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Holden4th wrote: ↑

Mon Oct 18, 2021 1:44 am

With the 25/3, I understand the 25 but am not exactly sure what the 3 is.

ResMed AirCurve 10 VAuto can run in a fixed bilevel mode.

25 IPAP / 3 EPAP

S mode
In S mode, you may set two treatment pressures-–one for inspiration (IPAP) and one for expiration (EPAP). The device senses when the patient is inhaling and exhaling and supplies the pressures accordingly. The difference between IPAP and EPAP levels helps determine the tidal volume.

https://www.respshop.com/manuals/37212_ ... n_menu.pdf

Holden4th wrote: ↑

Mon Oct 18, 2021 1:44 am

With the 25/3, I understand the 25 but am not exactly sure what the 3 is.

IPAP 25, EPAP 3. you can set EPAP to 3 in S mode on a S or VAuto.

Thank you.

Pugsy wrote: ↑

Tue Oct 12, 2021 6:50 pm

Probably at least 8 or 9 minimum. See how once you are asleep the pressure goes up and stays up for the most part??

But it's a big jump to go from 5 to 9 and might be uncomfortable and cause you to have trouble falling asleep which is of course unwanted.
I usually suggest smaller increments for increasing the pressure....like maybe 2 cm increase to 7 cm for a few days then maybe another 2 cm increase.....all the while watching the results. Might get lucky and with a more optimal minimum all night that the machine might not need to go quite so high.

Increase the max to at least 15 and see what happens. The machine won't go higher without a good reason.
Normally we just say leave it at the max of 20 ....only restrict the max if the going higher creates a problem like with aerophagia or way too many centrals pop up.

Last night's Oscar chart. I increased to 8-12 trying to inch up a little. But the F30i absolutely would not stayed sealed. It took me 10 mins to get it sealed when I first went to bed and then that long after I got up the first time I never could get a good seal. So I tried the P10 around 2 and the rest of the night was a disaster. Not sure where to go from here. I have had good luck with the full face mask and was running around 1.3 to 3.4 or AHI's. Should I go back to the settings of 7-11? Just when I think I have a handle on this, lol. I assume the ridiculous AHI's were a result of all of the leaks, etc.

Do whatever you need to do to get to sleep AND STAY asleep first and foremost. Without sleep....none of this matters.
The increase in central apneas does go along with leaks causing wake ups and points to false positive flagging from the awake breathing.

To be honest I wouldn't worry so much about the machine essentially setting a new minimum on its own at this time if using a higher minimum causes major leak issues.

Back off on the pressures a bit and work on mask fitting and leak issues first as best you can without causing massive sleep disruptions.
Maybe try smaller increments of increase at some point in the future.
You didn't hit 12 max last night but then you didn't sleep so great either but maybe the 11 max is an acceptable compromise for now. Just because the machine wants to go higher to deal with the FLs doesn't mean we have to let it go higher if the going higher creates a worse problem than the FLs are creating.

Go back to 7-11 for now and get yourself back to sleeping fairly solidly first....then maybe consider smaller increases with the maximum. Keep the 7 minimum for quite a while....if the machine sets a new minimum once you are asleep then it sets a new minimum and essentially takes care of the problem on its own anyway. There's no hard fast law that you just have to start out with the needed higher minimum. That's the beauty of apap mode. Let the machine sort it out for now.

If you can sleep solidly and feel decent during the day then don't worry too much about hitting the max just because the machine wants to kill FLs. If your OA and hyponea events stay low and you are sleeping good and feeling good...that's the primary objective. If your centrals are arousal/awake centrals...they should stay low in numbers if you are sleeping well.

THANK YOU. I woke up discouraged this morning and you have made me feel so much better. Personality wise I am an achiever and hate feeling like I have "failed." I will do as you say. I woke up feeling fine at 7 -11, so maybe that is just where I need to be for a while. Hugs!!!!

scf wrote: ↑

Fri Oct 22, 2021 8:22 am

Personality wise I am an achiever and hate feeling like I have "failed."

I hear you and I am in the same boat but I have also learned to accept "less than maybe ideal" and what is really important in the grand scheme of life. Sometimes it isn't always having the most perfect of settings or pretty graphs.

I have learned that sleep itself is absolutely critical to everything and the most perfect AHI or leak graphs or FL graphs don't mean jack you know what if we don't sleep. Listen to your body and worry less about what you might see on the reports.
Those reports are just guidelines anyway. Something to give you an idea what you might need to do if you weren't sleeping so great or feeling so great.

About 6 months into my therapy in 2009 I had the "miracle" day. Slept great and felt like superwoman all day. OMG it was so awesome. Back then I never looked at the sleep reports until the evening because I never wanted to cloud my thinking as to how I felt during the day. So imagine my surprise when that evening I looked and saw the AHI of 10.4....WTH...I was just certain that the AHI would be 0.0. Still can't explain it except I probably had a lot of arousal related events clustered together giving me a high AHI. Back then we didn't have flow rate data to look at to help figure out awake vs asleep flagged events and the machines didn't separate centrals from obstructives. We didn't have OSCAR back then.

I would gladly take an AHI of 10.4 every day of the week right now if I could get that miracle again.

Concentrate on sleep first...without sleep nothing else matters so much. Listen to your body. It really speaks the loudest and won't ever steer you wrong. Perfect numbers or pretty graphs don't guarantee good sleep and can be misleading.
Doesn't mean you have to stop trying little tweaks if you want to try something new.....but don't lose sight of the ultimate goal which is decent sleep and feeling decent during the day.

I could not find AN "Love you emoji on here, lol" I do need to not race to the computer every day and look at Oscar...it sets the tone for the day and that is not healthy. I just hope I can resist,

Have a great day.

Pugsy. I followed your advice and NAILED it last night. I reset the pressure to 7.2 and 11.2. AHI of 1.6. And a success rate of 7 hrs. and 27 mins. of uninterrupted sleep. I did not get up even once and never changed positions as far as I can tell. No mask leak Today I feel energetic and totally rested (as much as an old person can).

I caution new people on here to read and learn and follow the sage advice, but not to get caught up in thinking that there is some type of competiton to see who can get the lowest score. Or maybe that is just a personality flaw that I have, lol.

Hugs

scf wrote: ↑

Sat Oct 23, 2021 7:35 am

not to get caught up in thinking that there is some type of competition to see who can get the lowest score. Or maybe that is just a personality flaw that I have, lol.

Not a personality flaw at all. Just human nature in general. We target numbers or pretty graphs as "proof" we are doing the best we can do because that's what we have been taught to do. Human nature really.
Numbers and graphs are easy to measure but subjective feelings are difficult to measure. We tend to take the easy way out. Or we think that if we have the nice low numbers and pretty graphs that it guarantees we feel like superwoman/man. I wish it were that simple. Getting good numbers is actually very easy but feeling them is a whole different ball game.

Sleep is a very fragile commodity for a lot of people. Case in point the billions of dollars sleep industry in general.
That industry wouldn't be flourishing without fodder. I don't need a bed or an app or a gadget to tell me I didn't get enough sleep last night....my body is quite capable of telling me that fact if I just listen to it.
It's not all about OSA or my therapy or my machine settings either, no matter how much I might want to fix my sleep problems with little tweaks from the machine. Night before last my brain just wouldn't shut off....damn thing...it wanted to solve all the world's problems (and mine) and the insomnia monster set up shop. Then last night we had thunderstorms roll in and I have a neurotic dog who can hear it thunder a hundred miles away and just has to be in my lap. So last night bedtime was 3 hours late and today I get to try to fix a door frame the dog ate because I didn't get him in my lap soon enough. I am going to feel like crap again today. 5 hours of sleep simply isn't enough and that nice low AHI means absolutely nothing. Two nights in a row with 5 hours of sleep....crap city for sure. I don't need a gadget to tell me what my body will already tell me.

Anyway, enough of my soap box rambling. Good job on last night. Things will get better and better with time and experience. Don't beat yourself up when you have a bad night either. We all have them for any number of reasons and while annoying as hell it isn't the end of the world.

You nailed it with this post. But then you always do.

scf wrote: ↑

Sat Oct 23, 2021 10:37 am

You nailed it with this post. But then you always do.

She's got a habit of that, doesn't she?

She does and you as well!

scf wrote: ↑

Sat Oct 23, 2021 3:16 pm

She does and you as well!

scf wrote: ↑

Sat Oct 23, 2021 3:16 pm

She does and you as well!

no. this is not how the game is played. it's custom around here to call palerider a bully and flounce off!

are you trying to give him a swelled head?