Albino's Therapy Thread

[Albino_Mexican]

Hello everyone. Started therapy less than two weeks ago and as expected it's been a bit of a roller coaster. Currently using the equipment listed in my signature block although I did try the DreamWear Full Face Mask for two nights but I couldn't get a good seal so I went back to the nasal pillows which I'm fairly satisfied with. I'm going to try the Amara View Full Face Mask in a few days just to see if I like it better and or if it performs better. I was wondering if I could just get some help interpreting the data that is available from the machine specifically regarding pressure recommendations since my sleep tech isn't really engaging with the details but I'd really like to understand what's going on. I'm currently at the following settings:

5 - 20 cmH2O (auto)
5 cmH2O/30 min ramp
Humidity 3
Hose temp 3

My main concerns are that there has been no significant reduction in AHI and I feel like I'm waking up all the time which I understand is probably normal at this stage. Despite my limited experience/knowledge, I feel like my starting pressure needs to be tweaked higher as I don't think the machine is able to compensate fast enough at the current settings when events occur. Your insights are appreciated; thank you.

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[Albino_Mexican]

A few more.

[Pugsy]

Welcome to the forum.

As for your reports...obviously a big mess.

There's probably a lot of Sleep/Wake/Junk false positives in there because you admit to not sleeping so great.

You do need more pressure for sure.

The CAs/centrals we can't fix with more pressure if they are real.
You might want to read this and watch the videos.
http://freecpapadvice.com/sleepyhead-free-software

I would start with increasing the minimum to 7 or 8...hopefully you can get some solid blocks of sleep to evaluate.
Cross your fingers that the CAs are just related to arousal breathing from the OAs/hyponeas still happening and disturbing your sleep.
Once you can do that...and we see what is going on when the OAs/hyponeas get reduced then we can talk about the CAs if you are still having a lot of them.
For now...try to fix the obvious first and then see what's left over that might be a problem.

[Albino_Mexican]

Thanks for confirming my conclusion. I have a follow up with my sleep tech in 2 days so I'll bring it up. I'll update here following the Amara mask trial and hopefully a pressure adjustment.

[Jas_williams]

You don't need a sleeptech to change the pressures and a sleeptech cannot change pressures without an updated prescription from the Dr. But you can change the pressures yourself go to this link https://www.apneaboard.com/adjust-cpap- ... tup-manual and get the manual for your machine and the raise the minimum pressure to 8 or 9 and let's see how your data looks after that

[Albino_Mexican]

Thanks; I did as you suggested. Last night was pretty terrible; kept waking up all of the time. Hope I just need time to get used to the adjustment.

[Pugsy]

What did you last night for the minimum? If you made a big jump like to 9...that's a lot for a newbie to make in one jump.
That's why I suggested maybe 7.

Make smaller increases and take a little time to work yourself up to the needed pressure.

[Albino_Mexican]

I set it to 8; too much?

[Pugsy]

Obviously too much if you couldn't get comfortable and sleep well with it.
Some people are very sensitive to even relatively small changes in pressure....especially newbies already struggling adjusting to the mask and air and stuff.
If you can't get comfortable you aren't going to sleep so great.
Gotta get the sleep first and foremost before any of this stuff matters.

Back up...try just 1 cm above what you were using for few days...then try another 1 cm more...watch your reports.
You might get lucky and find you don't need as much as originally thought. I have seen some significant results from relatively small increases. I love it when I am wrong and people end up getting good results with less pressure than I originally thought.

I really wish people wouldn't tell newbies to almost double their pressure in an increase...that's just too big of a jump for most people.
Try 1 or 2 cm more first...then evaluate the reports...and then maybe a little more pressure.
It's a much easier adjustment for people (especially newbies) to make.

[Albino_Mexican]

Thanks Pugsy; I'll back it off to 6 for a while and see how it goes and take it from there.

[Albino_Mexican]

Going to try out the Amara View mask starting tonight...maybe tonight's the night I sleep well. Slept better last night though after dropping the minimum down to 6; at least for the first 4 hours or so.

[Albino_Mexican]

Last 2 nights haven't been too bad but there's still a lot of improvement to be had. I think there's a lot of SWJ because I still wake up a fair bit at night. Been watching the videos and trying to read what the graphs are actually saying so thanks for that. First image is still using the DreamWear pillows and the second is my first night with the Amara; both lower AHI than my diagnosed 17. Will continue to test the Amara until next Thu unless things go downhill from here. Been reading JonathanZK's ongoing thread and I'm encouraged that there may be hope for me yet with continued effort.

[Albino_Mexican]

So I've spent the last month trying a few different mask options and have finally settled on a medium Amara View FFM which I tolerate well, have few leak issues, and results in a consistent single digit AHI. I still wake up fairly frequently as I think I'm still getting used to wearing the thing but hopefully that settles down along with the SWJ that I think the machine is falsely flagging as CAs. I'm still running 6-20 / A-Flex 1 and will be working with my sleep tech to begin increasing the minimum after the holidays. Here's my last two nights; any thoughts/advice or am I on track? (I know I still have a way to go to get down to <1)

[Albino_Mexican]

Still seem to get a fairly consistent AHI of 8-9 or so when using the Amara View FFM. Bumped up my minimum pressure to 7, turned off FLEX and RAMP. Working towards a minimum pressure of 9 but only bumping it up every 2 weeks because it seems to take about that long for my brain to adjust. My sleep tech and I are both wondering if in the long term I might end up with a static pressure of 9 given how my brain doesn't seem to like pressure changes during the night. I'm ignoring the majority of the CA's for now as they appear to be most often flagged post arousal. Still not sleeping well because I think intermittent leaks and pressure changes are responsible for my awakenings. I do have a P10 nasal pillows mask on the way that I'm hoping works out as I never had leak issues with the DW nasal pillows mask but didn't like the way my lungs/chest felt when using it, nor the marks the on my cheeks that lasted most mornings. Not sure that the P10 is going to be much different but hey, I'm experimenting. While I don't feel I slept too well last night, I do feel pretty good today. I am noticing that my short term memory has improved and I haven't had the cognitive "fuzziness" lately among other benefits so I'm pleased with my progress so far but looking forward to further improvements. Anyway, figured I'd pop up another night of data and solicit some insight from the resident experts. What do you think? (Also, renamed the thread)

[Pugsy]

I will be really interested to see how you do with the nasal pillows you have coming.
You obviously need more pressure and more pressure is a problem for you.
You might get lucky and find that you don't need as much pressure with the nasal pillows as you do with the FFM.
It can happen...so do give the pillows an extra effort to make them work. They might make a world of difference in your results. Certainly worth trying. I have known people to be able to get by with 2 to 4 cm less and get better results when going to nasal pillow mask.