Newbie Self Diagnosis - In Denial - AHI Question

[marktheshark]

How did ya do with the new machine? Hopefully a good sleep, might take a bit to dial it in, but boy does it really work for you and with you vs other brands n types.

Still dealing with this head cold/sinus infection, so not yet!

[marktheshark]

Howdy folks, I'm back.

The new bi-level machine is SO much more comfortable to fall asleep with and overall feels so much more natural.

But I feel I'm still dealing with the same problem, making up a lot. You can see how many times I restarted the machine.

The one thing I did notice, is the flow limitations seem different, before it was widespread for the whole night, now it seems like there are higher peaks but lower valleys?

I know you all mentioned go to a higher minimum in the beginning of this journey, wondering if I should do that with this new machine, if so can you explain what settings to change?

[metsfan302]

I wish my screenshots looked like that! So glad it seems to be working out great for ya and yes the ResMed sure does feels so natural vs fighting against the machine as it seemed to be the case the few times I’ve been on the Philips. I have no knowledgeable input as far as tweaking it further yet. The machine seems much happier with you on the other end lol

[palerider]

Are you having problems getting back to sleep?

Are you having problems dealing with the pressure?

I see you've got the ramp set for 45 minutes, and starting really low, with all the times you're restarting the machine, that's a lot of the night you're going without therapy.

[marktheshark]

Are you having problems getting back to sleep?

Are you having problems dealing with the pressure?

I see you've got the ramp set for 45 minutes, and starting really low, with all the times you're restarting the machine, that's a lot of the night you're going without therapy.

I don't think I'm having trouble getting back to sleep.

I think I'm waking up and the with the higher pressure I can't fall back asleep unless I restart the machine.

I thought I had the ramp at 20 minutes, it says that on the machine itself, is that wrong?

[palerider]

Are you having problems getting back to sleep?

Are you having problems dealing with the pressure?

I see you've got the ramp set for 45 minutes, and starting really low, with all the times you're restarting the machine, that's a lot of the night you're going without therapy.

I don't think I'm having trouble getting back to sleep.

I think I'm waking up and the with the higher pressure I can't fall back asleep unless I restart the machine.

I thought I had the ramp at 20 minutes, it says that on the machine itself, is that wrong?

No, you're right, I screwed up reading the numbers. but still, that's over three hours that you aren't getting treatment during that night you pasted... see where it's not doing anything till it ramps up? If you can handle a shorter ramp, it might be a good idea.

[marktheshark]

Any other recommendations?

It seems every night looks the same with too many wake ups.

I did see an ENT last week who said I need sinus surgery! Guess I have a deviated septum and other obstructions that I can't remember what he called them. So, not sure how that plays into this. I went to see him because I finally kicked the afrin nose spray 3 months ago and now I am back to being blocked up every night.

I know for certain now that if I can sleep the first 4 hours of the night, I can really tell the next day. I am now wondering if my headgear is the problem, nasal irritation even with Lansinoh cream and head pressure from the chin strap. Its definitely better with the cream, but still wake up in pain.

[Miss Emerita]

Interesting news from the ENT! I will be very curious whether the nasal surgery will resolve your FL problem. Please let us know!

About discomfort from the chin strap: did you ever wind up trying taping? I can recommend Somnifix (though it is pricey).

And abour your nasal discomfort: have you tried a nasal mask (goes over the bottom part of your nose but doesn’t touch those sensitive ends of your nostrils)?

[marktheshark]

Interesting news from the ENT! I will be very curious whether the nasal surgery will resolve your FL problem. Please let us know!

About discomfort from the chin strap: did you ever wind up trying taping? I can recommend Somnifix (though it is pricey).

And abour your nasal discomfort: have you tried a nasal mask (goes over the bottom part of your nose but doesn’t touch those sensitive ends of your nostrils)?

I will check out that over the nose mask. Thanks!

[marktheshark]

So I am a little confused about settings.

I wanted to try different pressure limits, but when I go into the settings and change MAX EP and MAX PS, it doesn't seem to limit the max pressure to 8.0 like I have it set?

Not sure if you can see my settings from last night?

Maybe I need to be changing the IPAP MAX but I don't see that in the settings?

I feel like this new machine is making a difference and is so much more comfortable, I just feel I need to work on tweaking the pressure as I feel it's still waking me up.

[Pugsy]

There is no special separate setting for Max IPAP.
Max IPAP is a function of EPAP plus PS and since PS (2 to 8cm) can vary then IPAP is going to vary.
If you want to really limit IPAP you have to limit EPAP and also limit PS max.

Remember PS gets added on to EPAP to give you IPAP.

[marktheshark]

There is no special separate setting for Max IPAP.
Max IPAP is a function of EPAP plus PS and since PS (2 to 8cm) can vary then IPAP is going to vary.
If you want to really limit IPAP you have to limit EPAP and also limit PS max.

Remember PS gets added on to EPAP to give you IPAP.

Got it, I think lol.

What settings should I am for if I want to try a max pressure (or in the range) of 9.0?

Or am I just assuming 5.0 EPAP plus 5.0 PS = 10.00?

[Jas_williams]

There is no special separate setting for Max IPAP.
Max IPAP is a function of EPAP plus PS and since PS (2 to 8cm) can vary then IPAP is going to vary.
If you want to really limit IPAP you have to limit EPAP and also limit PS max.

Remember PS gets added on to EPAP to give you IPAP.

Got it, I think lol.

What settings should I am for if I want to try a max pressure (or in the range) of 9.0?

Or am I just assuming 5.0 EPAP plus 5.0 PS = 10.00?

Mark you will be seriously cramping the ASV, if you tune it down it won’t be able to do what it needs to do to treat any central apnoea.

[Pugsy]

If you do EPAP 5 and PS of 5 you get IPAP max of 10...and essentially a fixed bilevel setting.
You can add in some variables like min and max EPAP and min and max PS...as long as the max settings don't add up to more than 10 and each has some room to move around a bit...you have some auto adjusting functions available but 5 and 5....that's a fixed setting.