Tuning it in

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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jamcakes
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Joined: Fri Sep 24, 2021 7:01 pm

Tuning it in

Post by jamcakes » Fri Sep 24, 2021 8:05 pm

Hi Y'all,
I've been reading here because the machine that I've had for a few years has never been quite right and I was finally feeling bad enough to get an O2 meter and it scared me because it went down to 83% the first night I tried it. I jumped on here and did some research and knew I should first get the OSCAR, which I did. I tried sleepyhead with my old Philips machine years ago, but wasn't having trouble, so didn't keep up with the software. I wish I'd loaded it for my new ResMed machine sooner. ResMed AirCurve 10 vAuto, F20 full face mask, just in case it doesn't show in my signature. I'm in my mid-50s.

Three pics. First, the way it's been for several years, very sad, 10/16. Yep, my sleep doc/therapist/PA noticed that I was having a lot of CAs, but didn't know what to do about it.
I think I messed up the machine data by resetting, so it says Mode and Pressure and Setting data missing, but 10/16 is shown in the Statistics.
screenshot-Tues.png
Tuesday, the way it's been for a couple of years.
screenshot-Tues.png (99.36 KiB) Viewed 843 times
Then I misinterpreted what I read here about EPRs and set my EPAP too low, 6/12.
screenshot-Wednes.png
Wednesday, EPAP too low.
screenshot-Wednes.png (93.96 KiB) Viewed 843 times
Then I read a little more carefully and realized I needed to increase my EPAP, so I did to 11/12. Big improvements.
screenshot-Thurs.png
Thursday, EPAP closer to Pressure.
screenshot-Thurs.png (90.55 KiB) Viewed 843 times
So I'm on the right track and today I felt well rested much more of the day and didn't feel like I need to drown myself in coffee.
My plan is to keep it like this for a while and walk up both pressures slowly to see if I can reduce the hypopneas, unless advised otherwise.
Kind Regards,
John
ResMed AirCurve 10 VAuto
PAP Mode: VPAP-S
EPAP 11.0 IPAP 12.0 (cmH2O)

Central Texas

GrumpyHere
Posts: 508
Joined: Sat Feb 13, 2021 2:40 am

Re: Tuning it in

Post by GrumpyHere » Fri Sep 24, 2021 8:54 pm

A small suggestion to improve chart readability.

Based on your last screenshot you can adjust the scale on:
Flow Rate to ± 80-90
Leak Rate to ~40
http://www.apneaboard.com/wiki/index.ph ... _The_Guide

Y Axis: If you want to change the vertical scale of a graph, right-click in the label of a graph and select "Y axis". A small pop-up will show, and give the options Autofit, Defaults, and Override. Select override, the adjust the minimum and maximum numbers until the trace on the graph is to your liking. Note that you must keep the mouse cursor within the pop-up - if it strays outside, the pop-up will disappear.
Image
Last edited by GrumpyHere on Sun Feb 13, 2022 5:26 am, edited 1 time in total.
ResMed Lumis Tx - VAuto mode

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zonker
Posts: 11012
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Re: Tuning it in

Post by zonker » Fri Sep 24, 2021 9:36 pm

jamcakes wrote:
Fri Sep 24, 2021 8:05 pm

So I'm on the right track and today I felt well rested much more of the day and didn't feel like I need to drown myself in coffee.
My plan is to keep it like this for a while and walk up both pressures slowly to see if I can reduce the hypopneas, unless advised otherwise.
Kind Regards,
John
welcome to the zoo!

while i don't know anything about your type of machine, i just wanted to jump in and say how refreshing it is to see someone come to the forum and do some reading before posting. and obviously, you've put that learning to good use. that is a remarkable turn around in your ahi. kudos!

now, let's sit back and see what the more knowledgeable folk have to say.
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
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chunkyfrog
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Re: Tuning it in

Post by chunkyfrog » Fri Sep 24, 2021 9:59 pm

Ribbet.
(Which means we are so proud of you.)

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Pugsy
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Re: Tuning it in

Post by Pugsy » Fri Sep 24, 2021 10:02 pm

Be extremely careful with your experiments to increase your pressures.
Over half of your AHI is central apneas and more pressure won't reduce those numbers and may even increase them.
Also be careful with your PS setting...Pressure support or the difference between inhale/IPAP and exhale/EPAP.
Too much PS can also cause centrals.

I suspect that your problems with central apneas early on was the PS of 6 you were using. If you had reduced PS (or turned it off even) I think your centrals would have significantly reduced.

PS can actually cause centrals in some people. I have a suspicion you are in that group of people.

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chunkyfrog
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Re: Tuning it in

Post by chunkyfrog » Fri Sep 24, 2021 10:21 pm

Sorry, I missed that.
Research good--
But!!!
Some adjustments are better done after you run it by Pugsy, or another bilevel user.

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jamcakes
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Re: Tuning it in

Post by jamcakes » Sat Sep 25, 2021 9:09 am

This pic is last night in S mode with 11/12. Just a little worse than the night previous, with 2 OSAs that I didn't have the night before. Tonight, I'm going to try Vauto mode with PS of 1.
screenshot-Fri.png
Friday Night
screenshot-Fri.png (93.18 KiB) Viewed 766 times
ResMed AirCurve 10 VAuto
PAP Mode: VPAP-S
EPAP 11.0 IPAP 12.0 (cmH2O)

Central Texas

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jamcakes
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Re: Tuning it in

Post by jamcakes » Sun Sep 26, 2021 7:31 pm

Last night, tried the Vauto with PS =1, not bad, but not so great, either. Tonight, I'll try with PS =0 .
screenshot-Satur.png
Saturday night, PS = 1.
screenshot-Satur.png (102.99 KiB) Viewed 706 times
ResMed AirCurve 10 VAuto
PAP Mode: VPAP-S
EPAP 11.0 IPAP 12.0 (cmH2O)

Central Texas

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Pugsy
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Re: Tuning it in

Post by Pugsy » Sun Sep 26, 2021 8:00 pm

Put EPAP minimum of 7 (up from last night's 6) and keep PS of 1...and Auto mode...on your list of experiments to try if you like using PS.

Your minimum EPAP setting is going to be your most critical setting in terms of dealing with OAs and hyponeas.
You aren't going to be able to do much about the centrals with EPAP though or IPAP for that matter.
We can't fix centrals with more pressure with this model machine.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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jamcakes
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Re: Tuning it in

Post by jamcakes » Mon Sep 27, 2021 9:44 am

Thanks Pugsy and everybody! Best AHI score ever. I saw your post and adjusted before getting to sleep. I am having a little more trouble falling asleep and staying asleep than before, but it's probably because I'm just not as tired as I used to be. Or my physiology is adjusting to the changes in my sleep. Or I'm stressed about work and life. So, I only got about 4 hours of sleep last night. I'll stick with these settings for a while and see how it goes. I'm very comfortable with these settings. Here's the screen.
screenshot-Sun.png
Sunday sleep, Yay, AHI 2.07
screenshot-Sun.png (98.38 KiB) Viewed 676 times
ResMed AirCurve 10 VAuto
PAP Mode: VPAP-S
EPAP 11.0 IPAP 12.0 (cmH2O)

Central Texas

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jamcakes
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Re: Tuning it in

Post by jamcakes » Sat Oct 23, 2021 11:21 am

After some time, it's settled into AHI of around 2. There's still a lot of variation on my sleep, duration of sleep, ability to get to sleep. I was getting better AHI when I was using a smaller mask, but it was uncomfortable. I'm thinking of trying something other than a full face, but years ago, when I tried a nasal mask, the pressure would blow out my mouth when I slept.
Also, I've never increased the pressure, because I didn't have a feeling about whether that would help or harm. And since I didn't have a baseline, it would have been hard to determine. I might try a slight increase in pressure.
One other thing, I got a side sleeping pillow and have made more of an effort to sleep on my side. The pillow has helped. I resisted getting it for a long time, because of the expense. Better to have good sleep and avoid leaks, than to have that money.
OK, here's my latest OSCAR screen:
screenshot-1022.png
screenshot-1022.png (106.19 KiB) Viewed 508 times
ResMed AirCurve 10 VAuto
PAP Mode: VPAP-S
EPAP 11.0 IPAP 12.0 (cmH2O)

Central Texas

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zonker
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Re: Tuning it in

Post by zonker » Sat Oct 23, 2021 12:19 pm

jamcakes wrote:
Sat Oct 23, 2021 11:21 am
I'm thinking of trying something other than a full face, but years ago, when I tried a nasal mask, the pressure would blow out my mouth when I slept.
i'm sorry but i don't have the education to comment on your charts. but the bit i quoted, THAT i can help with. :lol:

this leaking of air out of the mouth is more common than you think. long story that i won't bore you with, but i can't( well, don't, actually) use a full face mask. so i use scunci hairbands to hold my tater trap shut.

there are other methods, including tape, which i won't use.

if you ever want to explore using nasal mask or pillows, let me know and i can provide more info.

meanwhile, good luck with your journey.
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
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jamcakes
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Re: Tuning it in

Post by jamcakes » Sat Oct 23, 2021 3:35 pm

Thanks Zonker,
They gave me a chin strap to try to help with the nasal mask, but I really didn't like that. I was doing some research, and I'm going to give the F30 a try.
Cheers!
ResMed AirCurve 10 VAuto
PAP Mode: VPAP-S
EPAP 11.0 IPAP 12.0 (cmH2O)

Central Texas

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zonker
Posts: 11012
Joined: Fri Jun 19, 2015 4:36 pm

Re: Tuning it in

Post by zonker » Sat Oct 23, 2021 5:45 pm

jamcakes wrote:
Sat Oct 23, 2021 3:35 pm
Thanks Zonker,
They gave me a chin strap to try to help with the nasal mask, but I really didn't like that. I was doing some research, and I'm going to give the F30 a try.
Cheers!
Image

good luck!
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

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Miss Emerita
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Re: Tuning it in

Post by Miss Emerita » Sun Oct 24, 2021 12:07 pm

You spend most of your night with your EPAP higher than 7, so I see no harm in experimenting with a higher minimum. Try 8 and see how it goes. Does it feel OK? Do you have an increase in CAs? A decrease in OAs or Hs? Give it a week, and if it feels OK and doesn't increase your CAs, you could try 8.6 or 9 and see how that goes.

At some point you might want to experiment with more pressure support, but not now. One thing at a time.
Oscar software is available at https://www.sleepfiles.com/OSCAR/