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Hi everyone, I've been using CPAP for about a month now. It has helped take my AHI number down from 9.3 to an average of about 2.3/hour. I've noticed a real difference in my general mood, energy levels, and so on, but I still feel a base level of fatigue that I noticed seems to be eliminated on the rare nights when I do get the AHI down to 0. So far that's only happened twice so far - the night of my titration study, which showed that a constant pressure of 7 worked well for me. The other time was a night I spent in a hotel room when I traveled out of town for a concert. I didn't even use the CPAP that night but I'm guessing that I had 0 events based on how rested I felt the next morning/day.
I'm currently learning how to read the data and adjust pressure and so on to try to cut the AHI down to 0 and was hoping for any thoughts on what my data might show. I'm happy to provide any additional information you might need to help evaluate my data. The only additional piece of information I can think to add for now is that my initial home study showed no central apnea events, so I assume the clear airway events on last night's data are a consequence my reaction to the machine settings. I'm thinking the next move is to figure out how to reduce those. Possibly narrowing the pressure range? Thanks in advance for any thoughts. I will update this thread as needed.
Yesterday I learned that I could adjust the CPAP settings myself. I changed the minimum pressure to 7 and turned on EPR (set it to 2) because that's what my titration study suggested would work. I had two fewer OA events but one more CA event than the previous night. More large leaks too. I'm guessing those were due to mouth breathing. I had some definite nose congestion after putting on the mask. I hoped it would clear up but I guess not. Overall my AHI was higher than the previous night but still around where it has tended to fall since starting therapy (mid 2s).
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Everything looks ok IMO. You can even try EPR of 3 full time. EPR will help with flow limitations, hypopneas, etc; but could cause more central apneas. If central apneas increase too much, turn down or even turn off EPR. Hopefully, your central apneas are treatment emergent (they should decrease significantly in a few weeks or so). Your pressure settings look good. You are not even hitting your 15 max - that is good. Your respiratory rate is ok even though it is at the lower end of normal. Not concerning IMO.
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Thanks for your reply. My initial at-home sleep study did not show any central apneas, so I'm guessing those are treatment-emergent. So those could go away as a matter of getting used to CPAP therapy? That's good to hear. I'll try EPR of 3 and see what happens. I'm definitely happy with the therapy so far. I'm just a bit frustrated that I haven't been able to reproduce the results from that clinic titration study. 0 apneas and felt great the next day. Just a bit puzzling. Thanks again.
Last night's data. I tried going without EPR. That took the central apneas down to below 1. Terrible leaks though. I'm not sure why. The mask was on fine when I woke up. Mouth breathing? I'm thinking I'll try a full face mask tonight.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Looks good. Work on the leaks. You could even bump up your max pressure by one since you are very close to it on your 99.5% The group of central apneas just as you fall asleep are probably sleep wake junk and don't need to be worried about.
Here are some tips to lower mask leaks. Mask Primer
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Thanks. I'll try bumping up the pressure one. I also realized that I can spend a little more time fitting the mask on before I call it a night. I think what's happening is the mask leaks when I turn my head and pull the mask slightly. Going to adjust the mask fit more carefully tonight.
A couple more night's worth of data. I turned EPR off and that reduced clear airway events so I'm sticking with that. Working on reducing mask leaks by being more careful about mask fit. I also ordered a nasal pillow mask to try as I've read that that can help reduce leaks since it's smaller. (Monday night was actually a nasal mask. I forgot to change the setting in the machine. I've been going back and forth because the full face mask feels more comfortable pressure-wise in that I feel that I can breathe more fully with it on but I also have more leaks with it and get woken up by the feeling off the air pressure passing over my face. I think I'll be sticking to the nasal mask until the pillow mask arrives.)
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Sounds good. Much less pressure needed in these 2 charts. I think it was around 15 in the 1st chart you posted. Only 11 or so needed here in these 2 charts. Decreasing the pressure needed can help with leaks also.
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
