CPAP Battle - Chart Attached

[mattw2019]

I have been battling with my pap machines ever since my diagnosis several years ago.  I started out with CPAP then BiPAP and have been experimenting with apap settings.

Even on nights with good AHI numbers, I always wake up feeling worse than without treatment.  

Attached is my most recent chart.  For some reason, I cannot get the Flow Limit graph to appear.

Thanks in advance for any help.

   

[Gideon]

There is no flow limit chart for PR machines.  Look for FL and RERA in the events chart.  The best way to find FL for PR machines is to look at a 2 min view and see them on the Flow Rate chart.

Drop your min PS to 3 to see if that helps your Central Apneas.  Could go lower and even to a fixed PS (Min PS = Max PS)

[mattw2019]

Thanks for the suggestions.  I will give it a go tonight.

[mattw2019]

Attached are charts from the past few nights.

Still struggling to keep the mask on for more than 4 hours but working on it every night.

I lowered the pressure to 4 because the machine wouldn't go to 3.  

Lowering the EPAP appears to have curbed the centrals but not sure if I have enough time on the machine to be statistically significant.

           

[Sleeprider]

The last advise from Bonjour was to lower your pressure support to 3.0. You are currently using a range of 4.0 to 8.0 pressure support and this more than anything else will increase central apnea. I don't think your problem is EPAP pressure but PS, and there is no association of EPAP with your AHI, but when pressure support increases, so does your CA. Please try EPAP min 5.0, PS min 3.0 PS max 3.0 IPAP max 12.0.

[OpalRose]

Drop your min PS to 3 to see if that helps your Central Apneas.  Could go lower and even to a fixed PS (Min PS = Max PS)

I think what bonjour is saying is to use the Pressure Support to a fixed mode.
Set it to Minimum PS 3 and Maximum PS 3.

While your at it, turn off the VS2 setting. They aren’t really snores and just clutters the graph. Leave the VS setting in place.

[mattw2019]

Gotcha.  Thanks.

[mattw2019]

Made the adjustments and had one of the most comfortable nights ever wearing the mask.  

Clear airway events were reduced significantly.  

Any recommended tweaks or should I give it more time?

Thanks.

   

[Sleeprider]

You are having clusters of obstructive apnea and this suggests a need for either the soft cervical collar or higher EPAP. Now that we have cleared the CA events we can start to work on the rest of it. Increase EPAP by 1-cm per night until the OA is resolved. For tonight you are looking at EPAP min 6.0, PS min and max at 3 and max IPAP at 12.

[mattw2019]

Thanks.  I didn't see your adjustment advice until this morning so I slept with the old setting.  Second night in a row that I slept comfortably. 

Not sure if there is useful information in this chart but if I read it right the IPAP stayed at maximum much of the night.

Report attached.