Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.
Login or Create an Account
Last night I decided to try a minimum pressure of 5 and maximum pressure at 5 in order to provide something more consistent to reduce CA.
Good news - CA was slightly lower.
Bad news - OA and RE made a slight appearance which never happens. Hypopneas went up a bit. Overall AHI was higher. I also seemed to wake up more during the course of the night.
I felt somewhat rested, but not where I'd like to be. Should I try going back to a range of maybe 5-7 or 5-8? Or trying a fixed pressure at 6?
First off, congrats on getting that leak rate down, it may correlate to your lowered CA events. The increase of hypopneas, appearance of OA and RE might be due to having reduced your pressure to a static pressure below your therapeutic threshold.
I don't have deep enough knowledge of the various types of sleep apnea to offer advice on machine settings, there are plenty of folks around here that do and hopefully some will come a long and take a look.
What I can say is, in my experience managing flow limit is key to controlling H,OA and RE, study that graphs correlations to pressure and flow rate make settings adjustments accordingly. For those of us prone to CA, it becomes a tight rope balance between enough pressure to manage flow limits and low enough pressure to mitigate some of the CA. Controlling leaks is very important. For EERS these days I just sleep with my head under the covers to keep an area rich in co2 around the mask, its worked wonders to keep the CA to a minimum with out much discomfort. Its proven effective time and again. Start out the night with covers over, later in the night under normal circumstances like rolling around or getting up to head to the bathroom then not covering up when going back to bed, it rarely fails, few to no CA during period under covers, a few pop up during the latter uncovered sleep session.
There's lots of conflicting opinions out there on managing CA, the best advice, most effective advice I have found is here. Search Sleeprider posts, read and heed.
When I first started, I too had a lot of central events. I’d wake up in the morning and become stressed and anxious that this wasn’t working for me and I was recording way more centrals than appeared in my pre treatment sleep study.
After working with my Sleep Dr on different titration combinations, the one that seems to work best for me is a fixed steady pressure of 6 or 7 with ramp and EPR off. This significantly reduced the number of centrals and brought my AHI down to a manageable number. When the pressure range was set with too much variation, it really messed with my breathing rhythm and sent everything into a downward spiral.
That’s been my experience anyway. Hope you find a solution that works for you.
(06-21-2023, 05:06 AM)ZacMirror Wrote: When I first started, I too had a lot of central events. I’d wake up in the morning and become stressed and anxious that this wasn’t working for me and I was recording way more centrals than appeared in my pre treatment sleep study.
After working with my Sleep Dr on different titration combinations, the one that seems to work best for me is a fixed steady pressure of 6 or 7 with ramp and EPR off. This significantly reduced the number of centrals and brought my AHI down to a manageable number. When the pressure range was set with too much variation, it really messed with my breathing rhythm and sent everything into a downward spiral.
That’s been my experience anyway. Hope you find a solution that works for you.
Thanks so much and that is definitely encouraging to hear! I tried at a fixed pressure of 5 and had decent success. Then I tried at a fixed pressure of 6 and had terrible AHI, so it's really tough to nail down the right number.
How did you decide on 6? Did you go in for a titration study? Or did they just review your data?
It was really just trying different settings under the supervision of my Sleep Dr. I was admitted to hospital for a physical injury I sustained and was fortunate that the Sleep Dr would come to the hospital each day to try to help me with my apnea while in a hospital setting. We spend 5 days trialling and then tweaking settings.
My Resmed AirSense 11 was originally set at pressure range of 4-20 with ramp and EPR on. That has works a treat for many people but for me it was a disaster. My specific breathing rhythm needs very limited (or no) variation in pressure, otherwise Centrals will go thru the roof. I was recording an AHI of 34 (33 of which were Centrals), when I had the pressure range wide open. My pre treatment AHI was only 33!! I was really freaking out and that made me discontinue CPAP and try the MAD.
After trying every increment between 5 and 9, trial and error (for my circumstances) showed that around 6.5 is the sweet spot. At this setting I was seeing AHI’s of around 10. When the ramp and EPR was turned off, I got further improvement and now see AHI of between 4 and 7. Last night was 4.6.
