Any Recommendations to Improve Therapy

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Any Recommendations to Improve Therapy

Post by Pugsy » Fri Apr 13, 2018 8:51 am

Your choice if you wish to try Ron's ideas.
Not something I would recommend but you might like his ideas.
In terms of AHI and/or therapy effectiveness...more pressure isn't needed but there's no harm in using more pressure all the time than is technically needed unless the more pressure causes a problem...like aerophagia maybe.

I am not too keen on the Auto Ramp thing though....I have seen too many examples of it not sensing sleep like it should but again that's your choice.

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klm49
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Re: Any Recommendations to Improve Therapy

Post by klm49 » Fri Apr 13, 2018 9:07 am

Ron AKA wrote:
Fri Apr 13, 2018 8:41 am
Snorynomore wrote:
Thu Apr 12, 2018 9:56 pm
Here is an image with the time right before I take off mask expanded. Anything unusual? I also posted an image of last night and I had another challenging night but I made myself remember what I was feeling and it felt like I couldn't get enough oxygen and felt like I was suffocating so I had to open my mouth to breath. I was also having condensation issues again so I had to wipe mask and sometimes that took care of problem.
You had me really puzzled for a while, until I realized you were posting two different nights. That second trace would indicate you were breathing normally and probably asleep, and then it stops. Kind of strange. In any case the symptoms you describe indicate you are not getting enough pressure - "it felt like I couldn't get enough oxygen and felt like I was suffocating so I had to open my mouth to breath". Based on that and the pressures I am seeing, I would suggest the following changes:

1. Ramp Start - Set this pressure to 6.6 cm in the Clinical Menu. The current 5 cm is too low for most people. This will give you more air when you are falling asleep, and in the night if you take off the mask for any reason and start treatment again, you will get this as the minimum pressure to start the ramp.

2. Minimum Pressure - I would set that to 8.4 cm to give you more air when the machine automatically ramps back down in pressure when you are asleep. That may be a touch high, but I think it is a good starting point to determine how much you need to feel comfortable.

Try those two changes and see if that helps some.
Let's see what's wrong with this picture:
less than 2 weeks ago you were asking people how to read sleepyhead graphs and now you think you are qualified to give people therapy settings.
I think you might do better not posting at all unless it's a question.

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Ron AKA
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Re: Any Recommendations to Improve Therapy

Post by Ron AKA » Fri Apr 13, 2018 9:09 am

klm49 wrote:
Fri Apr 13, 2018 9:07 am
Let's see what's wrong with this picture:
less than 2 weeks ago you were asking people how to read sleepyhead graphs and now you think you are qualified to give people therapy settings.
I think you might do better not posting at all unless it's a question.
I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.

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TASmart
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Re: Any Recommendations to Improve Therapy

Post by TASmart » Fri Apr 13, 2018 9:15 am

Ron AKA wrote:
Fri Apr 13, 2018 9:09 am
klm49 wrote:
Fri Apr 13, 2018 9:07 am
Let's see what's wrong with this picture:
less than 2 weeks ago you were asking people how to read sleepyhead graphs and now you think you are qualified to give people therapy settings.
I think you might do better not posting at all unless it's a question.
I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.
Based on your recommendation to start making changes to very good results, I wonder how much you have learned in the 3 years of reading Sleepyhead graphs. I am with Pugsy, OP is getting very good results and does not require any therapeutic changes. It is normal to wake a few times each night. Sometimes we recall waking, sometimes not. I would say the major issue with the OP's therapy is that she is not used to having a thing in her nose at night that is not to be picked out, and finds this disconcerting when groggy from a mid-night wake.
All posts reflect my own opinion based on my experience and reading.
Your mileage may vary
Past performance is no guarantee of future results
Consult with your own physician as people very

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klm49
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Re: Any Recommendations to Improve Therapy

Post by klm49 » Fri Apr 13, 2018 9:45 am

Ron AKA wrote:
Fri Apr 13, 2018 9:09 am

I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.
You should take your own advivce:

"However one should look at the SleepyHead charts first and get some advice from experienced people here."

viewtopic.php?f=1&t=170883&p=1241591#p1241591

Perhaps you would care to post your qiualifications to be suggesting therapy changes?

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Pugsy
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Re: Any Recommendations to Improve Therapy

Post by Pugsy » Fri Apr 13, 2018 9:47 am

Let's be clear....Ron has reportedly been reviewing his wife's results using SleepyHead for 3 years.
He's not been a cpap user himself for 3 years...in fact just recently diagnosed and per his own thread...still in the process of sorting out his own issues..
Minimal personal experience.

and for some reason likes to assume the stuff he likes in terms of various settings is something that the rest of the world would like.
He's not yet come to grips with the YMMV thing.
And that's why I don't often interject my own personal settings into the situation...I already know that what I might like doesn't matter at all to the next person.
What works for me doesn't mean squat to the next person.
He's quick to offer changes without asking more detailed information..

The one thing I would want to know before suggesting changing something that appears to be working is ....is this a fluke thing that happened this one night or is it a common occurrence and seen often.
Was the OP just wondering what might have happened and curious or having a problem and seeing this often.

I never ever suggest changes based on one report unless the need is so obvious that a blind person could see it or the person says....
I see this happening every night...any idea how to prevent it.

And the Auto Ramp thing....in theory it's the greatest thing since sliced bread for the people who like ramp.
In real life...it doesn't always work like the theory says. I have seen too many reports from people telling me that it doesn't always work like it is supposed to.

And why in the world suggest using Ramp of any kind to anyone with it already turned off and apparently not needing it and not complaining of the starting pressures at all.

Ramp is pretty much useless when the starting pressure is 6.6 and EPR is 3. Big whoopie.
Now if the minimum was maybe 12 and it was causing a problem...yeah...might be useful.
Why add something when there's been no mention of a problem that ramp might fix. It's just trying to fix something that isn't broken...IMHO.

Now I am not against using ramp if a person finds it suits there needs...but if someone doesn't have a need...why use it.
I didn't see anything in the OPs comments to lead me to believe that ramp might be needed.

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Ron AKA
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Re: Any Recommendations to Improve Therapy

Post by Ron AKA » Fri Apr 13, 2018 11:00 am

TASmart wrote:
Fri Apr 13, 2018 9:15 am
Ron AKA wrote:
Fri Apr 13, 2018 9:09 am
klm49 wrote:
Fri Apr 13, 2018 9:07 am
Let's see what's wrong with this picture:
less than 2 weeks ago you were asking people how to read sleepyhead graphs and now you think you are qualified to give people therapy settings.
I think you might do better not posting at all unless it's a question.
I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.
Based on your recommendation to start making changes to very good results, I wonder how much you have learned in the 3 years of reading Sleepyhead graphs. I am with Pugsy, OP is getting very good results and does not require any therapeutic changes. It is normal to wake a few times each night. Sometimes we recall waking, sometimes not. I would say the major issue with the OP's therapy is that she is not used to having a thing in her nose at night that is not to be picked out, and finds this disconcerting when groggy from a mid-night wake.
I'm only responding to the original posters question which was:

"So I am finally back to using my machine after figuring out the right hose temp and humidity to fix the water in the nose pillows. I am able to use the cpap for about 4-6 hours a night but my AHI still a bit high. Any recommendations for what I should do to improve my numbers and time on CPAP. I have woken up a couple of nights with severe dry throat so I know I've had mouth leaks."

I am not the type to say "take an aspirin and call me in the morning" type. The poster asked for help and I gave it, instead of giving excuses not to help.
Last edited by Ron AKA on Fri Apr 13, 2018 11:05 am, edited 1 time in total.

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Ron AKA
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Re: Any Recommendations to Improve Therapy

Post by Ron AKA » Fri Apr 13, 2018 11:04 am

Pugsy wrote:
Fri Apr 13, 2018 9:47 am
Let's be clear....Ron has reportedly been reviewing his wife's results using SleepyHead for 3 years.
He's not been a cpap user himself for 3 years...in fact just recently diagnosed and per his own thread...still in the process of sorting out his own issues..
Minimal personal experience.

and for some reason likes to assume the stuff he likes in terms of various settings is something that the rest of the world would like.
He's not yet come to grips with the YMMV thing.
And that's why I don't often interject my own personal settings into the situation...I already know that what I might like doesn't matter at all to the next person.
What works for me doesn't mean squat to the next person.
He's quick to offer changes without asking more detailed information..

The one thing I would want to know before suggesting changing something that appears to be working is ....is this a fluke thing that happened this one night or is it a common occurrence and seen often.
Was the OP just wondering what might have happened and curious or having a problem and seeing this often.

I never ever suggest changes based on one report unless the need is so obvious that a blind person could see it or the person says....
I see this happening every night...any idea how to prevent it.

And the Auto Ramp thing....in theory it's the greatest thing since sliced bread for the people who like ramp.
In real life...it doesn't always work like the theory says. I have seen too many reports from people telling me that it doesn't always work like it is supposed to.

And why in the world suggest using Ramp of any kind to anyone with it already turned off and apparently not needing it and not complaining of the starting pressures at all.

Ramp is pretty much useless when the starting pressure is 6.6 and EPR is 3. Big whoopie.
Now if the minimum was maybe 12 and it was causing a problem...yeah...might be useful.
Why add something when there's been no mention of a problem that ramp might fix. It's just trying to fix something that isn't broken...IMHO.

Now I am not against using ramp if a person finds it suits there needs...but if someone doesn't have a need...why use it.
I didn't see anything in the OPs comments to lead me to believe that ramp might be needed.
I would suggest you spend more time addressing the OP's questions and concerns, and much less time criticizing other people who are trying to help rather than blow smoke. I think you need to look in the mirror and ask yourself why you are at this forum. And, be honest.

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palerider
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Re: Any Recommendations to Improve Therapy

Post by palerider » Fri Apr 13, 2018 11:05 am

Ron AKA wrote:
Fri Apr 13, 2018 9:09 am
klm49 wrote:
Fri Apr 13, 2018 9:07 am
Let's see what's wrong with this picture:
less than 2 weeks ago you were asking people how to read sleepyhead graphs and now you think you are qualified to give people therapy settings.
I think you might do better not posting at all unless it's a question.
I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.
When are you going to START???

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Ron AKA
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Re: Any Recommendations to Improve Therapy

Post by Ron AKA » Fri Apr 13, 2018 11:07 am

klm49 wrote:
Fri Apr 13, 2018 9:45 am
Ron AKA wrote:
Fri Apr 13, 2018 9:09 am

I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.
You should take your own advivce:

"However one should look at the SleepyHead charts first and get some advice from experienced people here."

viewtopic.php?f=1&t=170883&p=1241591#p1241591

Perhaps you would care to post your qiualifications to be suggesting therapy changes?
How is this post helpful to the original posters questions?

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palerider
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Re: Any Recommendations to Improve Therapy

Post by palerider » Fri Apr 13, 2018 11:08 am

Ron AKA wrote:
Fri Apr 13, 2018 11:04 am
Pugsy wrote:
Fri Apr 13, 2018 9:47 am
Kind and reasoned words.
I would suggest you spend more time addressing the OP's questions and concerns, and much less time criticizing other people who are trying to help rather than blow smoke. I think you need to look in the mirror and ask yourself why you are at this forum. And, be honest.
She's one of the most revered and helpful and trusted people on the forum. As well as one of the most tolerant.

She could have banned your disrespectful self, but she hasn't, yet.

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mesenteria
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Re: Any Recommendations to Improve Therapy

Post by mesenteria » Fri Apr 13, 2018 11:11 am

Ron, that's what she's doing, as well as helping you to see that you are attempting to straighten a road that doesn't need straightening. Offering, suggesting, or directing changes to a regimen that is already optimized doesn't sound like helpful advice to me...or to Pugsy, apparently.
Last edited by mesenteria on Fri Apr 13, 2018 11:12 am, edited 1 time in total.

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palerider
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Re: Any Recommendations to Improve Therapy

Post by palerider » Fri Apr 13, 2018 11:11 am

Ron AKA wrote:
Fri Apr 13, 2018 11:07 am
klm49 wrote:
Fri Apr 13, 2018 9:45 am
Ron AKA wrote:
Fri Apr 13, 2018 9:09 am

I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.
You should take your own advivce:

"However one should look at the SleepyHead charts first and get some advice from experienced people here."

viewtopic.php?f=1&t=170883&p=1241591#p1241591

Perhaps you would care to post your qiualifications to be suggesting therapy changes?
How is this post helpful to the original posters questions?
Pointing out your lack of knowledge helps keep the OP from being led astray by you.

Everyone should do it.

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Pugsy
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Re: Any Recommendations to Improve Therapy

Post by Pugsy » Fri Apr 13, 2018 11:15 am

Ron AKA wrote:
Fri Apr 13, 2018 11:04 am
I would suggest you spend more time addressing the OP's questions and concerns, and much less time criticizing other people who are trying to help rather than blow smoke. I think you need to look in the mirror and ask yourself why you are at this forum. And, be honest.
I already said all I needed to say thank you.
And I could spend more time helping people if I didn't have to follow around people who think they know it all and like to talk like they do and don't know nearly as much as they think they know.
I didn't criticize you...I just explained my point of view about what you offered.
Anyone on this forum gets to do that...and that includes me.
Big surprise ...not everyone here is going to agree with you on anything...and they all get to voice their thoughts too.
If it hadn't been me..it would have been someone else. Get used to it...you are going to see a lot of it.
Like it or not...it's going to happen and some people won't be nearly as nice about it as I was/am.

As for the mirror remark...geez what a frigging whiny ass baby remark.
I have been here nearly 9 years now...May 2009 and using cpap the entire time.
I know exactly why I am here...and one of the reasons unfortunately has to be people like you.
Sigh...it's a dirty job but someone has to do it.
Have a nice day.

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Re: Any Recommendations to Improve Therapy

Post by prodigyplace » Fri Apr 13, 2018 11:17 am

Ron AKA wrote:
Fri Apr 13, 2018 9:09 am
I have been reading SleepyHead graphs for over 3 years now. We never stop learning unless we choose to.
So, tell us why you stopped learning or never started?? :shock:

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