machine handle any pressure needs.

If this were my report I would change it to apap mode and set the minimum to the 12 you are using now and open the max up to 20 and see where the machine wants to go to take care of the snores and OAs you are seeing. It's a starting point and at this point I would suspect that a higher minimum is needed but if using higher creates a problem I would re-evaluate pressure needs once I saw where it was wanting to go and if imperative that a higher minimum is needed then go up slowly in small increments.

If you can comfortably sleep on your side...that's an option also but staying on one's side is often easier said than done. I end up on my back often and I prefer side sleeping. I prefer side sleeping because sleeping on my back just plain hurts like hell but it doesn't stop me from ending up on my back no matter how much I try to stay on my side.

So if it were my report I would change over to apap mode...minimum of 12 if that is fairly comfortable for you...you can continue to use the ramp if it helps...and set the maximum to 20 and I would suggest change the Flex mode to AFlex and set it at 2 or 3 (whichever feels the best).
See what happens at those settings and sleep in whatever position offers better chance of sleeping.
Go ahead and take a sleep aid for now. It's not going to make all that much of a difference in pressure needs (if any difference).
Let's get you sleeping first and worry about doing without a sleep aid later.

Do you know how to change the settings?
If not, this explains how and there is a video too.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

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AcedDublB
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Re: Need Some Advice Please

Post by AcedDublB » Sun Nov 08, 2015 6:57 pm

Thank you for your recommendations which I have entered into the machine.

I will submit this evening's data tomorrow although I do realize that radical changes are not likely seen in one day.

Nevertheless it is best to modify rather than wasting another month likely spinning my wheels.

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AcedDublB
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Re: Need Some Advice Please

Post by AcedDublB » Mon Nov 09, 2015 10:18 am

Another great night, two in a row.

Altered machine to APAP with readings recommended by pugsy.

Big drop in AHI

Here is summary.[codeImage][/code]

There were no Events shown on the graph and I am having troubles uploading the entire screen print as imgur not cooperating.

Will post as soon as I can get it working.

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Re: Need Some Advice Please

Post by AcedDublB » Mon Nov 09, 2015 10:30 am

[codeImage][/code]

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Pugsy
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Re: Need Some Advice Please

Post by Pugsy » Mon Nov 09, 2015 10:34 am

Your AHI is better but still not where we would want it to be.

Not sure why no events are showing up because the AHI per the summary page was 14.67.

I am particularly interested in seeing the events, pressure, flow rate and leak graphs all in one image.
If you aren't seeing anything on the events graph...try putting the SD card back into the machine and let it do its thing (watch the LCD screen for when it stops reading the SD card) and then pull the card and import again into SleepyHead.

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AcedDublB
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Re: Need Some Advice Please

Post by AcedDublB » Mon Nov 09, 2015 10:44 am

Code: Select all

[img]http://i.imgur.com/rrJGqYi.png[/img]

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AcedDublB
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Re: Need Some Advice Please

Post by AcedDublB » Mon Nov 09, 2015 10:46 am

Code: Select all

[img]http://i.imgur.com/rrJGqYi.png[/img]

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AcedDublB
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Re: Need Some Advice Please

Post by AcedDublB » Mon Nov 09, 2015 10:53 am

Code: Select all

[img]http://i.imgur.com/S3nFgBm.png[/img]
http://i.imgur.com/rrJGqYi.png

http://i.imgur.com/rrJGqYi.png

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Re: Need Some Advice Please

Post by Julie » Mon Nov 09, 2015 11:01 am

HI, I wonder if you've tried a soft cervical collar - it helps keep your chin off your chest, opening your airway much better, and also helps keep your jaw (if not lips) closed better as well. It's worked for a lot of people who tend to curl up without even realizing it!

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Re: Need Some Advice Please

Post by Pugsy » Mon Nov 09, 2015 11:08 am

How do you feel about using minimum of 13 cm tonight? All the other settings the same?
If it is too much too soon...try 12.5 cm minimum and be prepared to increase by 0.5 every 3 or 4 nights.
I don't know how much more minimum you are going to need...that could be REM stage sleep where the pressure wants to go to 20ish. I suspect needing around 15 or 16 minimum and those needs put you up in bilevel machine category in terms of potential pressure needs and comfort. The amount of reduction available with Flex set at 3 is at most 2 cm and with pressures in the upper teens I think that a reduction of 3 or 4 would be miles more comfortable.
Since this machine is a loaner...we can talk about bilevel once we figure out what pressures you need or we hit a wall in terms of comfort with the minimum pressure increases.

Here...I put the address in between the IMG brackets from the forum Editor...

Image

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AcedDublB
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Re: Need Some Advice Please

Post by AcedDublB » Mon Nov 09, 2015 6:10 pm

Julie wrote:HI, I wonder if you've tried a soft cervical collar - it helps keep your chin off your chest, opening your airway much better, and also helps keep your jaw (if not lips) closed better as well. It's worked for a lot of people who tend to curl up without even realizing it!
I will order one on Amazon as you suggest.

Amazing help here, otherwise I would have had 2-3 months of frustration and minimal, if any progress.

To receive personal and immediate review and recommendations is truly a blessing.

I hope I can progress to where I need to get.

Thank you for your advice.

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Re: Need Some Advice Please

Post by AcedDublB » Mon Nov 09, 2015 6:24 pm

Pugsy wrote:How do you feel about using minimum of 13 cm tonight? All the other settings the same?
If it is too much too soon...try 12.5 cm minimum and be prepared to increase by 0.5 every 3 or 4 nights.
I don't know how much more minimum you are going to need...that could be REM stage sleep where the pressure wants to go to 20ish. I suspect needing around 15 or 16 minimum and those needs put you up in bilevel machine category in terms of potential pressure needs and comfort. The amount of reduction available with Flex set at 3 is at most 2 cm and with pressures in the upper teens I think that a reduction of 3 or 4 would be miles more comfortable.
Since this machine is a loaner...we can talk about bilevel once we figure out what pressures you need or we hit a wall in terms of comfort with the minimum pressure increases.

Here...I put the address in between the IMG brackets from the forum Editor...

Image
Made the minimum 13 as recommended and boosted the startup from 6 to 8 and cut ramp time from 30 minutes to 20. Flex is set at 3.

I use almost a full container of water in the humidifier tray each night. I use a chinstrap but I think it is only moderately successful. Possibly the recommendation of a soft cervical collar may indeed be beneficial.

Looking forward to a third sleep through nite. The last two nights have been amazing, never thinking about CPAP whatsoever, never waking up and 2 - 3 hours more sleep too.

Thank you again for your ongoing recommendations.

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Re: Need Some Advice Please

Post by AcedDublB » Tue Nov 10, 2015 7:55 am

3rd consecutive great night sleeping right through for almost 10 hours. took another sleep aid last night.

AHI continues to decline noticeably.

higher pressures are no issues.

Image

[urlhttp://imgur.com/a/O25RB][/url]

Image

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Re: Need Some Advice Please

Post by AcedDublB » Tue Nov 10, 2015 7:59 am


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