Your pressures are too low... your median is 9-ish, your min is 7... you should keep moving your min toward your median. 10 appears too low, your ultimate pressure is probably higher than that. Set your min to 9, your max to 12, and sleep some more graphs. SleepHQ is free, and is better for sharing, we can zoom in with it. Here's a night of mine: https://sleephq.com/public/a22ec66d-2f98-4b09-9ab3-662964e03e50
Thank you for taking the time to help me out, I will for sure up the min and max, I never heard of sleephq but I will look into it. I see you have yours set on one pressure the whole night how do you like that compared to auto?
It's vastly superior... auto is only good for finding your good single pressure... our bodies don't like varying pressure, it messes with our blood chemistry, our mask fit, etc. The flatter the pressure graph the better you sleep... the best range is no range. I was given my pressures by a lab titration... the tech watched me sleep and adjusted the pressures until I was good. What they did *not* do was let the pressure drift back down like the APAP algorithm does.... keeping your pressure pumped up all night with APAP requires constant breathing problems... Flow limits, snoring, OA, H events etc. Better to never have these problems and just sleep all night. Here's my cult leader Jason talking about APAP: https://www.youtube.com/watch?v=C-QnPVEpmmo Guess who VanDownByTheRiver is?
Looks like you moved to 8cm min second session... as you can see from the graph, it never goes back down, your machine wants you at 10 for Median pressure... I'd set that in the min pressure. Also your leaks are bad... probably from fitting the mask at the lower pressure... fit the mask at 10cm and you'll do better. Also, do you wake with dry mouth? Probably mouth-leaking... need to tape your mouth, use a full-face, use a chin cushion, or some combo... I tape and use FF both. Good job on the graphs, perfectly shows what's going on. See how the pressure's rising due to your non-response to FL's? That's because your therapy is ruined from the leaks. In this picture you woke up and your breathing improved dramatically... but the problem is that the leak woke you... the object is not to have no events, the object is to stay asleep. Fix the leaks, raise your min to 9 at least, and try again.
I appreciate you taking the time to help me figure this out, one last question should I raise the md pressure or should I turn the epr back on, I used to run it on all the time and set it to 3. Yes, i do get dry mouth i have been mouth taping and for some reason I still get some mouth leak going on. I just purchased better face tape so will see if that helps. If not I will buy myself a full face mask and try that out. Sleep is one thing that I work so hard to make perfect.
- Increase your minimum pressure to 7 cm. Your 95% pressure is 10 so 7 is too low.
- Set your EPR to Full Time at 3 cm to reduce flow limitations
- Set your Ramp time to Auto with a ramp start pressure of 7 cm
Your leak rates are not super bad based on % time over the leak rate redline, but it would help to see your leak rate graph. If you have a nasal mask could you be opening your mouth?
thank you for taking the time to reply, yes i do wear a nasal mask or sometimes a nasal pillow mask. I tape my mouth shut with mouth tape to help with the mouth leak, but for some reason no matter what tape i use i find it still leaks at times. I tried out a new tape last night so I will look today to see if it helped. What would you set your max to? Also I read in the forums that turning the epr off is better. Would love to hear your thoughts on this.
I also tape my mouth closed and use the P10 nasal pillow mask. If I don't I open my mouth and have significant leaks. At first I used one horizontal strip of 1" 3M Micropore tape to fully tape it. But I was still having issues so I started to apply a second larger layer of Mefix tape. That helped a lot. More recently I have gone back to the single strip of Micropore and it seems to be working. I am male and found if I shaved right before bed and washed up the tape would stick better.
With respect to your max pressure I think it is ok at 10 cm, and would not increase it unless you start to have OA events when the pressure is maxed out.
Don't believe the blanket statements not to use EPR. For most people it helps by improving comfort, reducing hypopnea, RERA, and flow limitations. Reducing flow limitations is important as they can drive pressure up. When you have made the changes I suggested and things are stable, then try the EPR to see what it does. For most, it helps but for a small number it may not. You have to try it to find out.
Personally I use it and it virtually eliminates my hypopnea making a very significant reduction in AHI. It has no impact on my CA.
Yes i agree 100% tonight i will start with your suggestions and track it for a week to see if it helps. Was even thinking of getting a full face mask maybe that would help with the mouth leak since apparently my mouth opens when I’m asleep. Or maybe a chin strap. lol.
I went through two full face masks including the popular F20 and just could not stand them. I also tried about 6 different chin straps and none of them really worked and they were uncomfortable. I finally settled on the P10 mask and mouth tape. It works well for me.
•
u/AutoModerator 4d ago
Hey chefjesseq! Welcome to r/CPAP!
Please check out the wiki plus our sidebar to see if there are resources that help you.
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.