Seeking Advice on CPAP Efficacy

Hello everyone,

I'm reaching out for insights and advice regarding my CPAP therapy, which I'm starting to question in terms of its effectiveness. I've been using the therapy as prescribed by my doctor, but I'm still occasionally feeling unrested in the morning and sometimes experience headaches.

Upon analyzing the data from my Resvent iBreeze + O2Ring, I've noticed a significant number of flow limitations, frequent occurrences of OA, and my AHI at times spikes to levels between 10-15.

Interestingly, the data from my O2Ring seem to closely correlate with the readings from the CPAP machine. However, when I catch up on sleep without using the CPAP, the O2Ring shows similar data to when I am using the machine. Does this suggest that the CPAP is not effective for me?

Could it be possible that some adjustments need to be made to the device settings - like the pressure, etc.? I am looking for any recommendations or similar experiences that could guide me on what to do next.

Please, any advice or insights would be greatly appreciated.

Thank you in advance!

I agree... that machine is not doing you much good.

From what I hear they're hard to sleep with... pressures chugging and otherwise not smooth.

If you can try a Resmed Airsense 10... if you were near Austin I'd lend you one. I don't like what I hear about that machine.

romkisel wrote: ↑

Tue Apr 30, 2024 12:39 pm

Interestingly, the data from my O2Ring seem to closely correlate with the readings from the CPAP machine. However, when I catch up on sleep without using the CPAP, the O2Ring shows similar data to when I am using the machine. Does this suggest that the CPAP is not effective for me?

No, it suggests that the present settings aren't effective enough

Could it be possible that some adjustments need to be made to the device settings - like the pressure, etc.?

Yes.
Who set up your machine? What was the doctor's exact prescription?

vandownbytheriver wrote: ↑

Tue Apr 30, 2024 7:05 pm

I agree... that machine is not doing you much good.

From what I hear they're hard to sleep with... pressures chugging and otherwise not smooth.

If you can try a Resmed Airsense 10... if you were near Austin I'd lend you one. I don't like what I hear about that machine.

Thank you so much for your response and for offering your help - it's truly appreciated!
Unfortunately, I'm not located near Austin, and cannot take advantage of your offer. Moreover, it's quite challenging where I live to try different CPAP machines due to limited availability...
It makes me wonder if the issues I'm facing could be related to the machine itself rather than to my treatment settings or my condition?

ozij wrote: ↑

Tue Apr 30, 2024 11:00 pm

Who set up your machine? What was the doctor's exact prescription?

Thank you so much for the response.

My doctor was responsible for setting up my CPAP machine. He did not provide me with detailed information about the pressure settings but mentioned that he would set the air heating function to make it easier for me to breathe. He also advised me to use the CPAP machine in the evening for about 40 minutes before going to bed to get accustomed to it.
In addition to the CPAP settings, he prescribed 3 mg of melatonin to be taken three hours before bedtime to help with sleep onset.

I've been using the CPAP machine with these settings for approximately a month now. My follow-up appointment with the doctor isn't scheduled for a while, so I'm trying to figure things out on my own in the meantime.
If you have any suggestions or advice based on this information, I would greatly appreciate your help.

btw, here's my session report during last night:

romkisel wrote: ↑

Wed May 01, 2024 4:26 am

It makes me wonder if the issues I'm facing could be related to the machine itself rather than to my treatment settings or my condition?

That is my suspicion. Here's a reviewer I trust.

https://www.youtube.com/watch?v=Sjv6utzL_zA

This comment from a user is pertinent here I think:

I have one of these iBreeze 20A. I discovered through trial and error that switching to the 19mm tubing smoothed out the pressure surges for me. Also use no Ramp, no IPR, no APAP. Basically, the less this machine has to think, the better it works. I’ve actually had a couple of nights with 0.0 AHI which I’ve never achieved with any CPAP! I like the compactness of the humidifier. It’s a pretty good CPAP for me once I got it figured out.

A relatively recent firmware update took care of the bumpiness
viewtopic/t185875/Resvent-Ibreeze-Softw ... l#p1431562
Lanky Lefty's review is 2 years old.

You can update the firmware yourself"
https://compasshealthbrands.com/itemFil ... -9-23).pdf

Looking at your OSCAR charts I see a number of things:
The machine works by adding pressure to the defined Exhale Pressure (EPAP) - the way Bi-Level machines do, and not by reducing from the Inhale Pressure (IPAP)

Look at your median IPAP pressure. You're spending 50% of the night at that pressure or above. In the other 50% of the next, you keep getting events that make your oxygen go down, and the pressure go up. Why stay there? Once you breathing stably, you machine drops the pressure - and things go wrong.

Do you want to make changes before talking to your doctor?
Can you get a detailed report of what made the doctor set up the machine the way he did?
Can you contact your doctor about your discomfort / dissatisfaction?

ozij wrote: ↑

Wed May 01, 2024 9:27 am

A relatively recent firmware update took care of the bumpiness
viewtopic/t185875/Resvent-Ibreeze-Softw ... l#p1431562
Lanky Lefty's review is 2 years old.

You can update the firmware yourself"
https://compasshealthbrands.com/itemFil ... -9-23).pdf

Thank you for the insights and the firmware update info. I'm a bit worried about updating the firmware by myself though - don't want to mess anything up.

ozij wrote: ↑

Wed May 01, 2024 9:27 am

Do you want to make changes before talking to your doctor?
Can you get a detailed report of what made the doctor set up the machine the way he did?
Can you contact your doctor about your discomfort / dissatisfaction?

I am open to making changes to the settings because my next appointment with the doctor isn't until early June, and unfortunately, I don't have the option to see him sooner. I think he might've set standard settings to start with.
Could you recommend specific settings to play with? Should I change the mode from apap to cpap? What pressure should I set?

Much appreciated!

Maybe you don't need a firware update. Do you know how to check your firmware version? I think the "how" is mentioed in the presentation I linked to.

The doctor, intentionally or not, set you up with a very low exhale pressure (EPAP), and a relatively narrow range - but we don't know why. Did you have a sleep study?
When you meet the doctor, what will you tell him about the settings you changed?
Aren't you afraid of messing up things when you change the settings?
When you say "standard settings" do you mean you think the doctor sort of, pulled the settings out of his hat, so to speak, and will check results and make change accordingly?

romkisel wrote: ↑

Wed May 01, 2024 10:14 am

Could you recommend specific settings to play with? Should I change the mode from apap to cpap? What pressure should I set?

If you decide to make changes, you have to be systematic and careful about it.
You would have to read the manual carefully - and all of us (you and anyone who tries to help you) have to be aware that the very basic way your machine is set up is different from how we set up ResMed machines (or most others).
I haven't read the iBreeze manual, and I can only say that *if* you want to make changes, you should aim for a higher minimal exhale pressure, because obstructive events start more or less when people have finished exhaling, and you want to prevent as many as you can.
I would search for a way to make sure that the minimum EPAP does not go lower than 6. On your charts it's as low as 3 sometimes.

Personally, I do fare much better with a set pressure (CPAP). Other's respond better to APAP - it's a trial and error issue.

ozij wrote: ↑

Wed May 01, 2024 12:13 pm

Maybe you don't need a firware update. Do you know how to check your firmware version? I think the "how" is mentioed in the presentation I linked to.

I've checked version in about settings, it's v01.09.00. It seems like I need to update it. My concern is that there are no updates for my CPAP's SVN (21166) in the link you've sent...

ozij wrote: ↑

Wed May 01, 2024 12:13 pm

Did you have a sleep study?

I had a simplified sleep study (doctor-ordered) SOMNOcheck device that monitored my SpO2 and breathing, resulting in the doctor determining my AHI to be 21.

ozij wrote: ↑

Wed May 01, 2024 12:13 pm

When you meet the doctor, what will you tell him about the settings you changed?

I'll explain that the initial settings didn't seem to help much, so I decided to experiment a bit to see if I could find a more effective setup.

ozij wrote: ↑

Wed May 01, 2024 12:13 pm

When you say "standard settings" do you mean you think the doctor sort of, pulled the settings out of his hat, so to speak, and will check results and make change accordingly?

Yes, that's the impression I got. It seems like the doctor chose these settings as a sort of general starting point - the ones that tend to help most people initially. I figure he planned to adjust after observing the results over time.

ozij wrote: ↑

Wed May 01, 2024 12:13 pm

Aren't you afraid of messing up things when you change the settings?

I think it's quite easy to change setting back if something will go wrong.

ozij wrote: ↑

Wed May 01, 2024 12:13 pm

If you decide to make changes, you have to be systematic and careful about it.
You would have to read the manual carefully - and all of us (you and anyone who tries to help you) have to be aware that the very basic way your machine is set up is different from how we set up ResMed machines (or most others).
I haven't read the iBreeze manual, and I can only say that *if* you want to make changes, you should aim for a higher minimal exhale pressure, because obstructive events start more or less when people have finished exhaling, and you want to prevent as many as you can.
I would search for a way to make sure that the minimum EPAP does not go lower than 6. On your charts it's as low as 3 sometimes.

Personally, I do fare much better with a set pressure (CPAP). Other's respond better to APAP - it's a trial and error issue.

I appreciate your cautionary note about making changes - it's definitely important to be systematic and careful.

It might be worth trying out some straightforward adjustments, starting with small steps. For example, I could begin by disabling iPR (which my doctor did say I could tweak on my own) or slightly increasing the minimum pressure. I'll be taking a gradual approach, monitoring the data closely as I go.

Later on, I might consider switching from APAP to CPAP mode to see if there's an improvement. It seems like balancing between what works personally and what's generally recommended involves some trial and error, and I'm ready to embark on that process.

romkisel wrote: ↑

Wed May 01, 2024 12:59 pm

ozij wrote: ↑

Wed May 01, 2024 12:13 pm

When you meet the doctor, what will you tell him about the settings you changed?

I'll explain that the initial settings didn't seem to help much, so I decided to experiment a bit to see if I could find a more effective setup.

It might be worth trying out some straightforward adjustments, starting with small steps. For example, I could begin by disabling iPR (which my doctor did say I could tweak on my own) or slightly increasing the minimum pressure. I'll be taking a gradual approach, monitoring the data closely as I go.

Later on, I might consider switching from APAP to CPAP mode to see if there's an improvement. It seems like balancing between what works personally and what's generally recommended involves some trial and error, and I'm ready to embark on that process.

I like your plan. And starting with minimizing pressure relief is a good idea.

I'm concerned - because I don't know enough - by what seems like a difference between EPR the way Resmed users know it, and the way OSCAR shows IPR and pressure settings on the chart. It could simply be an artifact of OSCAR's reading of the data produced by the Resvent. However, If it were my machine, and I wanted to make changes on it, I would make sure to download the Resvent event tracking program iMatrix, just to compare what it reports for the present settings. https://getwellue.com/pages/pc-software

Good luck - and keep us updated!