New--General Questions

Three anecdotal (non-expert) pieces of input.
1. I believe my PAP clock (Resmed AirSense 10 AutoSet) uses standard time, not daylight savings time.
2. I respectfully disagree with other posts saying your pressure is too low. I find that if I raise my max, the machine chases the new max WITHOUT having any effect on events. In my case (maybe not true of everyone), lower pressure is more comfortable and produces the same results, while higher pressure leads to Centrals. I have been on PAP for 9 months, so it is not "treatment emergent) centrals.
3. I have had good success using "standard" 19mm inside diameter tubing rather than "slimline" 15mm tubing. As it has been explained to me (my understanding of physics is almost zero), a given amount of air can be put through a tube in a given time but the air in the tube must be higher if the tube is smaller. It's hard for me to visualize this, so I like the analogy of water: putting x gallons through a water pipe in x hours requires more water pressure if the pipe is smaller. So the 19mm tube is more comfortable for me. It only costs ~$5 online. So cheap to experiment and see if it works for you. Just be sure to go into the settings and select "standard" tubing rather than "slimline."

Thank you palerider for that excellent info. I read your post and literally ran to the bathroom to trim my nose hair

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

Three anecdotal (non-expert) pieces of input.
1. I believe my PAP clock (Resmed AirSense 10 AutoSet) uses standard time, not daylight savings time.
2. I respectfully disagree with other posts saying your pressure is too low. I find that if I raise my max, the machine chases the new max WITHOUT having any effect on events. In my case (maybe not true of everyone), lower pressure is more comfortable and produces the same results, while higher pressure leads to Centrals. I have been on PAP for 9 months, so it is not "treatment emergent) centrals.
3. I have had good success using "standard" 19mm inside diameter tubing rather than "slimline" 15mm tubing. As it has been explained to me (my understanding of physics is almost zero), a given amount of air can be put through a tube in a given time but the air in the tube must be higher if the tube is smaller. It's hard for me to visualize this, so I like the analogy of water: putting x gallons through a water pipe in x hours requires more water pressure if the pipe is smaller. So the 19mm tube is more comfortable for me. It only costs ~$5 online. So cheap to experiment and see if it works for you. Just be sure to go into the settings and select "standard" tubing rather than "slimline."

Thank you for this info. #2 is why I'm hoping someone will look at my Oscar graphs. I feel worse than pre-cpap but my doctor keeps telling me how good my numbers look Obviously, it might really end up being the oxygen, but it's expensive, so I want to make sure I've looked into every possible reason for what's going on.

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

1. I believe my PAP clock (Resmed AirSense 10 AutoSet) uses standard time, not daylight savings time.

The machine has no concept of time zones, any more than any simple clock does.

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

2. I respectfully disagree with other posts saying your pressure is too low. I find that if I raise my max, the machine chases the new max WITHOUT having any effect on events.

You're always welcome to be wrong. The machine will NOT raise pressure with breathing issues causing it to raise pressure.

There's a *reason* that people who have far more experience than you do are suggesting an increase in pressure, and that is that pressure being too low is, by far the biggest problem people have.

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

In my case (maybe not true of everyone), lower pressure is more comfortable and produces the same results, while higher pressure leads to Centrals.

Approximately 15% of people have pressure emergent centrals, you are NOT typical, if indeed you're having such.

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

3. I have had good success using "standard" 19mm inside diameter tubing rather than "slimline" 15mm tubing.

You have more *imagined* "success with the standard hose, or maybe you didn't have your hose type set properly.

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

As it has been explained to me (my understanding of physics is almost zero), a given amount of air can be put through a tube in a given time but the air in the tube must be higher if the tube is smaller.

It does not matter how much air is 'put through the tube'. What *matters* is the pressure at any given instant in the dynamic system that is happening with a varying vent rate, and the increasing and decreasing flow rates that are necessitated by breathing.

The cpap works very hard, constantly adjusting the fan speed of the blower dozens of times per second, compensating for the various resistances between the pressure sensor and the patients face, including the presence or absence of the humidifier, an anti bacterial filter, length and yes, diameter of the hose, and type of mask.

The pressure at the outlet of the blower in the machine can be significantly higher than the pressure at the mask, because all of these resistances to flow would result in lower pressure at the mask, which would adversely affect the therapy pressure.

Since the name of the game is accurate therapy pressure, the machine compensates for all of these things. Had you actually put a manometer at the mask and measured the pressure at the mask, you would have found, imagination notwithstanding, that the pressures with the slimline hose and the regular hose, with appropriate settings, would have been identical.

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

It's hard for me to visualize this, so I like the analogy of water: putting x gallons through a water pipe in x hours requires more water pressure if the pipe is smaller.

You like a flawed (because it's incomplete and largely irrelevant) analogy. The pressure at the head end of the system does not matter in this case, all that matters is the pressure in the mask.

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

So the 19mm tube is more comfortable for me.

Whatever you imagine works for you.

However, please stop spreading nonsense.

Dontlovecpap wrote: ↑

Fri Sep 10, 2021 8:45 pm

clownbell wrote: ↑

Fri Sep 10, 2021 5:37 pm

dribble

Thank you for this info. #2 is why I'm hoping someone will look at my Oscar graphs. I feel worse than pre-cpap but my doctor keeps telling me how good my numbers look Obviously, it might really end up being the oxygen, but it's expensive, so I want to make sure I've looked into every possible reason for what's going on.

It's hard to interpret them with all the blank space. When you post another screenshot, and there's a short session (after noon) please go to the bottom of the left hand of the page, and turn off the short sessions, so that the blank space will go away, and it will expand the data. That said, based on what I could see, I still say your minimum pressure is too low.

Secondarily, in standard bilevel treatment, to increase oxygenation, one increases the EPAP (which in this case, is your minimum pressure), this holds your alveoli open more, allowing better oxygenation.

Thank you, palerider. I deleted the short session in last nights screenshot. As you can see, I did take the mask off a few times (but none because of itching!). At one point there was whistling coming from my mask, I've never had that happen before.

Would you suggest I raise it to 9, or higher?