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DoriC wrote: Another question, what type of hose management are you using so that it's not pulling on your mask and breaking the seal when you twist and turn? That may also account for the VS data. You can do a Search here for hose management and get lots of tips on that. I can assure you your Dr doesn't know any of this unless she's been down in the trenches with us.

I have the machine on the floor on the side of the bed. I've got not nightstand that will fit it. Anyway, I originally tried a single 6 ft hose to me and I kept getting wrapped up in it and about to strangle myself. I then hooked two 6" hoses together and I use whatever I need. I never roll around in my sleep enough to use up 12' of hose. I sound like a problem case - but it's the way I have been for as long as I can remember.

jonquiljo wrote:I did toss and turn a lot
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thrashing around. I had to double my hose length last week because I kept strangling myself with it.

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I originally tried a single 6 ft hose to me and I kept getting wrapped up in it and about to strangle myself. I then hooked two 6" hoses together and I use whatever I need. I never roll around in my sleep enough to use up 12' of hose.

DoriC wrote: what type of hose management are you using so that it's not pulling on your mask and breaking the seal when you twist and turn?
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You can do a Search here for hose management and get lots of tips on that.

jonquiljo, Dori's suggestion to look for hose management suggestions is a good one.

Check out the link below. There are many pictures that'll help you get ideas -- to make turning over a piece of cake.

LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

P.S. Raising the minimum pressure considerably should knock out most of your VS (vibratory snores.)

Well I can probably hook something like that together - but I'll wait until I get let back into the bedroom!

I will raise the pressure now each night and see what happens. If my mouth starts to open I will get a full face mask. I've got an old one (from my old machines), and it's an antique, but it will let me know if that is the way to go. Thanks.

One night at a time may well mess things up more as (especially with an 'antique' mask!) you'd normally need a few at each setting to get a real picture of things at any one level, one night being subject to any passing aberration (like odd leaks).

OK ... I need to give it time.
Well, we haven't had much of a summer in my neck of the woods. In fact by Calif. standards it's been downright cold.

Yes, that's been part of my surprise of having no joint pain this summer. I'm here in Sonoma County, CA and until the last few weeks we've had fall instead of summer. Cold, foggy mornings and evenings and cool days. Usually I'm in a lot of pain with that kind of weather, but not this summer. It's finally gotten warm enough to ripen the tomatoes, and hopefully there will be a grape harvest to keep my husband employed.

OK, OK. But how do you know if you've turned it too high? If you have turned it too low, you have more events and less quality sleep, but if you turned to too high what do you see?

Two things happen if the pressure is too high. First you may see more central apneas if the pressure is too high. Second, you may actually see more events because the machine is slower in responding to events when it has a wide range to work with. Generally the events are under better control in a more narrow range. I've read the explanation for this but can't remember the details. It has something to do with the algorithm used by the PR S1 machines do detect and prevent events.

If your pressure is optimal, you are less likely to open your mouth because you won't have that air hunger when you have an event. But to be certain, you might try taping or a chin strap because those leak spikes do show some mouth breathing going on. Eventually you will find the right pressure an may no longer need anything to keep a good oral seal. And sealing off that nasal pharynx with your tongue on the roof of your mouth really helps.

So that means that I need to slowly raise my lower pressure and I probably could just lower my ceiling pressure right away. Its at 20 and I probably could jump it down to 14 or 15 without a problem. It's never gone over 12.

I think I am just going to order a FF mask as I know I will need it if I ever get a cold or anything. I was playing around with my old one and it actually felt not bad - so a new one might be just what I need. I just opted originally for a nasal mask because I thought they would be less restricting and I didn't know (14 years ago) that my problem was mostly nasal.

So I just reflexively got a nasal mask this time around, but perhaps that was a mistake? I suspect a FF mask will be equally as easy to get used to and cover me in both those instances. I think I got used to having my face covered because I did a lot of scuba diving when I was younger. It might even feel "safer" because back then it was essential to get both your nose and mouth covered. Either way, I feel no less or more restricted either way.

BTW, Jan - we are (sort of) neighbors as I live in Northern Marin. I'm never up in the morning so I don't know what it's like. But other than the last couple of weeks its been terribly cold. I think Northern Marin gets warmer than much of Sonoma - but even then it's been not the greatest. My wife hates the heat and our house is so poorly designed that we need A/C most days over 60 deg. (long story)

OK ... so I'm supposed to keep raising my pressure until things start to lower and stop when it does no more good. Here is last night's report ...



Now what does anyone think of this .... should I go any higher????? Or should I start lowering the maximum now??? I really wish someone wrote a good book on this whole process of optimization. This site is great, but it would be so much easier to just lean it all reading a book - I know that's wishful thinking - I still must be sleep deprived!

This is great! What a difference!

Do not worry about the VS. The System One seems to measure these high.

I would leave it like this until or unless you have a lot of poor results in your data or you do not begin to feel rested soon!

You will not always have a great night like this but if this becomes your average over a few days and you begin to feel better, you have found your sweet spot.

I would not lower the upper pressure unless you want to. It will probably make no difference in the data. You were not getting up very much above 11 cm even before. You could make the maximum 12 cm and leave the minimum at 8 cm. I see that you did not use ramp last night. Good. You had a number of events will ramping up so leave it off.

I hope your data keeps looking much like this and you begin to feel the benefits of such good therapy!

Thanks. I thought lowering the maximum would optimize how the algorithm works to overcome "events"?

You look pretty "optimized" to me. 0.2 is AWESOME--most people would kill for that AHI!

Don't worry about the VS--they really are overscored by this machine--as long as your bed partner isn't complaining about you snoring you probably aren't.

Great data! Shh, keep it that way for a few days(or make it 8-12 if you're curious) and see how things go and gauge how you're feeling. I admire your determination.

At the bottom of your encoreviewer you have what looks like a pressure chart is this only available in a-flex mine is set in c-flex and i don't get that chart.

ANDYWT wrote:At the bottom of your encoreviewer you have what looks like a pressure chart is this only available in a-flex mine is set in c-flex and i don't get that chart.

You haven't set up your profile in TEXT not ICONNY, how can we tell what you can get. Jim

jonquiljo wrote:

DoriC wrote: Another question, what type of hose management are you using so that it's not pulling on your mask and breaking the seal when you twist and turn? That may also account for the VS data. You can do a Search here for hose management and get lots of tips on that. I can assure you your Dr doesn't know any of this unless she's been down in the trenches with us.

I have the machine on the floor on the side of the bed. I've got not nightstand that will fit it. Anyway, I originally tried a single 6 ft hose to me and I kept getting wrapped up in it and about to strangle myself. I then hooked two 6" hoses together and I use whatever I need. I never roll around in my sleep enough to use up 12' of hose. I sound like a problem case - but it's the way I have been for as long as I can remember.

The recommended length for XPAP Hoses are ten feet, It's even more important for APAP. Longer hoses reduce pressure,(a little, Not to worry), but more important APAP's need to monitor sleep sounds (VS too) and flow to adjust to what's going on. Long hoses can mask some of the required sounds also draging the hose on objects can cause false noises that the machine can read as VS. Jim

DoriC wrote:Great data! Shh, keep it that way for a few days(or make it 8-12 if you're curious) and see how things go and gauge how you're feeling. I admire your determination.

Well, I have raised my lower pressure to an apparent optimum of 8.5. I then lowered my upper pressure and have seen so far an optimum of 12, so the spread is 8.5. Last night I had an AHI of 0 with only one flow limitation. I still snore in the 3-4 range. I gave up on a FF mask, as I found once I finally got one to work, it was not as good. I'll save FF masks for when I get a cold.

At this point, it's time to quit messing with it - unless I can increase the "Flex" to minimize the "CPAP-nea" or the annoyance of wearing a mask and using a machine. I guess eventually I will get used to it. What are the downsides of raising "Flex"?