40 CA events a night? - Day 2 with CPAP

[buzzmcfly]

Brand new to the CPAP usage this is only day 2 for me.  My CA events are as high as 40! I still feel tired.   I am curious if I have settings wrong, leak issues etc.?    I've attached Oscar Data (the break in the data is when I removed the mask temporarily to re adjust it)

I don't have insurance.  I did do a at home sleep study which came back with 20AHI.  The clinic let me trial a Fischer and Pykel machine for 2 weeks with a dreamware nasal cradle mask, however I discovered I was mouth breathing.  I got a chin strap but found it so uncomfortable.  I did still manage to get my AHI down to 3 using that machine.   The clinician went over my results, but never mentioned anything about CA events ( I didn't have access to data from that machine directly like I do with my air sense).  As I don't have insurance, I have to pay the clinic for each appointment, I purchased my airsense 10 direct online but don't have support to set it up or dial in settings. 

Current set up:

- Airsense 10
- F30I Mask

[PeaceLoveAndPizza]

Some of the CA’s may be treatment emergent, so don’t worry about it yet.

Let’s dial in your settings a bit. Try the following:

Min pressure 8
Max pressure 12
EPR 2 full-time
No ramp (unless you absolutely need it)

What I want to see if is a bit more starting pressure along with a bit less EPR will reduce the CA’s. Sometimes we have to trade-off FL’s for CA’s, so looking to see if that is the case here.

You may also need to try out a soft cervical collar. Whilst you are not showing positional apnoea, you can still cause CA’s by moderate chin-tucking. Not enough blockage to trigger an H or OA event, but enough to cause CA’s. If you want to give it a try, you can read about them on our wiki. The link is in my signature.

Give that a go for a night or two and let us know how things work for you. When you do post again and if there are CA’s clustered, show two charts. The first is the entire night as you have posted and the second is a 2-3 minute zoom into one of the CA clusters.

[buzzmcfly]

Thank you so much for your response,

I will change those settings and give it a go.

[sptrout]

Agree with PeaceLoveandPizza. Kill the ramp; I have used a ResMed 10 for years and it has never been on.

ERP can cause all kinds of trouble; on/off or at some level of on. I would turn it off; nothing to lose and it may make a big difference. I have regretted ever turning EPR on after years of having it off. With it on it has tamed unusual hypos and CAs, but later the reverse would happen. Now I adjust it whenever the CAs of hypos go off the rails. I am not talking much; I want my AHI .5 or less.

CAs area tough nut to crack since there is very little a user can change: pressure range, EPR, or Ramp (not a likely cause IMO just useless in most cases).