2 years after nasal septum surgery, and I need help.

[JGaspar]

Hi everybody!
I have been using cpap since 2009, when there were no reports, but now we have OSCAR and Sleepyhead. My Apnea is under control, but I feel back without energy during the day, and I feel fatigue again. Before the septum surgery (2018), my pressure used to be from 9 to 12, now it is from 8 to 10. But the pressure that can be seen by graphics below and the statistics of 95% pressure seems to be saturated at 10.00.

Can anybody help me? to find new best min and max pressures?

PS: I have 1.76cm and 89kg.

[zonker]

Hi everybody!

in my humble opinion, you need to set min at 10 and max at 20.

you can see on your chart where your pressure goes up to 10 and pretty much stays there during your sleep. so you may as well start there.

and you may as well use the max of 20 in case you ever need to go there sometime during your sleep.

good luck!

[LSAT]

Your pressure is 8/10 because you have the max pressure blocked. If you look at your charts, the machine wants to go higher, but it can't because of the 10 max. As zonker indicated, your max pressure should be 20. The machine will only go as high as needed to stop an event.

[Pugsy]

Any special reason that you have tied the machines hands with the max limited to 10 cm?
It clearly wants to go higher but can't. Now if the going higher creates a problem (bad aerophagia or something) then I would understand why it is limited.

Are you having much nasal congestion now?

How is your sleep quality? Wake often or sleep soundly?
Do you take any medications of any kind? If so, what?

One report above shows 4 3/4 hours of sleep....is this common for you to have such short nights?
One report shows a little over 7 hours...is this common? Which is the most common?
How many hours of sleep do you average? Real sleep and not just laying in bed awake.

First thing I would try...unless you have a really good reason for not doing it....increase the maximum pressure to 20
Make no other changes.
See how things go.

[JGaspar]

Any special reason that you have tied the machines hands with the max limited to 10 cm?

No. After surgery, my sleep study was 9, and I put 8 to 10. Before surgery, sleep study was 10.

It clearly wants to go higher but can't. Now if the going higher creates a problem (bad aerophagia or something) then I would understand why it is limited.

On the past I had aerophagia.

Are you having much nasal congestion now?

Sometimes a little bit.

How is your sleep quality? Wake often or sleep soundly?
Do you take any medications of any kind? If so, what?

No medications, but a clean my nose with 0.9 solution water. Sleep quality, some days is good, some days is terrible.

One report above shows 4 3/4 hours of sleep....is this common for you to have such short nights?
One report shows a little over 7 hours...is this common? Which is the most common?
How many hours of sleep do you average? Real sleep and not just laying in bed awake.

The 1st night falling sleep without CPAP, my average is 7 hours.

First thing I would try...unless you have a really good reason for not doing it....increase the maximum pressure to 20
Make no other changes.
See how things go.

Can I change to 9-12, and post a new pic? I'm afraid to have aerophagia.

[Pugsy]

Sure, you can try max of 12 and see if the machine hits it very often.
If the aerophagia returns then back up. There's no urgent reason to increase the pressure or let it go higher.
I was just offering it as something to do to see if your daytime fatigue would lessen.

Any idea what changes when you go from good to bad sleep quality?

When I don't sleep so good during the night then I can pretty much guarantee that I will feel like crap and be exhausted the next day.

Any other health issues that you might have that could impact sleep quality? I have other issues unrelated to sleep apnea and the machine can't fix problems unrelated to sleep apnea or the airway.

[Julie]

Aerophagia usually results from the min. pressure being high, not the max setting... you're cutting your therapy off at the knees.

[JGaspar]

Sure, you can try max of 12 and see if the machine hits it very often.
If the aerophagia returns then back up. There's no urgent reason to increase the pressure or let it go higher.
I was just offering it as something to do to see if your daytime fatigue would lessen.

Any idea what changes when you go from good to bad sleep quality?

When I don't sleep so good during the night then I can pretty much guarantee that I will feel like crap and be exhausted the next day.

Any other health issues that you might have that could impact sleep quality? I have other issues unrelated to sleep apnea and the machine can't fix problems unrelated to sleep apnea or the airway.

Good morning!
No problems with aerophagia here, I felt my ears more sensitive to noises, and nostrils ok with no nasal congestion. I woke up naturally earlier, but I could have slept another hour, then I get up to pee, but I couldn't fall asleep again. I'm feeling more rested, let's see the rest of day. In the night I will upload the graphics. I have pre diabetes controlled to not become diabetes and I'm overweight, but when I was 79kg, meaning 10kg less, I still had apneas.

[ChicagoGranny]

PS: I have 1.76cm

How do you even pick up the mask or connect the hose?

You are getting some good advice on machine settings. Good luck!

[JGaspar]

PS: I have 1.76cm

How do you even pick up the mask or connect the hose?

You are getting some good advice on machine settings. Good luck!

HAhahahhaahh

[JGaspar]

Good night everyone!

Pugsy,
I felt good all day! Look the graphics of the last night, the maximum pressure is still saturated. Do you think I should increase gradually? Can I try 13.00?

[Pugsy]

Well....is the "I've felt good all day" just from no aerophagia or is it a general "I've felt good all day" that we all like to experience?

Normally I would probably be a little quicker to increase the minimum since the machine obviously wants to go there but sometimes where it wants to go isn't necessarily going to make you feel any better and sometimes it makes things worse.

So in this situation....I think I would be cautious with the max increases. I think I would give it 3 or 4 nights and see if everything holds and a nice trend develops. It's not like your AHI is high and you urgently need that more maximum immediately.

I think I would make sure that 13 doesn't give cause aerophagia with a few more nights of using it and then consider maybe another 1 cm increase.
A lot depends on how long a person might end up being at a higher pressure. Like maybe 1 hour at 13 doesn't cause a problem but 13 for 3 hours might cause a problem.

[JGaspar]

Well....is the "I've felt good all day" just from no aerophagia or is it a general "I've felt good all day" that we all like to experience?

Thanks a lot for the help!
I felt good all day, compared to the previous treatment with pressure 8 - 10, it's good, but not excellent. And it was excellent with "0" aerophagia.

Normally I would probably be a little quicker to increase the minimum since the machine obviously wants to go there but sometimes where it wants to go isn't necessarily going to make you feel any better and sometimes it makes things worse.

So in this situation....I think I would be cautious with the max increases. I think I would give it 3 or 4 nights and see if everything holds and a nice trend develops. It's not like your AHI is high and you urgently need that more maximum immediately.

I think I would make sure that 13 doesn't give cause aerophagia with a few more nights of using it and then consider maybe another 1 cm increase.
A lot depends on how long a person might end up being at a higher pressure. Like maybe 1 hour at 13 doesn't cause a problem but 13 for 3 hours might cause a problem.

Tonight, I will try 9.4 - 13, because I am afraid of possible aerophagia.

[Miss Emerita]

This is a question for the experts: might the OP benefit from using EPR, especially given the flow limitations?

[JGaspar]

Hi Pugsy,
Good night!

The graphics are better today!
I'm still here without aerophagia, but today I felt a little tired, I think it's about the new pressures and only 6hs of sleep.
I will hold on 9.4 - 13