4 months on CPAP
hi, I've been on CPAP for 4 months now and eventhough I feel like my sleep has improved, I think it could still be a lot better.
It also varies a lot for me with better and worse nights.
I tried changing the pressure a little bit (9.2/9.4/9.6) but couldn't feel that much of a difference.
I'm using a chin-strap if that makes any difference.
Any and all advice is appreciated!
RE: 4 months on CPAP
since I couldn't figure out how to edit my post, some additional info (just in case it makes any difference):
I'm 30 years old, 178cm, ~80kg. I have allergies and possibly a very mild form of asthma.
Also I'm dependent on decongestant nasal spray for sleeping and have been for a few years. I tried coming off it but couldn't and doctors haven't been of any help. But I'll try again.
RE: 4 months on CPAP
push 
RE: 4 months on CPAP
I hope you will bear with me while I describe the way another 'service' dials in their delivery. I'm talking about the artillery. They are often asked to provide fall-of-shot on an unplanned, unforeseen, target by someone ahead of them willing to call in corrections (it's a skill certain people are trained with who are NOT in the artillery, but who are tasked with directing the support the artillery can provide hastily when it is needed). If the guns are not entirely tasked with providing suppression on a high priority target, and they get a request for assistance from an infantry or armoured fighting unit miles ahead of them in combat, they will agree and begin to adjust their guns to bear on the new target as the combat person up front calls out coordinates. A first targeting shot is fired to find the range and direction, at which the artillery officer calls out, "Shot, over!" When the round impacts the terrain, the observer sends corrections.
Bear with me. The observer doesn't say, "Right 200, add 45 meters, over." Instead, he orders a gross correction in range because its hard to tell how far in front of the enemy position the shot actually landed, only that it did in fact land in the intervening terrain. Now, the artillery aren't schmucks. They're gonna be close. So, the observer calls into the radio, " Right 200, add 800, over." Yes, he's calling for a gross correction of a full 800 meters. This time, next shot, it almost has to be behind the enemy. So, next correction, "Drop 400." If that round shows bits flying up from the explosion, "Target, fire for effect!" At which the artillery opens up with a full battery and pummels the location into submission for the advancing friendly troops.
Okay, that was long-winded and quite outside CPAP lingo and business. I hope, though, that you see my point. Adjusting your pressure by a mere two or three tenths of a wee and stingy cm of H2O is not going to dial in the improvement of delivery that you need...the fall--of-shot where you really need it. So, please consider adjusting two to three cm, not parts of cm, at a time, and doing what the artillery and their forward observers do...'bracket' the target with an initial bold correction and then correct by halves after that.
Make sense?
RE: 4 months on CPAP
The usual expression is "bump"... 
When we see so many central apneas, we usually recommend reducing the EPR. I's suggest reducing by 1 each week, perhaps down to zero.
In addition, I'd suggest changing to APAP mode with a min of 7 and a max of 10. If you start getting some OA events regularly, then bump the min by .4 each week. Or decrease the EPR by 1. The reasoning here is that it is your pressure during exhale is what keeps your throat open; that lowest exhale pressure is your min pressure minus your EPR value.
Your current pressure of 10 is clearly enough to prevent OA; I want to find the lowest pressure that still prevents OA and gives you enough flow to be comfortable. After all, comfort and good sleep is the goal.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps 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.
RE: 4 months on CPAP
thank you both for your replies though you have me a little confused: If I understand that correctly, mesenteria suggested I try upping the pressure and you, pholynyk, suggested lowering EPR and pressure?
I tried lowering the EPR to 2 briefly but it was quite uncomfortable. I might be able to get used to it if it results in better sleep over all, I guess.
RE: 4 months on CPAP
I tried the APAP mode last night, min. 7 and max. 11. AHI at 2,6 is not too bad I guess but still quite some CA and a few H. What gives?
Also set the EPR to 2
RE: 4 months on CPAP
Narol, my message was that bolder corrections are more effective than small ones of the kind you had been trying until I replied. Rather than small increments, with CPAP it is better to add....OR...to subtract...at least two to four cm H2O. If it proves too much, revert by only half the initial correction, which typically gets us really close to the correct value. I didn't actually state that I though YOU should add or raise your pressure setting. Sorry if that was confusing. I think pholynyk might be giving you the correct guidance that pertains to your particular settings.
RE: 4 months on CPAP
fair enough. I read that everything under 5 AHI is fine so I'm not sure there's any need for playing around with the pressure but I'll try different EPR-settings to see if I feel any better. thank you
switch to EPAP, many CA, Oscar attached
hi, last time I posted someone suggested I switch to EPAP. I've done that and I feel like it's worse now but maybe the graphs can give you some insight into what's going wrong.
30yo male, not obese, somewhat healthy, on CPAP since December 2022.
thank you!
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