14 Nights of Cpap - Advice Please

[Koalapoo]

I have now been using my cpap machine nightly for 2 weeks and I am very pleased with the results as am sleeping much better, my energy levels are up and I actually feel refreshed most mornings.  Everything I have done has been done on the advice of this forum and I am in debt to the wise words forum members have used to guide me thus far. I am now using a soft collar to help control apnea events and it has been really helpful.  (No sore neck in the mornings.  Wonderful). 

I would like some advice/tips on improving my cpap experience as I have tinkered with the settings of my machine eg minimum pressure has been changed from 4 to 6 to 8 on various nights and I have tried different EPR settings and I am totally unsure of what Humidity/Temperature settings I should be on.  What settings would you recommend?

Also a couple of questions.

1.  I have been quite successful adjusting to the Resmed P10 Nasal Pillows but are the air leaks at acceptable levels?  I believe the significant leaks happen when I change sides and place my head to deeply on the side, sometimes slightly dislodging them.

2.  The Doctor recommended CPAP 9cm.  I don't know what that translates to.  My machine is set at auto.

3. Tidal Volume. I know it highlights displaced air each breath but when I comparing nightly data it varies a great deal for me eg.  A 14 night low of 960  to 1215 a different night.

Any help, advice. tips greatly appreciated.  Your input would be greatly appreciated.

             

[Sleeprider]

I think your doctor actually had a pretty good idea what pressure you needed and might have been a bit low. With a set range of 6 to 20 with EPR 1, your median pressure in this chart is 10.76/9.76 and the 95% pressure is 11.36/10.36. That is a pretty narrow range, and shows you get good efficacy at this pressure range. I think you would be well advised to raise your minimum pressure to 9.0, which would result in 9/8 pressure and probably avoid those OA events before good therapy pressure is reached. If you want to try in increase in EPR to 2, you will need this higher starting pressure. More EPR will further reduce flow limitations and may increase some respiratory statistics. We often increase EPR to treat flow limitations, RERA and hypopnea. Your results are currently very good, but I think you should try EPR 2 and decide if it's something you want to keep after trying it a few nights.

You have some leaks, but they are not going to prevent effective therapy, the question is more if they disrupt your sleep.

When we look at tidal volume and minute vent, we focus more on the median than the 95% or max. In this chart it is 460 mL at 15.6 BPM and a minute vent of 7.63. That seems solidly in the normal range, but normal varies according to your height, sex, weight and other factors. It's probably not something to focus on at this time.

[Canuck 2]

I have now been using my cpap machine nightly for 2 weeks and I am very pleased with the results as am sleeping much better, my energy levels are up and I actually feel refreshed most mornings.  Everything I have done has been done on the advice of this forum and I am in debt to the wise words forum members have used to guide me thus far. I am now using a soft collar to help control apnea events and it has been really helpful.  (No sore neck in the mornings.  Wonderful). 

I would like some advice/tips on improving my cpap experience as I have tinkered with the settings of my machine eg minimum pressure has been changed from 4 to 6 to 8 on various nights and I have tried different EPR settings and I am totally unsure of what Humidity/Temperature settings I should be on.  What settings would you recommend?

Also a couple of questions.

1.  I have been quite successful adjusting to the Resmed P10 Nasal Pillows but are the air leaks at acceptable levels?  I believe the significant leaks happen when I change sides and place my head to deeply on the side, sometimes slightly dislodging them.

2.  The Doctor recommended CPAP 9cm.  I don't know what that translates to.  My machine is set at auto.

3. Tidal Volume. I know it highlights displaced air each breath but when I comparing nightly data it varies a great deal for me eg.  A 14 night low of 960  to 1215 a different night.

Any help, advice. tips greatly appreciated.  Your input would be greatly appreciated.

That is a nice looking chart with Pressure nicely even most of the evening, The only thing I would change is your ramp time to 5 min with ramp pressure to 7 and that will help a lot with OA possibly.

[Koalapoo]

Thank you Sleeprider and Canuck 2.
I really do appreciate your advice and will take your suggestions on board.
I will give the changes as suggested a go - and report on them after I have tried them for several nights.
I am so glad I have found this forum! Excellent advice!