CAs in the early morning, lots of brainfog, looking for tips to tune my machine

[justaguy54321]

Hi all,

I have been using a CPAP for about 8 months now with mixed results. About 50% of days I feel ok, and 50% I fail to get restful sleep and experience a lot of brain fog. With treatment I experience almost exclusively CA events with most occurring in the early morning (my doctor told me that greater concentrations of REM sleep in the early morning could be an explanation).

I also struggle to keep my mask on all night. I tend to feel like I'm not getting enough air through my mask upon waking up, so I take my mask off and fall back asleep. Next time I wake up I put it back on and feel like I can breathe through it just fine again. I notice than when I feel like I'm not getting enough air, my respiratory rate goes up from ~17 to ~30 while my actual tidal volume drops.

I'm looking for tips on how to address CA events and potentially how to make treatment easier to tolerate. I've read other threads that gave me some ideas (such as reducing EPR down from 3), but it would be great to have an expert help steer me in the correct direction.

Thanks!
Tyler

   
   
   

[Sleeprider]

JustAGuy welcome to the forum. Your results are pretty good and the CA events are not worrysome. You are using a minimum pressure of 5.4 and maximum 8.4 with EPR 3. That gives you a range of 5.3/4.0 to 8.4/5.4 (inhale/exhale), so the EPR 3 is a bit of overkill for pressures that low considering the minimum pressure of your device is 4.0 cm. The maximum actually reached by your machine is only 7.0 cm. So the ideal of reducing EPR makes a lot of sense from the standpoint of reducing CA events, as well as consistency in your therapy.

We can either go with minimum pressure 5 and EPR 1 or minimum pressure 6 and EPR 2. EPR is a pressure difference between inhale and exhale that increases ventilation and thereby reduces CO2. This affects respiratory drive in some people and leads to CA events. I'm going to suggest you set a minimum pressure of 6.0, maximum 8.0 with EPR 1. I think that will really help the CA events, and after a night with those settings we can see if we should fine-tune for comfort and efficacy.

[justaguy54321]

Hi Sleeprider, thanks for the advice, I really appriciate the help.

I tried the settings you suggested (minimum pressure of 6.0, maximum 8.0 with EPR 1) but forgot to reset my ramp to Auto after testing out the settings, so I had trouble falling asleep with the mask on.

I'm going to give it another try with the same settings tonight to see how it goes. I attached my chart from last night for completeness sake, but I don't think I feel asleep during either of the second or third sessions with the mask on, so it may not be very informative.

   

[Sleeprider]

Looks promising so far.