New Pressure new problems

USMCVet · Post by **USMCVet** » Fri Feb 16, 2018 12:16 pm

My prescription has changed as of this morning to fixed pressure of 10. Cflex or whatever you call it has been locked out on machine for no exhale relief.
Previously my range was 6 to 20. 90% pressure was just under 8 with exhale relief of 3.

I figured I would try it out before going to work and things not so great.

1. I'm getting a headache while using it.
2. I don't feel like I'm exhaling all the way because of the straight pressure of 10.
3. I can feel more leaks but sure I can probably correct those with some adjustments.
4. Being woken up constantly with air shooting out of my mouth no matter if I am on my side or back.
5. Dry mouth probably because of above.
6. Chest pain. Feeling it now that I woke up and felt it during titration study when I was trying to sleep.

Pugsy · Post by **Pugsy** » Fri Feb 16, 2018 12:18 pm

Turn on CFlex if you want it.

You do know how to get into the setup menu and turn on Flex don't you?

USMCVet · Post by **USMCVet** » Fri Feb 16, 2018 12:22 pm

Yea , trying to be "good". Your right though I'll change it myself. After all cflex is not part of prescription I don't think.

TerrificSoporific · Post by **TerrificSoporific** » Fri Feb 16, 2018 1:13 pm

1.) Yes, do ensure that you have the exhale relief on.
2.) When you sense difficulty exhaling, you are awake. When you are awake you don't have sleep apnoea happening. What you are experiencing is a hypersensativity to new sensations. It means that you need some settling in time with the new pressure setting/arrangement. Distraction is the best way to help these feeling settle. You can be 100% sure that the difficulty exhaling will not be occurring while you are asleep.
3A.) Dry mouth can be a symptom of an inadequate pressure setting. If the pressure is not enough to hold open your airway, blockages will be happening. The body is being choked by itself, so your mouth opens as a choking response
OR
3B.) Dry mouth -Your CPAP pressure settings may be correct for your needs, but due to age and facial structure things are getting more floppy and less toned and your mouth is just dropping open for these reasons. In this case a chin strap may be trialed, or a full face mask if the chin strap is ineffective. .
Just some thoughts. Hope it works out for you.

USMCVet · Post by **USMCVet** » Fri Feb 16, 2018 5:13 pm

The exhaling issue doesn't seem like it's a mental issue. I can just tell with my natural exhalation I don't have enough ooomph lol. I can force full exhales but naturally breathing it's too much.
Maybe the extra force will be a good workout lol.

Other thing I noticed was my right ear wanting to pop or a build up of pressure in there.

Oh well it was only one nap and I'm sure things will normalize after a week or so.

ajack · Post by **ajack** » Fri Feb 16, 2018 5:30 pm

I thought they were going to use 15 for your o2? Are they building up to that?
If you do do your own adjustments, have the minimum pressure with flex at 10, so if you have 2cm flec, you would use 12cm to get 10..if that makes sense.

Don't try to breathe out, just let it happen. Your lung won't completely empty because of the pressure, but you do get enough air. google peep and alveolar recruitment

Pugsy · Post by **Pugsy** » Fri Feb 16, 2018 5:41 pm

Flex at a setting of 2 isn't necessarily equal to 2 cm like ResMed does.
Flex relief is flow based so the amount of reduction depends on air flow and not a per cm per setting thing.
For some people that setting of 2 might only give a drop of 1 cm...and for some people the setting of 3 might only give 1.5 cm drop.
But according to Respironics it's "up to 2 cm reduction"...and that's all it will do even at the setting of 3.

ajack · Post by **ajack** » Fri Feb 16, 2018 5:49 pm

good point and why I used the cm rather than the setting number. Resmed and philips are different in the results of the setting.

USMCVet · Post by **USMCVet** » Fri Feb 16, 2018 7:22 pm

I thought 15 too but miscommunication. I asked tech what did I get up to meaning what's my number, she took it as how high did she get me lol.

ajack · Post by **ajack** » Fri Feb 16, 2018 11:33 pm

Even though it turns out I was so close with 9 and allow me to gloat for a moment.

I know I would have said, try another cm and go 10. That was about the 95%

Just looking at the chart, I like 12cm and 94% better, but over 90% is the goal and 92% is good. I probably don't like 12 enough to suggest it.

min epap10 or min pressure - flex = 10
and max 15 sounds a plan

USMCVet · Post by **USMCVet** » Fri Feb 16, 2018 11:47 pm

ajack wrote: ↑
Fri Feb 16, 2018 11:33 pm
Even though it turns out I was so close with 9 and allow me to gloat for a moment. I know I would have said, try another cm and go 10. That was about the 95%

Just looking at the chart, I like 12cm and 94% better, but over 90% is the goal and 92% is good. I probably don't like 12 enough to suggest it.

Honestly with oxygen things have slowly gotten better. I have heard sometimes with new sleep studies to verify CPAP is still needed they have person stop for a week or two first. So I wonder now that I stop oxygen it pressure will still help.

Yes you were right LMAO! What I don't get is how do I have AHI of 14 at pressure of 8 lol????? I call shenanigans!

Also I got the call today! Pulmonologist appointment for last Wednesday of this month. Just need to get CD of my last chest x-ray.

Oh and when I say chest pain from new pressure I don't mean entire chest like my lungs are getting workout but chest pain over heart that I have had for over 10 years.

Now my question is if I have APAP why not set min to 10 and Max to 15 ?????

USMCVet · Post by **USMCVet** » Fri Feb 16, 2018 11:48 pm

I just noticed you suggested same plan. I have pissed off my current VA provider so I want to wait for new one and get permission to play around more. After all I have a right to be involved in my health care according to VA lol

ajack · Post by **ajack** » Fri Feb 16, 2018 11:53 pm

That could be a very valid point, I hope it isn't the case. Time will tell and you have an spo2 meter.
I know some labs (the one I went to) want you off your cpap for a few nights, to get a real study on what is happening.

I think min 10 is a sensible pressure from the study. I would have auto to cover a bad night if needed and 15 sounds fair. It can be 20 or 13, as long as it's a few over 10, toi give the machine room to move. You will see if it wants more.

USMCVet · Post by **USMCVet** » Sat Feb 17, 2018 12:02 pm

It's just like i started all over with CPAP. Felt like i couldn't get enough air last night . I just have to dial in how much to breathe. Big breathes make it worse and little breathes make it better.

While i agree generally with the advice we give new people to up pressure from 4 to at least 6 i am now not so sure that feeling of not getting enough air is always caused by the low pressure.

USMCVet · Post by **USMCVet** » Sat Feb 17, 2018 12:18 pm

Ok i set something seriously wrong last night and my above post is now certainly inaccurate.

How the heck did this happen???? Pressure set to 10 but only went to 5?

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