Newbie

gwfl · Post by **gwfl** » Wed Mar 25, 2020 1:09 pm

Updated:
Saw my therapist and we decided to try new mask Airfit P30i (was not able to find this mask for my profile). Much nicer and easier to sleep with but I still have trouble falling asleep...takes almost an hour of waiting and adjusting mask to eliminate leaks. Once done I sleep well and longer. I also adjusted my max pressure up to 12 (from 11). I got hold of my sleep report and it stated "no optimum pressure found"...so they were guessing and therefore I felt comfortable raising to 12. I may soon raise it to 13.
But even so I still can't get my AHI down to a good level. The increase to 12 from 11 did bring it down a fair amount but not enough so 13 might get me better results. I'll try to attach the OSCAR report and highligh an hour or two.

My AHI was 23.6 for this night

download/file.php?mode=view&id=10385

Pugsy · Post by **Pugsy** » Wed Mar 25, 2020 1:26 pm

The AirFit P30i is indeed listed in the equipment profile. Go to the AirFit section in the A's and look closely...it's there...I just checked.

How about changing from fixed cpap mode to auto (apap) mode and make the settings 12 minimum and 20 maximum and see what happens? It will give you an idea more quickly as to how much more pressure you need if you wish to continue with fixed cpap mode or you might find that auto mode gives some decent results with those settings.

gwfl · Post by **gwfl** » Wed Mar 25, 2020 2:08 pm

My mistake my mask is the Airfit F30i.
Funny you should suggest setting the machine for auto and raising pressure. I was reading about that in another newbie post this morning. That would be what sounds like a big change...should I consult with my therapist first...any risks to such a change? I'll call her in the morning and raise my CPAP to 13 tonight.

Also my report indicited 14.5% Central apenas

Pugsy · Post by **Pugsy** » Wed Mar 25, 2020 2:43 pm

The AirFit F30i is down in the R's because they happened to stick ResMed in front of AirFit.
It's the first one in the R section I think.

I wouldn't be afraid to try auto mode at least for one night with a history of a few centrals. A few centrals is actually normal and no big deal.
You aren't having an alarming number of centrals even now...those clear airway apneas you see flagged...those are centrals and some of them are awake breathing flagged by mistake because by your own admission you are having a lot of trouble falling asleep and it's taking a long time.
The machine only measures air flow...it has no way to know if you are asleep so when you lay there tossing and turning and fidgeting your breathing is irregular (compared to asleep breathing) so the machine flags that irregular breathing as some sort of apnea.

If you use auto mode the machine won't go higher than it thinks it needs to no matter what you set the max at.
Example...if you set the max at 20 but the machine doesn't sense a need to go over 15 it won't go higher than 15 and it doesn't change anything else.

Your choice though...going to auto mode will give you a better idea what you might need for the obstructive stuff (OAs and hyponeas) faster but you can get to the same place going up slowly in fixed mode if you wish.

zonker · Post by **zonker** » Wed Mar 25, 2020 5:31 pm

gwfl wrote: ↑
Wed Mar 25, 2020 2:08 pm
My mistake my mask is the Airfit F30i.
Funny you should suggest setting the machine for auto and raising pressure. I was reading about that in another newbie post this morning. That would be what sounds like a big change...should I consult with my therapist first...any risks to such a change? I'll call her in the morning and raise my CPAP to 13 tonight.

Also my report indicited 14.5% Central apenas

you can consult if you like. most of us here are self treating. it's just faster to make our own changes to get better results.

this doesn't mean you should change things willy nilly. it's a big reason why you post oscar charts here.

you CAN do it yourself, if you want. or not. it's up to you.

good luck!

gwfl · Post by **gwfl** » Sat Mar 28, 2020 1:37 pm

Raised my pressure to 12 and got AHI down to 23.5....thought I was on the right track so raised it up to 13 and it stayed the same and the next night up to 31.5. I've been as low as 18 but my number is all over the place...no consistancy.
Pugsy, think you are right about changing to APAP but not sure of the settings for Auto and if there are other settings to change at the same time.
download/file.php?mode=view&id=10464

Jas_williams · Post by **Jas_williams** » Sat Mar 28, 2020 1:47 pm

Hi it looks like you have mixed apnoea your machine wont treat that and you need a different machine probably an ASV you need to go back to your dr and complain, your not being adequately treated. Did you have any CA’s in your Sleep study ? Can you post a copy here with your personal details hidden ?

gwfl · Post by **gwfl** » Sat Mar 28, 2020 2:33 pm

Sleep study showed 14.5% CA's

Pugsy · Post by **Pugsy** » Sat Mar 28, 2020 2:53 pm

Here's what I would suggest if trying apap mode.
Mode....auto
Minimum of 13
Maximum of 20
EPR ...off

Jas....we know about the centrals but for right now just trying to deal with the obstructives and see how many centrals are left needing to be dealt with.
His doctor won't do anything for 6 weeks so we are using the 6 weeks to try stuff. Might get lucky.

Jas_williams · Post by **Jas_williams** » Sat Mar 28, 2020 3:56 pm

Pugsy wrote: ↑
Sat Mar 28, 2020 2:53 pm
Here's what I would suggest if trying apap mode.
Mode....auto
Minimum of 13
Maximum of 20
EPR ...off

Jas....we know about the centrals but for right now just trying to deal with the obstructives and see how many centrals are left needing to be dealt with.
His doctor won't do anything for 6 weeks so we are using the 6 weeks to try stuff. Might get lucky.

I appreciate your trying to treat the obstructives but some of those and the Hypopnoeas look to be periodic breathing based on the flow graphs. Not sure how much lower the numbers will go. Maybe I am being pessimistic.

Pugsy · Post by **Pugsy** » Sat Mar 28, 2020 4:15 pm

Jas_williams wrote: ↑
Sat Mar 28, 2020 3:56 pm
I appreciate your trying to treat the obstructives but some of those and the Hypopnoeas look to be periodic breathing based on the flow graphs. Not sure how much lower the numbers will go. Maybe I am being pessimistic.

I once had a chance to help a woman who was having a ton of both centrals and OAs. I would have bet my last dollar and my first born child she needed ASV but we had nothing but time since her doctor was totally out of the picture and a new doctor was a 4 month office visit away. Her central index was between 20 and 30 consistently along with a 15 to 20 obstructive index with pressures below 10.
We decided what the hell....nothing to lose...lets just kill off the OAs and see what that does to the centrals. So we went up to 15 cm minimum pressure...and killed off the OAs down to 1 or 2 per hour but the amazing part was the centrals essentially totally went away.
We never did understand it all but it happened. It's probably the only time I have seen it myself but see it I did so I know not totally impossible. Yes, we understand highly unlikely but since we have nothing but time...one or two nights setting an atom bomb off on those OAs is worth a try. Miracles can happen.

His doctor absolutely refuses to even look at anything until 6 weeks has passed...and it's impossible to get another sleep doctor on board at this stage of things in this current climate. Might as well try going out on that long skinny limb looking for a miracle.

Right now with this last report.. AHI of 31....OAs and hyponeas (assuming they are obstructive in nature and I understand they might not be) and centrals running 4 to 5 per hour....
Primarily obstructive....let's see what happens if we go killing OAs with more pressure. Might get lucky...might not get lucky...but a one or two night experiment is unlikely to cause a huge problem and if it does we know not to do it again.

What else can we do? He probably doesn't have a couple thousand dollars to go buy an ASV machine on his own even if he could find one. His doc won't help for 6 weeks. Might as well at least try something instead of sitting around with our thumbs up our butts.

gwfl · Post by **gwfl** » Tue Mar 31, 2020 8:44 am

Decided to NOT sleep on my back last night. Generally always slept on my sides and occassionally on my back. I also lowered my max psi down to 12 again and tightened my mask a bit. My AHI dropped to 20.5. Big improvement! Hoping to get it under that 20 threshold....maybe with a better pillow designed for side sleeping?
Are there reviews here for pillows?

Pugsy · Post by **Pugsy** » Tue Mar 31, 2020 8:56 am

gwfl wrote: ↑
Tue Mar 31, 2020 8:44 am
Are there reviews here for pillows?

Bed pillows for what? So you can sleep on your side more easily?
There are numerous "cpap pillows" out there and they all come with a YMMV sticker.
Lots of past discussion here about various bed pillows but the end result is they are just like masks...one person might love a pillow and the next person hate it.

If you are thinking about one of those cpap pillows with cut outs so that there is a place for the mask to rest and not have pressure on it....I tell people to get a cheap memory foam pillow and cut out their own little cut outs like the high dollar "cpap pillows" have before they go spending big bucks on a special pillow that may or may not work well for you.

BTW is cm to h2O and not psi that is the measurement for the pressures these machines use.
We abbreviate it to just cm....
PSI is a whole different measurement.

gwfl · Post by **gwfl** » Tue Mar 31, 2020 9:55 am

Thank you...good advice.

gwfl · Post by **gwfl** » Wed Apr 22, 2020 8:42 am

Starting to get AHI down below 10cm's but it's still erratic going up to 19cm the other day. Right now my focus is on side sleeping with appropriate pillow and mask for side sleeping. Also having an issue with falling asleep in a timely manner. Sometimes it takes me well over an hour and I think this effects my AHI. I'm thinking of going to a FFM such as the ResMed Mirage Quattro that seems like it would be more secure for my tossing around while sleeping and at the same time can ease pressure on the bridge of my nose.

download/file.php?mode=view&id=10974

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