Need guidance on CPAP

[palerider]

The more I know the more I know I don't know.

That puts you head and shoulders above a number of people here.

[cpapmoma1]

Life "stuff" sometimes slows me down but I'm back now

Pugsy, I did raise the max pressure to 12 and no other changes. The leaks have been getting worse,

but AHI pretty good and feeling rested. Will be getting a FF Dreamwear sure hope it helps some during the allergy season.

Here are the 3 latest SH charts courtesy of my "puter tutor".

[cpapmoma1]

Hi all
It's been a while and still trying to optimize therapy. I probably need to be Pugsied again
Made these changes recently- 7/10 raised max from cpap 8 to 13. On 7/20 raised EPR from 2 to 3 and found that is much more comfortable. Less mouth-breathing going on. Would any more pressure changes help? Anything else need some attention?
My sleep has been good with few wake-ups and only rare naps in daytime. Periodic congestion pops up now due to toxic algae here in Florida waters where I swam and did scuba some time ago. A heart-breaking situation.
Good to see Pugsy had some family time and is back now.
Dreamwear FF mask arrived and is being customized for a trial run. Never saw a headgear that couldn't be improved
Thanks for sticking with me and where do I go from here? All comments welcome- wise and otherwise
Screenshots:
7/12 good sleep-good day even with leaks
7/19 working on leaks
7/21

[Pugsy]

Adding a little more EPR drops the overall pressure a bit..
And if you are going to try a full face mask..might need a little more.

I would increase minimum pressure by 1 cm more...and unless you are starting to have aerophagia with the higher maximum...increase the maximum by 1 or 2 cm. It sometimes wants to go higher but can't.

Still an improvement over what the initial setup was giving you.

[cpapmoma1]

Hi all

Back again for some guidance and input.
Sept. was feeling pretty good. Had my 83 rd birthday and had a perfect APAP night. Wow. (not both the
same night- couldn't stand so much good stuff at once). Gold stars to all the members whose posts educated me. Pugsy gets 5 stars, of course.

Mouth leaks have been an issue forever. Even though the tape has been intact and mask leaks haven't
bothered me much, leaks still showing on charts and at times coincide with events. It's a mystery. Am
working on the DW FF for congested times and trying the tongue training in hopes of losing the tape.

On the "perfect" night was the first time I tried using humidity. Just water in the tank, no heat. Seems one tiny tweak can do a lot. Living in Fl. I thought there was an over-supply of HUMID here

Sending three charts - perfect night
next night
problem night

Max seems good, but will put it up to 20, now that I am educated a little. Would raising the min be a good idea?

Probably ? possibly ? not an apap problem, I know but every little tweak can help.

All input much appreciated. Thanks guys.

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[Pugsy]

How's your sleep quality overall? Sleeping fairly soundly for the most part or having a lot of little wake ups? I see at least one wake up where you turned the machine off briefly. Were there other times? How many?

I see no need to increase that minimum at this point based on these reports anyway.
That one ugly cluster on the problem night...those are centrals and more pressure wouldn't have prevented those little buggers.
Unless you see problem nights like that one often...I don't know that I would worry much about it. Sometimes we just have "off" nights for various reasons. Even now I sometimes will still have a random off night where things go to hell and I have no idea why.

Mask leaks...if you are taping your mouth and the tape is staying in place then any large leaks flagged will be from mask movement.
It just happens sometimes. Unless it's waking you up or you are having a large amount of time spent deep in large leak territory I wouldn't worry about it. From these 3 reports though....leaks are no where near where they would impact therapy.
Now if even little leaks are waking you up then that's a different story. Any leak...big or small...that wakes us up needs to be dealt with because anything that disturbs our sleep is unwanted. Sometimes we can fix those disturbances and sometimes we can't but we can always try to do the best we can.

I think you have done quite well at least on paper.

I have no idea what might have happened with that one ugly cluster. I know that sometimes it just happens for some reason to some people. I have had it happen myself but not quite as ugly as yours. I never figured out why and since it doesn't happen very often enough for me to put forth any effort into trying to figure out why, I just shrug my shoulders and blame the aliens and move on.
Now if you are seeing this fairly regularly then you need to inform your doctor about it.