NoOnesPerfect therapy thread

[djams]

Pressure is being changed to 8/20, so definitely a step in the right direction. Of course, if I wait for the DME to do it remotely, it could be a while

How did you do with these pressures?

[NoOnesPerfect]

Pressure is being changed to 8/20, so definitely a step in the right direction. Of course, if I wait for the DME to do it remotely, it could be a while

How did you do with these pressures?

Actually had AHI under 5 - first time in a while, and only the third time in a month and a half. Still only managed a bit under 5 hours, and still tired, but it is definitely a step in the right direction. I’ll keep these settings for a week and see if the improvement holds up, at which point it may be time to make more adjustments. I had no problem at all handling the higher pressures other than waking up to fix mask leaks twice.

Nice thing is that if this improvement continues, it will make it much easier to focus on whatever other issues are preventing me from sleeping through the night. Up until now, all the sleep doc would talk about was apnea - obviously a problem, but likely not the only one.

[NoOnesPerfect]

having better results now that minimum pressures have been increased. Still need to work on sleeping through the night and getting more sleep hours in though. Anyway, I was curious about flow limitations - from the graphs, I seem to have them all through the night - Is the flow graph here showing those limitations, or is there some other cause for the flattened curve? Other than working with the pressures and EPR, is there anything else I should think about to relieve those limitations? Nasal sprays, surgery, etc? I do have pretty much constant nasal congestion, so the flow limitations didn't come as much of a shock.

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[zonker]

flonase for the congestion.

[Miss Emerita]

You could maybe try seeing an ENT and an allergist.

[NoOnesPerfect]

You could maybe try seeing an ENT and an allergist.

I wish I could - getting a referral from my PCP is not exactly easy. I could ask the sleep doc for a referral, but I don’t think my insurance will accept that. Never know until you try though.

[Chris8243]

I have a question about your charts on June 13th. It lists your min/max as 8-20, which is what you said they are set to. But under the statistics, it lists minimum pressure at 6? Hmmm. I see your pressures are going high, up to almost 16 for 95% of the time with a max of 19.44 as the high. Logically from what I've read on this forum, if your starting pressure was higher, the machine wouldn't have to respond so much to an event. And the increased pressure responses from the machine are not instant, nor are the going back to the set pressure, there is a lag on both.

I've seen similar high pressures in my own charts. The high pressures were causing me to wake up, I know because I've looked at the machine to see what it was. Felt like a hair dryer being blown into my nose & mouth and I couldn't catch a breath. Are any of your wake-ups similar to that feeling?

[NoOnesPerfect]

The minimum pressure of 6 is due to use of the ramp function - I have it set to start at 6, but once it detects a sleeping flow pattern it ramps up to 8 fairly quickly. By the time any events show up, the minimum pressure is at 8 for me.

So far, the most frequent cause for waking up (at least that I remember) is excessive pressure that results in (is caused by?) a mask leak. Is it the pressure or is it the leak waking me up? Can’t tell for sure, but turning the machine off and back on quickly (starting the ramp function all over again) has proven to be the solution. No amount of fiddling with the mask when the pressure is over 15 has stopped the leak.

The leak may be caused by shifting sleep positions, or it might be from increased pressure as a response to flow limitations. I have no way of telling, but I am starting to pay more attention to what position I am in when I wake up.

[Chris8243]

Is it the pressure or is it the leak waking me up? Can’t tell for sure, but turning the machine off and back on quickly (starting the ramp function all over again) has proven to be the solution. No amount of fiddling with the mask when the pressure is over 15 has stopped the leak.

Turning the machine off/on is a good idea! I read that suggestion in another post one time. That way we can see what was happening when we look at Sleepyhead data. Was it following a cluster of events which caused the pressure to increase? Or was it a gremlin I tried doing the off/on but have only been able to do so a few times. I guess in my sleepiness (and annoyance at that point) I just turn the machine off and never turn it back on. Someday we will get this sorted out!

[NoOnesPerfect]

I guess in my sleepiness (and annoyance at that point) I just turn the machine off and never turn it back on. Someday we will get this sorted out!

I turned on the SmartStart feature, so all I have to do is exhale once or twice and the machine starts up on its own. I also hit the button twice pretty quickly before rolling back over to go back to sleep - once to turn it off, again to turn it on - it’s already a habit for me, even after only a month of doing it that way. The SmartStart feature is a backup in case I screw up the button stabbing .

[NoOnesPerfect]

Update after today’s meeting with the sleep doctor -

This was obviously a compliance meeting, but I did end up with minimum pressure being raised to 12 and maximum to 15 (the occasional leak was getting pressures up to 20, which woke me up, so he limited the max to help me sleep through the night). The logic for the particular settings was exactly what people have discussed on this site, with the only difference being that he was more interested in the monthly stats rather than daily stats. I am not scheduled for another meeting for a year, which I find troublesome since I still have significant sleeping problems that are not being resolved with xPAP. I was hoping for more discussion about other things that might be preventing me from sleeping more than an hour or two without waking up, or from sleeping more than a total of five hours a night.

If things don’t improve after another month or so of therapy, I likely will schedule another appointment to discuss non-xPAP solutions to add to my treatment. He made it plain I could quit xPAP if I wished since it did not appear to be helping (and my apnea is in the mild/moderate category) but I want to really give it a chance first, so I will be following the advice of the people here going forward regarding using the machine.

I just wanted to thank the people here for their help, and stress again that the logic you all have presented is the same as what the doctor used, except a lot more timely.

[PatOnCPAP]

Mind if I ask how you got RE flags to show on your chart? I'm also using the Airsense 10 with Oscar software and cannot find the option anywhere in preferences or the green/black event flags to choose to show RERAs.

[NoOnesPerfect]

Mind if I ask how you got RE flags to show on your chart? I'm also using the Airsense 10 with Oscar software and cannot find the option anywhere in preferences or the green/black event flags to choose to show RERAs.

Under the graphs, but on the left side, is a drop down menu that lets you pick or exclude what event types will be included in the graphs. Make sure RE is on. As far as I know, that’s all there is to it. However, you noted that the option wasn’t available to you, so I really don’t know what is different about my setup. Hopefully, one of the OSCAR experts will chime in.

[PatOnCPAP]

Hmmm. Mine only has these 5 options on that drop down...
Very weird, same machine you are using from what I can see.

[jimbud]

Hmmm. Mine only has these 5 options on that drop down...
Very weird, same machine you are using from what I can see.

I am not an expert, but maybe you need to check the boxes in ;
File
Preferences
Events


Maybe.
JPB