HELP needed for 13-yr CPAP user!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Iamstumped
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Re: HELP needed for 13-yr CPAP user!

Post by Iamstumped » Sat Nov 12, 2022 12:33 pm

JoyD. wrote:
Sat Nov 12, 2022 9:59 am

I also want to start monitoring my OXYGEN SATURATION levels during the night. DO ANY OF YOU HAVE RECOMMENDATIONS FOR AN AFFORDABLE DEVICE TO DO THAT . . . a watch, etc.?? (I do have an iPhone SE, if that might be involved.)

JoyD.
I use the Wellue O2 ring. You can find it at Wellue.com
Not neccessarily importing the info into either OSCAR, or SleepHq, at this time. I do connect it to, and do download the info to my iPhone 13 Max

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JoyD.
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Re: HELP needed for 13-yr CPAP user!

Post by JoyD. » Sat Nov 12, 2022 1:03 pm

ROBYSUE1 WROTE:
How long have you been dealing with aerophagia?
Thank you for responding, robysue. I just noticed "what I assumed" was some aerophagia last night for the first time (that I can remember). I assumed it was aerophagia because I was burping & feeling an uncomfortable pressure in my chest - my taped mouth could not expel the burp & I didn't want to swallow it. It had been recommended that I increase the Minimum pressure setting up to 9 from 7 in order to try to improve my AHI. But with the burping & chest tightness I thought it might help to reduce the Minimum pressure down to 8 for the remainder of the night. At 8, it seemed to help, but I finally got up and stayed up.
In my opinion you should NOT have been working so hard to avoid sleeping on your back. Pain is a real sleep killer. And if the pain was less while lying on your back, you would have been a whole lot better off getting some real sleep on your back rather than tossing and turning all night long enduring pain while trying to avoid back sleeping.
That makes a lot of sense re. allowing myself to sleep on my back if I need to w/o worrying, so that at least I can sleep comfortably (in spite of a trade off with more events). I'll follow that advice in the future!

[I had posted: "My WEEKLY report currently says that 95% of the time the pressure is 13.20 or below. Maybe it's too early to do this (because of any erroneous results when I was dealing with LLs several days ago & using the "For Her" Mode), but I'm tempted to set my pressure at 8-14 tonight and see what happens. Is that unreasonable?"]
Is reducing your pressure range to 8-14 a good or bad idea?

Well that depends. If you're trying to figure out what kinds of pressures your stomach can take because of aerophagia problems and you can handle the idea of your AHI being higher than usual, it makes some sense.

And given that your 95% pressure is usually 13.2, then setting the max pressure at 14 makes some sense: You are allowing your machine to go up to (and exceed by a bit) the pressure that is usually as high as you need it to be to treat your apnea.

But if you make this change in the settings, I would encourage you to keep these settings for at least 4 or 5 days, even if the first night seems like it's a disaster. Sometimes our bodies need a bit of time to really adjust to the new settings.
Well, beside wanting to experiment with increasing the Minimum Pressure -- at the same time, I have switched from the "APAP for Her Mode" to the regular "APAP Mode" since I had previously been running AT LEAST 11 for the pressure 95% of the time in that "for Her mode", and I read that the "for Her Mode" doesn't perform accurately over a pressure of 12.

Last night it was on regular APAP mode for the second night, and I've been watching to see what would happen if I upped the Minimum pressure. But, it seems, a 9 is too high to be comfortable. All this to say . . . I have NOT yet found a good range of pressure to give me a decent AHI. And over the past week there have been variables (such as huge large leaks - see posts above - which I finally conquered with proper mouth-taping! Now I'm working on getting the AHI fixed. Because of the variables over the last 7 days, I'm not sure that the 95% pressure of 13.2 for the WEEK is reliable. I'm still motivated to try the range of 8-14 tonight, and keep myself comfortable in spite of any need to sleep on my back . . . and yes, I can try to keep to that plan for 4-5 days.

Thank you for your input!

JoyD.

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Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle
Mask: Zest Nasal CPAP Mask with Headgear
Additional Comments: Pressure:10.2min-17max; ClimateLine Heated Hose; OSCAR 1.4.0; BACKUPS: AirFit P10 & Evora Hybrid FF; Respironics-Remstar Auto M-Series.
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ozij
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Re: HELP needed for 13-yr CPAP user!

Post by ozij » Sat Nov 12, 2022 9:00 pm

One thing I really like about ResMed machines: you can change the pressure in 0.2 steps.
This can be very helpful when trying to get your body used to higher pressures. It means it may take you a long time to reach the preferred minimum pressure - but it gives you a better chance of reaching it comfortably, eventually.

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JoyD.
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Re: HELP needed for 13-yr CPAP user!

Post by JoyD. » Sun Nov 13, 2022 10:06 am

OZIJ WROTE:
One thing I really like about ResMed machines: you can change the pressure in 0.2 steps.
This can be very helpful when trying to get your body used to higher pressures. It means it may take you a long time to reach the preferred minimum pressure - but it gives you a better chance of reaching it comfortably, eventually.
You know, I did notice that when I was changing the setting . . . but the advantage of upping it slowly by 0.2 increases at a time to build up my tolerance for increasing minimum pressures didn't occur to me. Sounds like a great idea which I'll start doing tonight! Thanks O! :D

JoyD.

_________________
Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle
Mask: Zest Nasal CPAP Mask with Headgear
Additional Comments: Pressure:10.2min-17max; ClimateLine Heated Hose; OSCAR 1.4.0; BACKUPS: AirFit P10 & Evora Hybrid FF; Respironics-Remstar Auto M-Series.
Last edited by JoyD. on Sun Nov 13, 2022 11:55 am, edited 2 times in total.
CPAP Accessories:
Pur-Sleep Pillow, Wellue O2 Ring
___________________________________________________________________________
"In the depths of winter, I finally learned that within me there lay an invincible summer." ~ Albert Camus

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JoyD.
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Re: HELP needed for 13-yr CPAP user!

Post by JoyD. » Sun Nov 13, 2022 10:34 am

Well, I had a much more pleasant night, not worrying about sleeping on my back. (I did jam some small, firm pillows behind my back. And I am in the process of putting a tennis ball pocket on one of my sleeveless polos). Last night I did change my pressure range to 8-14 (would like a 9 or 10 Minimum, but can't seem to tolerate the pressure). Based on Ozji's last post which pointed out that I may be able to tolerate higher Minimum pressures by adjusting the pressure up slowly in 0.2 increments or so . . . I'll be starting to do that tonight, a great idea!! :D

So here are my OSCAR results from last night, 11/12/22:
STATISTICS: https://imgur.com/a/y3dSInV
DAILY VIEW: https://imgur.com/a/zNxSNLI
DAILY VIEW, Zoomed 1x (does this give more info??): https://imgur.com/a/JTaxqI2

I've been reading the Apnea Board Wiki on Optimizing Therapy. I've found this Wiki topic to be so helpful and educational !! https://www.apneaboard.com/wiki/index.p ... ng_therapy

JoyD.

_________________
Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle
Mask: Zest Nasal CPAP Mask with Headgear
Additional Comments: Pressure:10.2min-17max; ClimateLine Heated Hose; OSCAR 1.4.0; BACKUPS: AirFit P10 & Evora Hybrid FF; Respironics-Remstar Auto M-Series.
CPAP Accessories:
Pur-Sleep Pillow, Wellue O2 Ring
___________________________________________________________________________
"In the depths of winter, I finally learned that within me there lay an invincible summer." ~ Albert Camus

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JoyD.
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Re: HELP needed for 13-yr CPAP user!

Post by JoyD. » Mon Nov 14, 2022 8:51 am

Was very tired during the day yesterday, Sunday 11/13 . . . felt like going back to bed at 2:30 in the afternoon, but stayed up hoping to have a good night of sleep which I did (although I was up and down during the night, I caught up on some sleep and feel better this morning.)

Here are my OSCAR results from last night, 11/13:
Statistics: https://imgur.com/a/yVYuoO6
Daily View: https://imgur.com/a/4njYj3q

Glad to see last night's AHI (7.18) lower than the previous night (10.08). I'm slowly increasing the Minimum Pressure by 0.2 each night, beginning last night. I'll continue to do this. Hoping to ultimately be able to tolerate the Minimum Pressure up to 10, at least 9.

Any comments welcome!

JoyD.

PS - Can't seem to get the Snore chart in view on my 12" laptop, but it is very rare to see anything on the Snore chart.

_________________
Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle
Mask: Zest Nasal CPAP Mask with Headgear
Additional Comments: Pressure:10.2min-17max; ClimateLine Heated Hose; OSCAR 1.4.0; BACKUPS: AirFit P10 & Evora Hybrid FF; Respironics-Remstar Auto M-Series.
CPAP Accessories:
Pur-Sleep Pillow, Wellue O2 Ring
___________________________________________________________________________
"In the depths of winter, I finally learned that within me there lay an invincible summer." ~ Albert Camus

lynninnj
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Re: HELP needed for 13-yr CPAP user!

Post by lynninnj » Mon Nov 14, 2022 2:12 pm

wow good improvement. I am glad for you.

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JoyD.
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Re: HELP needed for 13-yr CPAP user!

Post by JoyD. » Wed Nov 16, 2022 9:07 am

FINALLY my AHI was normal last night: 1.58 :D

PUGSY WROTE on 11/11/22:
FWIW....I think you are going to need more minimum and at some point I also think you should consider adding in EPR again to see if EPR helps reduce the FLs.
Now how much more minimum??? That's really something we can't tell for sure but I am thinking somewhere around where the median average is which is around 10 cm. Probably for sure 9 cm and there's a good chance a little more.
Also...I wouldn't be surprised if you were actually on your back more than you think. :lol:
So, after 5 nights in the regular Autoset Mode, I made these two changes, encouraged by Pugsy:
1. Set the MINIMUM PRESSURE to 10 (also put the MAX pressure up from 14 to 17 so as not to miss occasional clustered events when Supine).
2. Set EPR (level 2) on FULL NIGHT to try to get rid of so many Flow Limitations (as well as tolerate the "10" Minimum Pressure.)
And it appears to be working!! :D :D I'll keep these settings . . . and hope the AHI continues to be low!

Here are my OSCAR reports from last night 11/15/22
Daily View: https://imgur.com/a/bE7lTXR
Statistics: https://imgur.com/a/HhcZBdy

NOTE: The pressure surge at the end of session 2 from an increase in Flow Limitations can be attributed to waking up in the Supine Position!

I'll continue with last nights SETTINGS and hope my AHI stays normal (as it always was for 13 years, until recently). Many THANKS to everyone's input, encouragement, and help in helping me solve first my Large Leak problem & most recently in getting my AHI back to normal!

And since the bottom line to everything is getting Oxygen into the lungs so the body can function well (particularly the heart). . . I want to be sure my O2 saturation is in good shape during the night. So I've ordered the Viacom-Wellue O2 Ring for all-night monitoring. When I get it set up with Oscar, I'll include the O2 & Heart Rate graphs.

Continued comments & suggestions welcome!

JoyD.

_________________
Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle
Mask: Zest Nasal CPAP Mask with Headgear
Additional Comments: Pressure:10.2min-17max; ClimateLine Heated Hose; OSCAR 1.4.0; BACKUPS: AirFit P10 & Evora Hybrid FF; Respironics-Remstar Auto M-Series.
CPAP Accessories:
Pur-Sleep Pillow, Wellue O2 Ring
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"In the depths of winter, I finally learned that within me there lay an invincible summer." ~ Albert Camus

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robysue1
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Re: HELP needed for 13-yr CPAP user!

Post by robysue1 » Wed Nov 16, 2022 10:04 am

JoyD. wrote:
Wed Nov 16, 2022 9:07 am
FINALLY my AHI was normal last night: 1.58 :D
Congratulations! I hope you're also feeling good today and I hope you woke up feeling rested!
So, after 5 nights in the regular Autoset Mode, I made these two changes, encouraged by Pugsy:
1. Set the MINIMUM PRESSURE to 10 (also put the MAX pressure up from 14 to 17 so as not to miss occasional clustered events when Supine).
2. Set EPR (level 2) on FULL NIGHT to try to get rid of so many Flow Limitations (as well as tolerate the "10" Minimum Pressure.)
And it appears to be working!! :D :D I'll keep these settings . . . and hope the AHI continues to be low!
Keep these settings for at least 4 or 5 days to see how they work over multiple nights. You might not always have an AHI that low, but then again, you might have better AHIs numbers than today. (Here's hoping!)

Just as important as the AHI is, it's also important to keep track of how you're feeling: Do you wake up rested? And at the end of the day do you think you functioned and felt pretty good? If you wind up getting a solid 4-7 days of waking up feeling rested and then feeling pretty decent during the day using these settings, you'll know you've got the machine dialed in again and that you can go back to not studying the data so intensely every day (unless, of course you enjoy doing that).

If you hit some bumps in the next 4 or 5 days, let us know and if necessary you can revisit the idea of increasing the pressure a bit more (at 0.2 cm each time) until your AHI is controlled when you sleep on your back and you are consistently feeling good.

I'm really happy for you!

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Re: HELP needed for 13-yr CPAP user!

Post by chunkyfrog » Wed Nov 16, 2022 10:10 am

Plese note: painful, intractable gas can also be a symptom of a sick gall bladder.
If gas-x gives temporary relief, see your doctor.
Aerophagia will not respond to simethicone--wrong gas involved.

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Re: HELP needed for 13-yr CPAP user!

Post by Pugsy » Wed Nov 16, 2022 10:23 am

Well done.

Now I gotta go to the ER....I dislocated my shoulder patting myself on the back. :lol: :lol:
I had a good idea what was needed but I wasn't so sure that you could tolerate what was needed.

Since apparently your pressure needs exceed what the for Her mode can adequately deliver effectively, I do think that the regular auto mode is a better choice for you....at least for now. Maybe down the road if you can stay off your back better then you could revisit the for Her mode again.

I am concerned about the breaks in therapy though.....several of them and the awake time lasts longer than I would like to see.
But we take baby steps when we have to....we can still get there even with lots of baby steps.
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JoyD.
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Re: HELP needed for 13-yr CPAP user!

Post by JoyD. » Wed Nov 16, 2022 12:14 pm

PUGSY WROTE:
I am concerned about the breaks in therapy though.....several of them and the awake time lasts longer than I would like to see.
But we take baby steps when we have to....we can still get there even with lots of baby steps.
Being female, and 81 years old, 3 or 4 potty breaks during the night seems unavoidable for me. I think that's the problem rather than being awakened by CPAP stuff. :? :oops: 8) Then, while I'm up . . . :roll:

Since my ResMed doesn't know when I'm asleep or awake . . . I'm sure my hours of "usage" is significantly below my actual "sleep" time. With all my breaks & then lying in bed awake, I think maybe I need a usage time of 10+ hours (which I am able to do since I'm retired), rather than 7-8 hours. It's now 2 pm, and already I'm feeling tired.

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Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle
Mask: Zest Nasal CPAP Mask with Headgear
Additional Comments: Pressure:10.2min-17max; ClimateLine Heated Hose; OSCAR 1.4.0; BACKUPS: AirFit P10 & Evora Hybrid FF; Respironics-Remstar Auto M-Series.
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Pur-Sleep Pillow, Wellue O2 Ring
___________________________________________________________________________
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lynninnj
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Re: HELP needed for 13-yr CPAP user!

Post by lynninnj » Wed Nov 16, 2022 2:05 pm

Happy! Happy!

Joy! Joy!

yay and good for you.

(Pugsy- I let out an audible gasp when I read trip to the ER. Don’t scare me like that! lol)

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JoyD.
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Re: HELP needed for 13-yr CPAP user!

Post by JoyD. » Thu Nov 17, 2022 7:55 am

Well, AHI went up a bit, but for NOW I'll take anything under 5.

Last night all settings were the same as 11/15, except I turned the RAMP OFF. I felt no difference with comfort . . . so ramp seems to be unnecessary since I have EPR 2 on. - Now I am on the 10 Minimum pressure right from the start all during the night as I return to bed after several potty breaks, wasting no time with ramp on before I go to treatment levels.

OSCAR reports for last night, 11/16/2022:
DAILY VIEW: https://imgur.com/ruMXyxY
STATISTICS: https://imgur.com/a/EGOJ4sl

As I Zoom on my Flow Rate, looking at each breath I am still concerned at ALL THE FLOW LIMITATIONS throughout the night.
Any suggestions here??


After 4 more nights at the current settings, these are some changes I'm considering (one at a time, 4-5 nights before adding another change):
1. Increasing the Minimum Pressure by 0.2 every 4-5 days to see what happens to AHI & FL.
2. Once I've settled on a Minimum pressure . . . changing the EPR Level to 3 from present 2. I'm wondering if that reduce my FLs further? (I don't want the EPAP too low as to miss treating apneas).
How does that sound??

Yesterday I was very tired (no doubt I got inadequate sleep because last night's "usage rate" of 8.5 hours" was probably only 4-5 hours AT BEST of actual sleep since I lay in bed a considerable length of time before falling asleep with each wake up. So . . . LAST night I went to bed early at 7:35pm and got up at 6:46am (11 hrs, 11 min), hopefully getting 8-9 hours sleep. (I was so tired, I seem to remember upon awakening, each time, that I didn't lie awake in bed for a long time waiting to sleep last night.)

We'll see how I do today.

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Machine: AirSense 10 AutoSet with Heated Humidifer + P10 Nasal Pillow Mask Bundle
Mask: Zest Nasal CPAP Mask with Headgear
Additional Comments: Pressure:10.2min-17max; ClimateLine Heated Hose; OSCAR 1.4.0; BACKUPS: AirFit P10 & Evora Hybrid FF; Respironics-Remstar Auto M-Series.
Last edited by JoyD. on Thu Nov 17, 2022 8:09 am, edited 3 times in total.
CPAP Accessories:
Pur-Sleep Pillow, Wellue O2 Ring
___________________________________________________________________________
"In the depths of winter, I finally learned that within me there lay an invincible summer." ~ Albert Camus

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Pugsy
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Re: HELP needed for 13-yr CPAP user!

Post by Pugsy » Thu Nov 17, 2022 8:03 am

Are you experiencing any nasal congestion????
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