Kate's Therapy

If I change mode to straight CPAP at 20cms, am I likely to have a much different experience to my current APA 19-20? Does the Resmed change its EPR when running as CPAP instead of APAP?

katestyles wrote: ↑

Thu Apr 18, 2019 9:39 am

Waking with my mouth so dry I have to spend time ungumming it before I can say thank you for my morning coffee.......

I assume this is due to my jaw falling down and the air trying to escape through my taped lips (some of it does)

I have been taping vertically, from upper lip to under chin to try to avoid the jaw drop, but apparently it isn't working.

Currently running at 19-20, AHI is good, but I am waking in the night. (leaks, events)

I can get unbroken sleep if I ditch the mask and take a nap - I have had several PAP-free naps this week.

I am now sleeping with no pillows, just a small travel pillow, which fits under my neck when I am on my back, and under my ear when on my side. It is my attempt to keep my airway open for back sleeping.

Dry mouth sucks. Everything is all stuck together in there and it hurts and then it hurts more to unstick it. Then my tongue is super sensitive all day. I feel for you.

What tape are you using now? Have you tried taping horizontally? Do you purse your lips before applying it?

I know- bunch of questions. I think I've already said that I've found the 3m micropore to be most effective for me. And pursing the lips seals them off - creates an effective moisture barrier(applying horizontally). Honestly, I get a bleep-like seal if I do it right. Also add support strips.

I've gained so much confidence in my tape job that I've gone scunci-free the past few nights.

But then again, I'm dealing with less than half the pressure you use. Maybe I should just shut up.

I run my Resmed machine at a straight pressure by setting the IPAP and the EPAP at the same value while leaving the machine in APAP mode. I think in CPAP mode you would still have EPR but would lose data about FLs. At any rate, IPAP=EPAP in APAP mode should do what you want. (What a bunch of acronyms!). I hope the experts will correct this advice if it is wrong.

Miss Emerita wrote: ↑

Thu Apr 18, 2019 6:15 pm

I run my Resmed machine at a straight pressure by setting the IPAP and the EPAP at the same value while leaving the machine in APAP mode. I think in CPAP mode you would still have EPR but would lose data about FLs. At any rate, IPAP=EPAP in APAP mode should do what you want. (What a bunch of acronyms!). I hope the experts will correct this advice if it is wrong.

Losing FL flagging when in cpap mode only applies to Respironics brand machines.
ResMed will continue with FL flagging no matter which mode is used. Hurts nothing at all to do it your way though.
EPR is the same in either mode...same options and functions the same.

Thanks, Pugsy!

djams wrote: ↑

Thu Apr 18, 2019 5:45 pm

katestyles wrote: ↑

Thu Apr 18, 2019 9:39 am

I have been taping vertically, from upper lip to under chin to try to avoid the jaw drop, but apparently it isn't working.

Currently running at 19-20, AHI is good, but I am waking in the night. (leaks, events)

Dry mouth sucks. Everything is all stuck together in there and it hurts and then it hurts more to unstick it. Then my tongue is super sensitive all day. I feel for you.

What tape are you using now? Have you tried taping horizontally? Do you purse your lips before applying it?

I know- bunch of questions. I think I've already said that I've found the 3m micropore to be most effective for me. And pursing the lips seals them off - creates an effective moisture barrier(applying horizontally). Honestly, I get a bleep-like seal if I do it right. Also add support strips.

I've gained so much confidence in my tape job that I've gone scunci-free the past few nights.

But then again, I'm dealing with less than half the pressure you use. Maybe I should just shut up.

I purse my lips, and tape with inch wide johnson and johnson waterproof tape in three vertical stripes from upper lip to under my chin, then tape width wise with a strip or two.

I think the micropore stuff made my face react, so I have been staying away from it.

I think the current problem is that the tape is not drool proof.

So storms in Florida caused lots of plane cancellations, so my vacation is being extended by two days.

I had made provision for one extra day of underwear, clothes, meds and bleeps - it could be time to mcGuyver up a PAP interface!

katestyles wrote: ↑

Fri Apr 19, 2019 3:53 pm

So storms in Florida caused lots of plane cancellations, so my vacation is being extended by two days.

I had made provision for one extra day of underwear, clothes, meds and bleeps - it could be time to mcGuyver up a PAP interface!

or do like they did for apollo 13.

where's gene krantz when you need him?

zonker wrote: ↑

Fri Apr 19, 2019 5:23 pm

katestyles wrote: ↑

Fri Apr 19, 2019 3:53 pm

So storms in Florida caused lots of plane cancellations, so my vacation is being extended by two days.

I had made provision for one extra day of underwear, clothes, meds and bleeps - it could be time to mcGuyver up a PAP interface!

or do like they did for apollo 13.

where's gene krantz when you need him?

We passed Cape Canaveral on our way to the airport, but now I am stuck in Orlando.

"We have a problem, Orlando" doesn't have the same ring to it.

katestyles wrote: ↑

Thu Apr 18, 2019 2:06 pm

If I change mode to straight CPAP at 20cms, am I likely to have a much different experience to my current APA 19-20? Does the Resmed change its EPR when running as CPAP instead of APAP?

No, epr is epr.

palerider wrote: ↑

Mon Apr 22, 2019 12:27 pm

katestyles wrote: ↑

Thu Apr 18, 2019 2:06 pm

If I change mode to straight CPAP at 20cms, am I likely to have a much different experience to my current APA 19-20? Does the Resmed change its EPR when running as CPAP instead of APAP?

No, epr is epr.

Good to know. ty

so I changed to straight 20 cms to provide data to the sleep clinic person. My AHI has gone up.
i can make some wild guesses as to why, but would prefer hypotheses from my knowledgable friends.

I'm guessing that I have too little pressure sometimes, causing the snores and FL, and too much sometimes, causing more CA (either as genuine CA or as SWJ)

am I barking up the wrong tree?

Well, it's an insignificant amount of centrals... do they look post arousal, or real?

palerider wrote: ↑

Thu Apr 25, 2019 4:28 pm

Well, it's an insignificant amount of centrals... do they look post arousal, or real?

I'm not bothered by the centrals. Even if they are real. They are much more likely SWJ, since I am waking frequently to deal with aerophagia, low level leaks which hiss really loudly, and other random reasons.

I think the OA count is up too though.

If I saw a chart like this from a newbie, I would tell them to increase the minimum pressure.

OAs and hyponeas can be SWJ too. And the machine will respond like they were real if in auto mode with room to move up.
I have personally seen it happen.
That's why I am not so quick to tell people to increase the pressure until I have an idea how well they slept or didn't sleep.
I know for a fact that you can get false positive SWJ OAs and hyponeas.
Heck a while back I had an AHI of 3.4...and a nice common normal mixture of centrals, OAs and hyponeas...and I went and looked at the flow rate for every single event and not a one of them were real asleep events. They weren't even iffy....they were blatant arousal related flagged events and the machine did try to kill them with more pressure but they weren't real and thus they still happened.
It happened to just be a crappy night's sleep from extra crappy back pain. I remembered lots of awakenings that night and lots of tossing and turning and that's what prompted me to go put those events under the microscrope.

Not a single real asleep event the entire night....AHI of 3.4 and every single flagged event was SWJ...and I had a bunch of OAs and hyponeas in there. That's when the light bulb went off in my head that SWJ isn't limited to centrals.

So that's why I always ask how the person thinks they slept before I start saying the "more pressure" thing.