DevilBliss DV54 AutoAdjust CPAP -Help

[alexchetty]

Doc said to say on meds for nausea and take the reflux meds twice a day for a week.
I've also set the cpap machine back to the default settings
Lower: 5.0
Upper: 15.0
Delay: 0
Smart flex: 3
Smart flex mode: full time
IRnd: 3
ERnd: 3

Going to try the setting on factory default tonight.

[49er]

Doc said to say on meds for nausea and take the reflux meds twice a day for a week.
I've also set the cpap machine back to the default settings
Lower: 5.0
Upper: 15.0
Delay: 0
Smart flex: 3
Smart flex mode: full time
IRnd: 3
ERnd: 3

Going to try the setting on factory default tonight.

Hi alex,

I am rushing so please ask questions if necessary. Personally, I would leave things as they are but turn off the smart flex setting to see if that lowers your AHI.

In my opinion, you are on the right track but need to find tune things to get the AHI down. Going back to the default setting is making too many changes at once and is not going to help your situation, particularly since your AHI has spiked.

And by setting the minimum pressure at 5, it will take the machine alot longer to address your apneas which won't help your AHI and may make it worse. The goal is to find the right minimum pressure so that when you have apneas, the machine is able to address them immediately.

I would like to see if you can get away with not having to raise your pressure. But if you feel you need the smart flex, that would be the next option which I would advocate raising to 8 if your minimum pressure is currently 7.5.

49er

[alexchetty]

23October2013
95th Percentile Pressure 12.0
90th Percentile Pressure 11.0
AHI 9.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 8.25
EPI 4
Mask: Full Face Mask

Decided not to make too many changes, as suggested by 49er. so just moved the pressure band slightly.
Lower: 6.0
Upper: 15.0

-CPAP seemed to be working better now. This morning I don't feel like I've been competing with the machine. Still slight nausea, but now I'm almost convinced it's the post nasal that's causing that. Also not as tired as the last 2 days.
-AHI is still high, but I'll wait a couple of days before making any changes (increasing the lower pressure or turning off SmartFlex).

[49er]

23October2013
95th Percentile Pressure 12.0
90th Percentile Pressure 11.0
AHI 9.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 8.25
EPI 4
Mask: Full Face Mask

Decided not to make too many changes, as suggested by 49er. so just moved the pressure band slightly.
Lower: 6.0
Upper: 15.0

-CPAP seemed to be working better now. This morning I don't feel like I've been competing with the machine. Still slight nausea, but now I'm almost convinced it's the post nasal that's causing that. Also not as tired as the last 2 days.
-AHI is still high, but I'll wait a couple of days before making any changes (increasing the lower pressure or turning off SmartFlex).

alexchetty,

What do you mean when you say you felt you were competing with the machine? Glad to hear you're not as tired.

49er

[alexchetty]

"Competing with the machine" - when I first put on the mask, just before going to bed, my breathing is fine. I'm able to breathe in and out without and mask leaks or struggle. Once asleep and the pressure rises (not sure what to) the mask starts to leak, which awakes/ startles me. This occurs quite a bit during the night. I then reset the process by switching the machine off and on again. I am able to breathe easy again. When the mask leaks it seems like the flow of air coming from the machine is greater than my exhale breathe, which then causes some of the air to leak out the sides of the mask.
When I wake in the morning it feels like my lungs have become accustom to the CPAP and I feel short of breathe for at least the first 2 hours of the day, after which I breathe fine again.

[49er]

"Competing with the machine" - when I first put on the mask, just before going to bed, my breathing is fine. I'm able to breathe in and out without and mask leaks or struggle. Once asleep and the pressure rises (not sure what to) the mask starts to leak, which awakes/ startles me. This occurs quite a bit during the night. I then reset the process by switching the machine off and on again. I am able to breathe easy again. When the mask leaks it seems like the flow of air coming from the machine is greater than my exhale breathe, which then causes some of the air to leak out the sides of the mask.
When I wake in the morning it feels like my lungs have become accustom to the CPAP and I feel short of breathe for at least the first 2 hours of the day, after which I breathe fine again.

Thanks for clarifying alexchetty. A few thoughts.

Even though you haven't had a problem with excessive leaks with the exception of one time recently, perhaps you could be someone whose sleep is quite disturbed by even the slightest one. So perhaps you might want to look into mask liners to see if that would help. Padacheck is my number one recommendation and Karen provides superb customer service.

Since pressure changes also may be disturbing you, I would either tighten your auto range considerably or set the machine on a straight cpap pressure and turn off smart flex. Since you now have your minimum pressure at 6, you can use that number if you prefer and do something like this - 6 for a straight cpap pressure or use 6-10 as your auto range.

I could be totally wrong about the smart flex elevating your AHI but I am really curious to see if disabling that feature would help get it down.

49er

[alexchetty]

Will try your recommendation Friday evening. That is turn off Flex.

[49er]

Will try your recommendation Friday evening. That is turn off Flex.

Sounds good.

49er

[alexchetty]

24October2013
95th Percentile Pressure 12.5
90th Percentile Pressure 11.5
AHI 9.5
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.25
EPI 10
Mask: Full Face Mask

Decided to make changes, as suggested by 49er, and switch off SmartFlex.

Lower: 6.0
Upper: 15.0

-CPAP seemed to be working better now. no nausea. slightly tired.
-AHI is still high, but I'll wait a couple of days. maybe it will stabilize.
-Full face mask leaked a lot. Without smartflex, pressure reached the upper level and stayed there (0.5 alternating change), this caused mask leaks and arousal.
-maybe i need to bring the upper pressure down to about 13. (suggestions?)

[Hawthorne]

Having your minimum pressure at 6 cm is still a problem, in my opinion. With your 90th/95th percentile pressure being at 11.5 and more, the minimum is too low.

It is still taking too long to get to an effective pressure for you, when it has to go from 6 to 11.5.

I don't think you need to be concerned about your maximum pressure but you need to get that minimum up. I suggested 8 or 9 early on in this thread. I still think you need to be at 8,9 and maybe 10 or more cm to begin to get that AHI down and feel consistently better.

[49er]

Having your minimum pressure at 6 cm is still a problem, in my opinion. With your 90th/95th percentile pressure being at 11.5 and more, the minimum is too low.

It is still taking too long to get to an effective pressure for you, when it has to go from 6 to 11.5.

I don't think you need to be concerned about your maximum pressure but you need to get that minimum up. I suggested 8 or 9 early on in this thread. I still think you need to be at 8,9 and maybe 10 or more cm to begin to get that AHI down and feel consistently better.

Agree with Hawthorne, Alexchetty. When you were at 7 or 7.5, once you tried to see if turning off the Smart Flex Feature had any affect on AHI, inching the minimum pressure up was going to be my next suggestion, particularly after you reported on 10/22 being tired and an ahi of 8.5. And you had been at this pressure for a while so making a change wouldn't have been premature.


49er

[alexchetty]

25October2013
95th Percentile Pressure 12.0
90th Percentile Pressure 11.5
AHI 4.0 -New lowest ever result!
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.75
EPI 4
Mask: Full Face Mask

Made the changes, as suggested by Hawthorne and 49er;
Lower: 9.0
Upper: 15.0
Smartflex: off

and one additional change:
Delay Pressure: 8.0 (even though delay is set to: 0)

-feeling very tired this morning.
-face mask did not leak as much, but still enough to wake me up a couple of times last night.

[49er]

25October2013
95th Percentile Pressure 12.0
90th Percentile Pressure 11.5
AHI 4.0 -New lowest ever result!
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.75
EPI 4
Mask: Full Face Mask

Made the changes, as suggested by Hawthorne and 49er;
Lower: 9.0
Upper: 15.0
Smartflex: off

and one additional change:
Delay Pressure: 8.0 (even though delay is set to: 0)

-feeling very tired this morning.
-face mask did not leak as much, but still enough to wake me up a couple of times last night.

Hi alexchetty,

Good news about AHI being lower even though you are feeling very tired.

Again, I suspect you may be one of those folks who gets disturbed by small leaks that are disturbing your sleep. I had suggested previously looking into mask liners such as Padacheck. How do you feel about that suggestion?

Also, you may or may not be being doing this but cleaning the mask every day and washing your face before bedtime can cut down the leaks.

Or if you can't get the leaks under control with this full face mask, you might need to try another one. Forum member mcdover sells certain brands for $30.

I would stay at this pressure range to give things a chance to stabilize.

49er

[alexchetty]

I am trying to find a mask liner supplier is South Africa.

Will stay on this pressure for a while.

[49er]

I am trying to find a mask liner supplier is South Africa.

Will stay on this pressure for a while.

Sounds good.

49er