Moving up to aircurve Vauto

[Pugsy]

I wouldn't change anything for tonight except for working on the leaks. The mask is moving around on your nose if you have taped your mouth shut.
There are limited culprits when it comes to leaks.
Mouth leaks of course but if the mouth is taped and the tape doesn't come loose.....can't be mouth leaks.
The mask can move around...fitting and sizing issues can cause the leaks.
Finally remote chance that there is a hole somewhere in the hose or mask but I can't see the leak line to see if it looks like a hole somewhere or not.

Did you or do you use the Flex option for exhale relief?
Which Respironics machine are you using?

[Pugsy]

Gotta go run some errands but I forgot to ask....how old is the headgear for the P10? Maybe it is tired and not providing enough tension.

[tiredNorlando]

On the dreamstation apap I did not use flex..


The headgear and pillows aren’t even a month old.

[tiredNorlando]

I switched back to the F40 mask last night, less leaks for sure, looks like my pressure is pegged at 14 all night, any tips on what I should raise it to as well as what to set the ps to?

I got sleephq to work finally. see below

https://sleephq.com/public/teams/share_ ... 8f5bf5a826

[Pugsy]

Why did you decide to use PS of 5? I don't think I ever mentioned that setting. I don't ever recommend more than 4 cm PS unless special circumstances.

How did you sleep? Your flow rate says "not so great" because all but one of those flagged events were arousal/awake related.
How do you feel today?

It's common to need a little more pressure to get the job done when using a full face mask over a nasal mask.

If you told me you felt great today and slept great then there is no urgent need to change anything.

Personally.....pick a setting and use it for at least a week (preferably 2 weeks) and quit changing things so often....unless a setting is a disaster in some fashion.

[tiredNorlando]

I thought it was on 4, I just noticed it’s at 5. I felt pretty decent today, still a little tired but not completely dragging all day like usual.

Can you explain the flow rate and what looks good and not good?


Should I put it at 4ps tonight ? And should I bump the ipap to 15?



Thanks

[Pugsy]

Can you explain the flow rate and what looks good and not good?

Asleep breathing is nice and regular and smooth and boring.

I circled the asleep breathing in this image in red. The rest that isn't inside the red....not sound asleep.


Same time frame image but zoomed out....again only the stuff inside the red is asleep breathing.
All that crap after the circle I wasn't asleep.


You have a lot of irregular breathing in yours.

Should I put it at 4ps tonight ? And should I bump the ipap to 15?

What to use isn't as important as being consistent. With your current settings the machine is essentially not able to do any auto adjusting. If you want a small range just to see what the machine wants to do. If auto adjusting is what you want.
EPAP min....8 or 9
PS...4
IPAP max 14
You will get a very small and tight range available if you use those settings.

You don't need more pressure I don't think...not with 95% of your flagged events being post arousal events as it is now.

You don't have a settings problem....you have a sleep quality problem. There's no magic button on the machine that fixes that.
Trust me...I have this problem myself and as much as I wish for that magic button that will fix my crappy sleep....it's just not there.

[tiredNorlando]

The crazy graph after 6 am was when I was half awake this morning, I knew I was awake, but was just trying to get some extra snooze time, knowing it was my day off I wanted to sleep in a little longer lol.

I’m more concerned about the time from 10pm to 5 am.

[tiredNorlando]

Can you explain the flow rate and what looks good and not good?

Asleep breathing is nice and regular and smooth and boring.

I circled the asleep breathing in this image in red. The rest that isn't inside the red....not sound asleep.


Same time frame image but zoomed out....again only the stuff inside the red is asleep breathing.
All that crap after the circle I wasn't asleep.


You have a lot of irregular breathing in yours.

Should I put it at 4ps tonight ? And should I bump the ipap to 15?

What to use isn't as important as being consistent. With your current settings the machine is essentially not able to do any auto adjusting. If you want a small range just to see what the machine wants to do. If auto adjusting is what you want.
EPAP min....8 or 9
PS...4
IPAP max 14
You will get a very small and tight range available if you use those settings.

You don't need more pressure I don't think...not with 95% of your flagged events being post arousal events as it is now.

You don't have a settings problem....you have a sleep quality problem. There's no magic button on the machine that fixes that.
Trust me...I have this problem myself and as much as I wish for that magic button that will fix my crappy sleep....it's just not there.

Pugsy- it was pointed out to me that I I have palatal prolapse on my expirations, any thoughts on this?

[Pugsy]

Pugsy- it was pointed out to me that I I have palatal prolapse on my expirations, any thoughts on this?

No. I don't do that stuff.
You need to probably talk to whomever it was that says you have palatal prolapse on exhale.
Sorry.

[tiredNorlando]

Explains why I’ve felt like crap on cpap for so long even with good numbers

[tiredNorlando]

Well I got my supine sleeing issue resolved, got a backpack gizmo and its keeping me on my side all night long! here is my data from last night, I feel so much better, I cant belive all this time I had good ahi but felt like crap was from sleeping on my back and my palate was collapsing on exhale.

https://sleephq.com/public/ca3d52d1-2c8 ... f39479fa49

anything I should change settings wise now that I have the palatal prolapse under control? I am still using the bipap and I prefer it to the cpap by a lot!

thank you as always

[Pugsy]

anything I should change settings wise now that I have the palatal prolapse under control?

Only thing I can think of (assuming you can always stay on your side while sleeping) is maybe you don't need as much pressure.
I know of a person who needs a pressure of 19 cm when on their back but only 9 cm when on their side. It's not unusual to have a marked difference in pressure needs when back vs side sleeping.

Not something I suggest doing right now though...it's certainly not urgent and really not necessary but something to think about in the future.

Otherwise....sleeping better and more importantly feeling better....I wouldn't be in any great rush to change anything.
But if you decide in the future to experiment with a bit lower pressure...reduce minimum EPAP a little but leave max IPAP setting alone. Again this is something you could do but it's not a necessity as long as these results can be duplicated and aren't just a one off weird result.

[tiredNorlando]

ok, I will just leave things where they are for now, thanks again for your help pugsy!