btbderek’s therapy thread

[Miss Emerita]

Such good news, btderek! Your leak graph is a thing of beauty; clearly you're on an excellent path.

I'd suggest leaving your settings right where they are for a week or so. If you continue to feel great, then don't change them.

If you feel there's room for some further improvement, you could go up 1 in your minimum pressure. This would be mostly to see whether it'd help reduce the number of OAs. Be sure to stick with any changes for a while before evaluating the need for further changes.

[btbderek]

In other words, if you are waking up feeling well rested and refreshed and your AHI is reasonable (it was on this night), there's no good reason to worry excessively about back sleeping. Sometimes the battle to stay off your back involves too many other compromises that can interfere with getting a good night's sleep. In an ideal world, the pressure settings on your xPAP should allow the machine to prevent the vast majority of events even when you are back sleeping.

All of this is good news, particularly if last night turns out to not be an outlier.

Getting to where you can sleep with the machine all night long is far more important than trying to stay off your back when you are sleeping with the machine.

Thank you robysue for your reply! I do think the collar done a lot of the work for me as far as keeping my neck from crimping/dropping and allowing me to use the Nasal Pillows coming from a full face hybrid. It is a night and day difference using the nasal mask and feels like nothing is on my face compared to the full face that I didn’t love having plastered to my face.

Hopefully last night was not an outlier like you said, and I can keep closing the gap and get more continuous sleep. It sure helps to have a night like that to know it’s possible on work on the issues that are there.

Such good news, btderek! Your leak graph is a thing of beauty; clearly you're on an excellent path.

I'd suggest leaving your settings right where they are for a week or so. If you continue to feel great, then don't change them.

If you feel there's room for some further improvement, you could go up 1 in your minimum pressure. This would be mostly to see whether it'd help reduce the number of OAs. Be sure to stick with any changes for a while before evaluating the need for further changes.

Thank you Miss Emerita! I was pleasantly surprised with the leak graph too, I was sure that I was going to have to add mouth tape or something to pair with the collar, I know it’s only been a couple nights but I’m really sold on what the collar has done for me even so far.

Yes my plan is to give everything about a week and just really compare notes (or Oscar charts in this case) afterwards. I know I have wanted to increase the pressure even more before the swap to Nasal Pillows, but if the trends continue as they are I may not need very much of a bump in pressure, really trying to stick to at least a week after making any change as I have read suggested several times in these forums, which I think makes a lot of sense. Don’t want to be a dial winger and not be able to see the effectiveness of any changes.

[btbderek]

Just wanted to post a little update along with my last three nights of OSCAR charts. Would like anyone who wouldn’t mind to look at two things on my charts.

First, the flow limit. Does this look like an acceptable level for flow limits? If you compare to older charts I’ve posted in this thread, they have been reduced quite a bit in my personal opinion, but I’m not knowledgeable on the subject to know if they are at an acceptable level now or if there shouldn’t be much of anything there at all.

Also, I notice that at about two or three times during my sleep, you can see that my pressure max’s out at 20. I have my pressure relief at 3 and on 10-20 pressure range. Sleeping flat on my back with 1 pillow, nasal pillows and a hybrid travel pillow (just a front portion cushion for chin stabilization, strap around back, couldn’t handle the soft collar I was using, this one has worked great for me). Is there anything that would help this, as in reducing pressure relief or upping my lower pressure setting? Someone in a Facebook CPAP group a while back said that upping my lower pressure could potentially cause my pressure to max out more than it is currently.

Here’s the last four nights worth of graphs









As for the update, things have been going very well I would say specifically since I had last posted almost three weeks ago. As I stated earlier, I’m still using nasal pillows and swapped to my hybrid travel pillow. The soft collar was fairly uncomfortable, I even pulled it off a few nights unknowingly in my sleep which also took my mask with it. Since swapping to the travel pillow, I have been getting full nights sleep with no issues. I also went to one pillow and laying on my back. I really tried to get the side sleeping down, but I just couldn’t do it, I would wake up in the middle of the night from tossing and turning which sometimes made my mask slide up and cause leaks. Ever since laying flat on my back with one pillow, I have slept all the way through the night and my flow limit seems to be better than ever, although my pressure seems to increase from this. I feel very well rested and am sleeping quite well, so I may just re visit trying to side sleep down the line if that’s what I need to do, I have been getting mixed opinions on this subject.

At my doctors visit, they were very pleased in my improvements and finally scheduled me out to a one year check up. Between all the helpful advice on this forum and the shot in the dark at trying that nasal pillow mask, this progress would not have been possible, so I’d like to really thank everyone here. I never would have imagined I could feel so normal again before I started this venture, a couple of months ago I felt very hopeless that I would be able to successfully comply with therapy after 4 months of getting absolutely nowhere, it’s amazing to think now that I’m at the point I don’t have to wear my mask multiple hours during the day just to make 4 hour a day compliance. So thank you everyone! I’m still excited to stick around to learn more to the point that I would feel knowledgeable enough to contribute to helping others like you have here.

[robysue1]

What I immediately notice is that the machine is maxing out when you have small clusters of OAs combined with flow limitations. AND before these events happen, your machine is coasting on at around 13cm or so. So it could be that you need to increase your minimum pressure by a couple of cm. That may help these clusters from getting started in the first place.

[btbderek]

What I immediately notice is that the machine is maxing out when you have small clusters of OAs combined with flow limitations. AND before these events happen, your machine is coasting on at around 13cm or so. So it could be that you need to increase your minimum pressure by a couple of cm. That may help these clusters from getting started in the first place.

Thanks for the advice, I was thinking of bumping it up to 12cm but I wanted to check in here first before I did anything. I will bump up my pressure a couple of cm tonight to see what that does for a few nights.