I was doing well, but so frustrated now.

[scholsh]

Here's my background....
Diagnosed in May, sleep study showed ahi of 32.5 Got my CPAP machine and first mask in June, I was able to jump right in started wearing it for at least 7 hours. Your forums have been a God send to me, I read them often and have learned a LOT from your wisdom and experience, but this is my first post.

I downloaded Sleepyhead, and love the info it shows. The sleep doctor set me at a CPAP of 8, which I quickly found to be way too low. (My titration study only had a minimal two hour sleep time, don't think I ever got much solid sleep time) I adjusted the machine to Autoset, worked with my min and max, and am currently at 13 - 20. I thought I was doing well, AHI all month were between 2 and 5 pretty consistently. This week it zoomed up to 7.42 and 10.38! Yikes.

I have changed masks three times, actually started 'small' with a Wisp, then an Amara Hybrid View, then decided I probably needed a FFM, using the Simplus. Have no problem wearing it, I am a very 'determined' mouth breather with a deviated septum. Can not keep my mouth closed no matter what I try... I believe most of my problems are coming from the mouth breathing....

I am at a loss of where to go with this and know you can help ,,,, I have my screenshots for the last four days to show you whats going on, but I can't get them out of my documents into this post.... I know that is the first step for you to help.... how the heck do I post those?

[Pugsy]

Need to host the screen shots on some place like imgur and then link to them in your post.

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

[scholsh]

Did this work?

[Wulfman...]

Here's my background....
Diagnosed in May, sleep study showed ahi of 32.5 Got my CPAP machine and first mask in June, I was able to jump right in started wearing it for at least 7 hours. Your forums have been a God send to me, I read them often and have learned a LOT from your wisdom and experience, but this is my first post.

I downloaded Sleepyhead, and love the info it shows. The sleep doctor set me at a CPAP of 8, which I quickly found to be way too low. (My titration study only had a minimal two hour sleep time, don't think I ever got much solid sleep time) I adjusted the machine to Autoset, worked with my min and max, and am currently at 13 - 20. I thought I was doing well, AHI all month were between 2 and 5 pretty consistently. This week it zoomed up to 7.42 and 10.38! Yikes.

I have changed masks three times, actually started 'small' with a Wisp, then an Amara Hybrid View, then decided I probably needed a FFM, using the Simplus. Have no problem wearing it, I am a very 'determined' mouth breather with a deviated septum. Can not keep my mouth closed no matter what I try... I believe most of my problems are coming from the mouth breathing....

I am at a loss of where to go with this and know you can help ,,,, I have my screenshots for the last four days to show you whats going on, but I can't get them out of my documents into this post.... I know that is the first step for you to help.... how the heck do I post those?

As I start typing, I see Pugsy has posted a link to instructions.

But, you didn't say what your humidifier setting is.
And, your answers should be in your reports. However, I suspect your pressure range may also be a "suspect".
APAPs need snores and flow limitations to trigger pressure increases.

Anyway, if you get your reports posted, maybe we'll get some ideas.


Den

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[scholsh]

[scholsh]

OK, I got it, these were the last two nights..... Open to all suggestions,,,,,

[Wulfman...]

WOW! That's ugly! (sorry)

Are you aware if you're sleeping on your back?

But, I'm focusing on the pressure line when you're NOT having events and comparing it to when you ARE.

You might want to try a straight pressure of something between 10 and 12 cm. and see how that goes.


Den

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[scholsh]

Here's the "good" night for comparison

[Pugsy]

It works but if you would use the last line in the box of addresses then I could click on the image so I could then enlarge it so I could see the numbers better. They are tiny like it is right now.

Are you seeing much CSR being flagged?

My first thought was that you probably just need a little minimum pressure adjustment upwards when coming from a nasal interface mask to a full face mask. It's fairly common to sometimes see that a little more pressure is needed with a full face mask than a person got by with when using a nasal mask.
Now with seeing that really ugly cluster and big CSR time frame...I am not so sure...if you often see CSR flags.

Things seem to go really well for the bulk of the night and then for some reason there's a big change. Makes me wonder what changed. Might be REM stage related...might be related to sleeping position (on your back maybe).

What is your maximum pressure setting? I can't tell if you are maxing out the pressure or not....it appears that you are.

[scholsh]

Here is the one night recently when I put the machine back on CPAP with 13.4 instead of APAP. I tried the other link for you. And yes, I did have a CSR. They happen maybe once a week or so, and I can always tell... get the old sensation pre-treatment of having a hard time breathing. And yes, my biggest issues seem to happen late in the night (or early in the morning) when I start to roll over on my back after mostly side sleeping earlier.... and probably REM time too.

[scholsh]

Oops, sorry, that was not the night that showed CSR, but I have seen them.

[Wulfman...]

That last one looks "good" with the exception of the solid obstructions. I would suspect sleep position in those two time frames that night.


Den

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[scholsh]

Strange, the original sleepyhead does show it under CSR, but when I posted it it did not. So, what do I do about the incidents when I am on my back?

[Wulfman...]

I think straight pressure will work better for you if you can work on staying off of your back.


Den

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[Pugsy]

Are you on any meds of any kind? If so, what?

Can you get a close up screen shot of the CSR flagged individual breaths and same sort of close up of the breaths in one of those ugly clusters that didn't get flagged as CSR?

Do you know how to do that?
Easiest way...go to the events tab...then click on the OA category...then find a time frame where CSR is flagged and click on one of the events in the middle...then you get a zoomed in section...then take a screen shot. Do the same thing with some OAs that aren't flagged as CSR. Want to compare the breaths.

Normally CSR relates to centrals and yours are OAs but sometimes the machine can get fooled.

Oh...are you using EPR?

I would be tempted to treat them like OAs if it wasn't for the CSR flags and you saying that you feel worse on those nights.

Have you had CSR flags with the nasal mask or is it just with the full face mask?

If they are related to being on your back...either stay off your back (easier said than done sometimes) or increase the pressure...and if you see in apap mode that the pressure is maxing out during those ugly clusters...try opening up the max a bit. Same thing if they are REM related.

If you want to try Den's fixed pressure idea...you are going to have to use a lot more pressure all night...IF (big if) those are really obstructive in nature...fixed at higher than the max was in apap mode.