Newish User / Questions / Problems / Thoughts

[palerider]

1. Continue to increase the minimum. - It's at 10.0 now. Small raises, like less than 1? Or do you suggest more?

For most people, I don't see any reason to go in smaller increments than 1, sometimes more, depending on what the data looks like. Your last chart suggests a minimum of 12, maybe 13, but if you want to go to 11 and see what that does, that's ok too.

2. Raise max pressure back up. This is the part that really hard for me. I'm a very light sleeper, I wake up a lot during the night, when I wake up the pressure goes up quickly because my breathing (me) forgets to or is too lazy to exhale, for many, sometimes very many seconds at a time.

If you're just not exhaling, but not blocking your throat, the pressure won't go up, because that looks like a central apnea.
https://www.youtube.com/watch?v=-gie2dhqP2c
https://www.youtube.com/watch?v=4GW97Xk06N8

Having your max so low that the machine hits it just *guarantees* that the machine is unable to prevent breathing events ,and breathing events wake you up, that's why you're on cpap in the first place, because breathing events wake you up.

3. You said starting the the ramp start pressure. You mean't raising the ramp start pressure, right? - Yesterday was my first day with it at 5.4 instead of 4. It was a little weird at first, I might take it a little higher today, but I think I'll have to get more used to it before I go much higher.

Yes, that's what I meant, i'll go back and fix the post to avoid future confusion. The less you rely on ramp, the quicker your breathing is treated.

Other notes, I had tried turning EPR down to 2 last night, but I feel like I need 3, at least for now. I wish the machine could figure out that I'm awake quickly and go back down to the ramp pressure without me feeling around for the machine and finding the stop and start buttons.

Set EPR to whatever you like. As to shutting the machine off and back on... if you have SmartStart turned on, just pull the mask away from your nose for a moment till the machine shuts off, then put it back on, (or disconnect it at the quick connect where the short hose connects to the main hose.

[UglyBob]

1. Continue to increase the minimum. - It's at 10.0 now. Small raises, like less than 1? Or do you suggest more?

For most people, I don't see any reason to go in smaller increments than 1, sometimes more, depending on what the data looks like. Your last chart suggests a minimum of 12, maybe 13, but if you want to go to 11 and see what that does, that's ok too.

2. Raise max pressure back up. This is the part that really hard for me. I'm a very light sleeper, I wake up a lot during the night, when I wake up the pressure goes up quickly because my breathing (me) forgets to or is too lazy to exhale, for many, sometimes very many seconds at a time.

If you're just not exhaling, but not blocking your throat, the pressure won't go up, because that looks like a central apnea.
https://www.youtube.com/watch?v=-gie2dhqP2c
https://www.youtube.com/watch?v=4GW97Xk06N8

Having your max so low that the machine hits it just *guarantees* that the machine is unable to prevent breathing events ,and breathing events wake you up, that's why you're on cpap in the first place, because breathing events wake you up.

3. You said starting the the ramp start pressure. You mean't raising the ramp start pressure, right? - Yesterday was my first day with it at 5.4 instead of 4. It was a little weird at first, I might take it a little higher today, but I think I'll have to get more used to it before I go much higher.

Yes, that's what I meant, i'll go back and fix the post to avoid future confusion. The less you rely on ramp, the quicker your breathing is treated.

Other notes, I had tried turning EPR down to 2 last night, but I feel like I need 3, at least for now. I wish the machine could figure out that I'm awake quickly and go back down to the ramp pressure without me feeling around for the machine and finding the stop and start buttons.

Set EPR to whatever you like. As to shutting the machine off and back on... if you have SmartStart turned on, just pull the mask away from your nose for a moment till the machine shuts off, then put it back on, (or disconnect it at the quick connect where the short hose connects to the main hose.

1. Thanks. I'll try 11 for tonight.

2. It's hard to show with the size of screen shots, but I'm about 60% certain that the only times it goes that high is when I'm actually awake. I zoomed in on a few events where the pressure went up high, or I kept having clear airway events, and they all seem to be when I'm awake by looking at the Insp. and Exp. Times, at least if I'm looking at it right. But there's a good chance I'm not. I'll see if I can get a few shots of those.

3. I turned that up a little, very little bit, to 5.6. Breathing normally with pressure while awake has been difficult for me. But the fact that I turned it up yesterday means I'm getting a little better with it.

Smart start is on, but I have to turn it off when I wake up because I really can't breathe well with pressure that high. And when I take it off it takes a long time to reset or turn off. It makes a lot of noise, and I don't want to wake the woman up.

Thanks again for all the help! I really appreciate it! I would love to get this under control but from what I see it's all trial and error, I'm not the type that can make major changes without it messing with my head.

[palerider]

1. Thanks. I'll try 11 for tonight.

2. It's hard to show with the size of screen shots, but I'm about 60% certain that the only times it goes that high is when I'm actually awake. I zoomed in on a few events where the pressure went up high, or I kept having clear airway events, and they all seem to be when I'm awake by looking at the Insp. and Exp. Times, at least if I'm looking at it right. But there's a good chance I'm not. I'll see if I can get a few shots of those.

Central (what Oscar is temporarily calling 'clear airway' (which is a made up term by Philips)) apneas don't cause pressure increases.

3. I turned that up a little, very little bit, to 5.6. Breathing normally with pressure while awake has been difficult for me. But the fact that I turned it up yesterday means I'm getting a little better with it.

As time goes on, breathing against the pressure will likely become easier and easier.

Smart start is on, but I have to turn it off when I wake up because I really can't breathe well with pressure that high. And when I take it off it takes a long time to reset or turn off. It makes a lot of noise, and I don't want to wake the woman up.

Make sure you have your mask type selected properly.

[UglyBob]

Smart start is on, but I have to turn it off when I wake up because I really can't breathe well with pressure that high. And when I take it off it takes a long time to reset or turn off. It makes a lot of noise, and I don't want to wake the woman up.

Make sure you have your mask type selected properly.

Good advice, but yes, I have pillow selected. By the way, the first video you linked in the last post is great. https://www.youtube.com/watch?reload=9&v=-gie2dhqP2c I don't understand why ResMed doesn't link that much instead of the usually pretty boring and uninformative MyAir videos. I guess they realize most people don't care about learning about their conditions. Thanks again for answering my questions! I hope I'm not making everyone crazy with all newbishness.

[palerider]

Good advice, but yes, I have pillow selected. By the way, the first video you linked in the last post is great. https://www.youtube.com/watch?reload=9&v=-gie2dhqP2c I don't understand why ResMed doesn't link that much instead of the usually pretty boring and uninformative MyAir videos. I guess they realize most people don't care about learning about their conditions. Thanks again for answering my questions! I hope I'm not making everyone crazy with all newbishness.

That's why they have the 'dummy mode' for their machines, and myair (yay, you participated, here's your trophy!)

[zonker]

I guess they realize most people don't care about learning about their conditions. Thanks again for answering my questions! I hope I'm not making everyone crazy with all newbishness.

nope. much rather someone coming in and asking questions than someone coming in making assumptions.

this is a fact based forum. if you come in with some wild imaginings and still stick to them after being corrected, well THAT newbie is going to drive us crazy.

[UglyBob]

I guess they realize most people don't care about learning about their conditions. Thanks again for answering my questions! I hope I'm not making everyone crazy with all newbishness.

nope. much rather someone coming in and asking questions than someone coming in making assumptions.

this is a fact based forum. if you come in with some wild imaginings and still stick to them after being corrected, well THAT newbie is going to drive us crazy.

Even when you guys are like "raise your min by 2 and your max by 6" and I'm like "uhh...I'm scared of change, for now I raised my min by .4 and my max by 1.0?"

[Okie bipap]

Large changes are not dangerous. However, they may lead to aerophagia for some people. I started my treatment with a pressure setting of 20 to 25 cm. I wasn't sure if this much pressure was really necessary, so I set my lower pressure to 8 cm and left the upper limit set to 25 just to see where the machine really needed to go. My current pressure is 19 to 25 cm, so they weren't too far off with their initial guess.

[zonker]

Even when you guys are like "raise your min by 2 and your max by 6" and I'm like "uhh...I'm scared of change, for now I raised my min by .4 and my max by 1.0?"

hey, you read MY saga.

you do you. important part is getting the therapy optimized.

[palerider]

I guess they realize most people don't care about learning about their conditions. Thanks again for answering my questions! I hope I'm not making everyone crazy with all newbishness.

nope. much rather someone coming in and asking questions than someone coming in making assumptions.

this is a fact based forum. if you come in with some wild imaginings and still stick to them after being corrected, well THAT newbie is going to drive us crazy.

Even when you guys are like "raise your min by 2 and your max by 6" and I'm like "uhh...I'm scared of change, for now I raised my min by .4 and my max by 1.0?"

Sure, take your time, I'll look again when you've gotten to where I suggested.
ta!

[UglyBob]

I guess they realize most people don't care about learning about their conditions. Thanks again for answering my questions! I hope I'm not making everyone crazy with all newbishness.

nope. much rather someone coming in and asking questions than someone coming in making assumptions.

this is a fact based forum. if you come in with some wild imaginings and still stick to them after being corrected, well THAT newbie is going to drive us crazy.

Even when you guys are like "raise your min by 2 and your max by 6" and I'm like "uhh...I'm scared of change, for now I raised my min by .4 and my max by 1.0?"

Sure, take your time, I'll look again when you've gotten to where I suggested.
ta!

I'm using a minimum of 13 now, which is what the titration test suggested. Some nights. like last night, I have a lot of leaks. Last night the leaks were caused by the pillows moving. Usually the leaks are from the mouth, but mainly in the last hour of trying to sleep, in the time between my girlfriend's alarm going off and the time when I have to wake up.

I do feel like I'm sleeping better. I actually know I am. I never bothered setting an alarm since I would wake up all the time. Last week I had to call into the office because I overslept. I don't feel any more rested when I wake up though. Maybe that will come with more time. Oh well, here's the screenshot from last night.

[zonker]

I'm using a minimum of 13 now, which is what the titration test suggested. Some nights. like last night, I have a lot of leaks. Last night the leaks were caused by the pillows moving. Usually the leaks are from the mouth, but mainly in the last hour of trying to sleep, in the time between my girlfriend's alarm going off and the time when I have to wake up.

I do feel like I'm sleeping better. I actually know I am. I never bothered setting an alarm since I would wake up all the time. Last week I had to call into the office because I overslept. I don't feel any more rested when I wake up though. Maybe that will come with more time. Oh well, here's the screenshot from last night.

i hesitate to make any bold statements regarding leak rates, because i'm usually wrong. i've got a bit to learn about that!

however, if you want to cut back on the leaks (are they waking you up?), there is a method i use that i swear by-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

of all the advice and tips and tricks i've learned here, this has had the most positive impact on my therapy. i have modded jay's suggestion to fit my own skull, but it's pretty much the same thing. his method alone stopped leaks and lowered my ahi by a full point.

oh! meant to add that i think you are doing great.

now let's hear what others have to say!

[UglyBob]

Thanks! I went ahead and bought a pack since they're so cheap. They look more comfortable than a chin strap.

[zonker]

Thanks! I went ahead and bought a pack since they're so cheap. They look more comfortable than a chin strap.

excuse me if this has come up in your thread before but, are you using a firm foam cervical collar? i use that in conjunction with the scuncis and just realized i failed to mention that above.

at any rate, let me know if it works or not. we are all of us different enough that what works for me may not work for thee.

[UglyBob]

No I'm not. I have enough trouble falling asleep. I don't think I'd even consider that. It sounds awful! Hahaha