Priorites

[xface]

First, I really, really enjoy reading this forum, hearing the great suggestions and trying them. But that's just problem... I need to prioritize the suggestions somehow. After about 9 different masks and 3 machines, I'm not sure where to start again. Since my new biflex bipap machine is in the shop, I'm back to the PB 420e and messing around again.

I'm looking for a checklist! One that I can go down in order of importance, check it off and move on to the next item.

Can you make suggestions/changes to this?

1. Mask leaks under control. I know every mask and kind is different, and this seems pretty well covered in the forum.
2. Reduce Apneas. I think this usually means increase pressure/increases bipap EPAP/increase minimum APAP. Then we throw in the... unless its central apneas.
3. Reduce Hypopneas. I have no idea how to reduce this one.
4. Reduce snoring. Taping or pressure?
5. Reduce Flow Limitations. Huh?

and Snoredog's question "How do you feel? Do what make you fell better"

How about adding/subtracting to this so I can put it by my bedside and recite nightly?

And thanks again for all the great info.
Al

[Snoredog]

if it were me I would (in priority):

1. Control Apnea: Should be able to get them under AI=5 with about any machine. If you can drive them lower then the better. Note: you also have to assume that the machine is accurate and reporting those residual apnea as obstructive and not central apnea.

2. Leaks: You need to keep an eye on external mask leak, know what your intentional mask leak rate is for your pressure/mask combination.

3. Hypopnea: Don't worry about those, most autopap machines score those with "shorter" timed duration/volume, so not all reported hypopnea (from the machine's viewpoint) result in a 3% drop in Oxygen levels, Apnea DOES, so that is why I have it #1 at the top.

When your bipap comes back from the shop, adjust the pressures so it takes care of the individual events, IPAP will take care of the the FL's, HI's and EPAP takes care of the AI's and snores. So if you are still having residual AI's then you need to bump up the EPAP minimum to take care of those, if you are continuing to have Hypopnea, you can shorten PS=4 and it should pull up EPAP and help eliminate both.

But with your 420e, I'm afraid your exhale relief may be non-existent. You are probably using they Bipap to rid yourself of aerophagia, it will probably return within a few days on the 420e, but the 420 should keep your AHI in check.

[xface]

Thanks, Snoredog for the info.

My AI on the PB420e is 2 to 3 with about a third made of Apnea/CA. I think that's good but the Bipap or remstar machines don't show this.

My requirements are lower on the PB420e, it's running 8 to 11 max--- this is lower than my Bipap (11/15). I'm not having much problem with aerophagia. My hypopneas are up to 3-5 though.

But after all this, I feel better and I seem to be sleeping longer! Go figure. Better numbers with the bipap, but I just don't feel as good. Maybe I'll set the Bipap lower when I get it back and try that for a week.

Thanks again.
Al