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Kayak
Unread post  Post subject: New to the forum, from France  |  Posted: Sat Feb 25, 2017 12:27 am
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Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

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Hello all,
I was diagnosed OSA five years ago, and made my first attempt with a CPAP... Which failed miserably, as I gave the machine back after 3 months (yes, we have real social security in France...). Objectively, I think it was due to a mix of poor support, inadequate equipment and of course, my own inhibitions about "equipped" sleep. Constant leaks, pressure surges at the wrong moments, eye infections...

Unfortunately, the symptoms did not just fade away :roll: and I decided a few weeks ago to give it another try, but this time, with a more renown sleep therapy team.
My AHI was evaluated at 120.6, no REM sleep at all, with frequent O² desats at 60%... very scary numbers which prompted my decision to REALLY try this again... but this time, with the right support and equipment.

The team selected the Resmed Airsense 10 "elite", coupled with a F&P Eson 2 nasal mask. Compared to the "old" equipment... the CPAP is a miracle of silence, and the mask is... almost easy to forget, so well it adapts and stays in position. I do have slight issues with mouth breathing... But hopefully, this forum will help me address them.

Of course, the numbers below represent only two days of data, but they give me great hope:

Image

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trish6hundred
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Sat Feb 25, 2017 2:34 pm

Joined: Tue Apr 14, 2015 12:10 pm
Posts: 736
PAP Mask: Fisher & Paykel Simplus
PAP Machine: Resmed S9AutoSet for Her
Humidifier: H5I
Pressure Setting: Titrated Pressure is 10 CM-H2O, I use a range of 7/20 CM-H2O.

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Hi kayak,
WELCOME! to the forum.!
Hang in there for help with your graphs, better luck to you this time around with your CPAP therapy.


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jb.sing
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Sun Feb 26, 2017 4:01 pm

Joined: Thu Sep 08, 2016 4:33 pm
Posts: 179
PAP Mask: amara view,
PAP Machine: dreamstation a pap
Pressure Setting: 11

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These graphs do show great improvement over where you were at.
And this forum is very valuable. So is the sleepyhead program. If you download sleepyhead program to a computer, you can see lots of data that will help you (and your doctor) improve the numbers more.


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Kayak
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Mon Feb 27, 2017 12:51 am
User avatar

Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

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Thank you both for your welcome. I use Sleepyhead and ResScan 5.7... I find Sleepyhead much more user-friendly, presumably because of its intended public (amateurs like most of us).

There are two things I'm going to need help with, very quickly if I want to continue therapy...

1. It's not labeled as severe, but it seems I have chronical rhinitis... And the result is post-nasal drip which accumulates in the back of my throat, and adds to the soft tissue obstruction, as the night progresses. Most CPAP techs seem to be quick to prescribe full-face masks - but is there an alternative, a drug treatment that can help?

2. I rip off my mask every "night" around 4AM, almost in a state of panic (claustrophobia?)... It takes some mental effort to put the mask back on, my own good, etc etc.
Do any of you have the same problem, and if you do... How do you counter this?

The numbers are improving, but the post-nasal drip and the "pause" I make every night at 4AM are a real problem... help :)

_________________
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TheLankyLefty
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Mon Feb 27, 2017 10:22 pm
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Site Admin

Joined: Mon Aug 15, 2011 10:22 am
Posts: 4635
PAP Mask: Practically tried them all.
PAP Machine: Use Phillips Respironics System One APAP with Aflex for mask testing
Humidifier: None
Pressure Setting: When testing, I use APAP with a range of 5-10

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Kayak wrote:
- but is there an alternative, a drug treatment that can help?
For chronic rhinitis? I'm not very good with pharmacology, so I'm going to abstain from answering this one on any professional level. For me, when I get post nasal drip it is usually during allergy season here. I just take an antihistamine (zyrtec generic) and it drys me up.

Kayak wrote:
2. I rip off my mask every "night" around 4AM, almost in a state of panic (claustrophobia?)... It takes some mental effort to put the mask back on, my own good, etc etc.
Do any of you have the same problem, and if you do... How do you counter this?
Definitely use SleepyHead to see what is happening right before this. I could postulate, but won't do any good. Most likely it's a sleep disordered breathing problem, or it can also be a leaking problem. Those are the most common problems, but without some kind of data to back it up, I don't know.

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Kayak
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Tue Feb 28, 2017 12:26 am
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Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

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Thank you, admin :)
Another tech I spoke with tells me that post-nasal drip with obstruction kind of disqualifies nasal masks, such as mine. He recommends using a facial mask instead. Is the facial mask harder to get accustomed to than the nasal?

Also, can you let me know which data you require from Sleepyhead, to give me an opinion?

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onemoretime
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Tue Feb 28, 2017 9:08 am

Joined: Wed Nov 30, 2016 6:06 am
Posts: 43
PAP Mask: dreamwear med frame small mask
PAP Machine: resmed air 10 autov
Humidifier: heated
Pressure Setting: PS 4.0 over 4.4-16.0 (cmH2O) Auto pap

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an ENT practitioner should assist with rhinitis and state if a nasal mask is not usable. Using the breathing machine with humidifier and keeping all clean may or may not help. I have ripped off my mask a few morning when i am trying to roll over further and the leaks/mask torque irritates me. of course many of my obstructions were occurring in early a.m. and the mask pressures were not keeping my breathing regular. auto pap leveling helped to adjust must better.


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diamaunt
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Tue Feb 28, 2017 12:07 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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Kayak wrote:
Thank you, admin :)
Another tech I spoke with tells me that post-nasal drip with obstruction kind of disqualifies nasal masks, such as mine.

garbage.

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how to post:
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur


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Kayak
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 12:50 am
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Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

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diamaunt wrote:
Kayak wrote:
Thank you, admin :)
Another tech I spoke with tells me that post-nasal drip with obstruction kind of disqualifies nasal masks, such as mine.

garbage.


Er... Can you be more specific?

_________________
SleepyHead on multiple computers / SD card data sync


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Kayak
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 1:31 am
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Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

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Can someone please explain "Flow Limitation" to me?

Image

_________________
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diamaunt
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 2:43 am
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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Kayak wrote:
Can someone please explain "Flow Limitation" to me?

watch this: https://www.youtube.com/watch?v=-gie2dhqP2c
there'll be a test after.

_________________
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how to post:
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur


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Kayak
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 9:13 am
User avatar

Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

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diamaunt, I tend to be a good student, thank you for the link :)
So basically, the flow limitation graph shows that that at some points in time, the positive flow encounters resistance by the "obstruction"... Correct? In my case, probably a mix of the usual culprits and of the mucus from the post-nasal drip (I spit enough of the crap every morning to know it's obstructing...).
As I won't lose 50 pounds overnight, I presume the best way to counter this is to increase cmH2O pressure? In my case, the tech wanted me to try 7 for a month... Which is not working out too well.

I'll increase to 12, as prescribed (er... "Hofstein" formula), and post the results tomorrow. Thanks again :)

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TheLankyLefty
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 9:25 am
User avatar
Site Admin

Joined: Mon Aug 15, 2011 10:22 am
Posts: 4635
PAP Mask: Practically tried them all.
PAP Machine: Use Phillips Respironics System One APAP with Aflex for mask testing
Humidifier: None
Pressure Setting: When testing, I use APAP with a range of 5-10

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Kayak wrote:
I'll increase to 12, as prescribed (er... "Hofstein" formula), and post the results tomorrow. Thanks again :)
Sounds good. Increasing is the best way to counter any obstruction. 12cmH20 may be overkill if you aren't seeing OSA or clear events tagged as hypopneas.

Only way to find out is to try though! :)

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diamaunt
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 8:01 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
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Pressure Setting: 18/13-25/19

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what he said ;)

_________________
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BillyHW
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 8:53 pm
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Joined: Mon Jan 23, 2017 10:35 pm
Posts: 108
Location: Alberta, Canada
PAP Mask: F&P Simplus
PAP Machine: Philips Dreamstation Auto
Pressure Setting: 12 to 20 cmH2O

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Kayak wrote:
Hello all,
I was diagnosed OSA five years ago, and made my first attempt with a CPAP... Which failed miserably, as I gave the machine back after 3 months (yes, we have real social security in France...). Objectively, I think it was due to a mix of poor support, inadequate equipment and of course, my own inhibitions about "equipped" sleep. Constant leaks, pressure surges at the wrong moments, eye infections...


I can't really understand giving up. My AHI and O2 desats were also around yours to start with, and I felt like total crap. I couldn't function. Working and driving were horrible.

This has to work or I'm finished.


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BillyHW
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 9:05 pm
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Joined: Mon Jan 23, 2017 10:35 pm
Posts: 108
Location: Alberta, Canada
PAP Mask: F&P Simplus
PAP Machine: Philips Dreamstation Auto
Pressure Setting: 12 to 20 cmH2O

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diamaunt wrote:
Kayak wrote:
Can someone please explain "Flow Limitation" to me?

watch this: https://www.youtube.com/watch?v=-gie2dhqP2c
there'll be a test after.


That's the best video explaining sleep apnea I've seen. Thanks for posting.


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Kayak
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 9:36 pm
User avatar

Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

Offline
Best numbers yet, except towards the end :)
I must've moved my mask... Leaks, snoring and of course, apneas. The good news is that 12 is working for me, really easy to tolerate.

BillyHW, it's easy to give up, if you're not receiving adequate support, information, and if you're poorly equipped. This time around, it is not the case... The equipment is good, and the guys on this forum are extremely helpful :)

Image

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diamaunt
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 9:47 pm
User avatar

Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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Kayak wrote:
Best numbers yet, except towards the end :)
I must've moved my mask... Leaks, snoring and of course, apneas. The good news is that 12 is working for me, really easy to tolerate.

BillyHW, it's easy to give up, if you're not receiving adequate support, information, and if you're poorly equipped. This time around, it is not the case... The equipment is good, and the guys on this forum are extremely helpful :)

Image

12 isn't working for you, especially with a EPR of three, which makes it a 9.

what EPR does:
Image

your flow limitations are huge, and your hypopneas are really bad, your base pressure needs to be increased to tame both, either raise the pressure, or decrease EPR. probably raising pressure will be easier to take for the time being.

_________________
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Kayak
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 9:59 pm
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Joined: Fri Feb 24, 2017 11:43 pm
Posts: 125
Location: France
PAP Mask: F&P Eson 2
PAP Machine: Airsense 10 Autoset
Humidifier: None
Pressure Setting: Min 12.6 Max 18 (cmH2O) - EPR 2

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Thank you diamaunt, I'll increase to 15 cmH20 and keep the current EPR (3). More updates tomorrow :)

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diamaunt
Unread post  Post subject: Re: New to the forum, from France  |  Posted: Wed Mar 01, 2017 10:35 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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your chart exhibits the problem with fixed pressure machines for some people, you're doing fine for most of the night, but when you get into long rem (or roll on your back) towards the end of the night, you need more pressure.

so you either have a bad time for a while, or spend the whole night with more pressure than is needed.

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