[CPAP] Help needed to update settings

[SteveC]

Hi all,

I have been using a Resmed S9 for about 11 years, sometimes with high AHI and sometimes low. I can't figure out why and to be honest, a couple of different doctors have been unable to as well.

After an overnight sleep study a few years back I was told as my readings were borderline I had a choice of using my Resmed S9 or not, due to the hassles I chose not.

A recent stint in hospital showed very high AHI readings, but once out of hospital the AHI started to come down. My doctor said a high reading every few days is OK.

I have a beard and am using a Resmed Airfit N30I nasal mask, after trying several masks this is the best. My beard is not very full, but does appear to cause excessive leaks with most masks. 

I do have troubles with a dry mouth, it appears I am a mouth breather. I have tried a chin strap, it helps a bit but I still wake up with a dry mouth in the middle of the night.

I wake up feeeling tired in the morning, but that feeling often goes durnig the day. In my country, Austalia, once I turn 75 in a few years time I have to get re-certified as a driver, and part of that process is ensuring the sleep apnea is under control, so I need to try and sort this out soon.  
       

[Crimson Nape]

Since most of your events are CA in nature, I would try setting the minimum and maximum pressure to 7 cm.  This may not be a cure all with the CPAP model you have, but it may reduce any pressure induced events.  It shouldn't take long to see if this is producing any positive results.

Also, you say this comes and goes. Are you taking any medications when these occur?

I forgot to tell you that you need to select the "Insert into post" after importing the images into a post. I edited your post to correct this for you.

- Red

[SteveC]

Hi Crimson,

I am on medication, both for high blood pressure and from last week due to PE blood thinners.

I am actually going to Resmed tomorrow for them to look at my results and make an assessment, in the past they charged for this but apparently now it is free of charge.

If I set min and max to the same, is that not the same as using CPAP?

I made a slight adjustment with my mask last night and the machine showed a leak of 30 and AHI 10.18. Although, looking at the leak chart, it shows a low leak for most of the night, but a high leak on occasion. I guess that maybe when I went to the bathroom and the high leak rate is an average. 

I have only just started using Oscar, a bit of a learning curve to understand it. Oscar shows two sessions, for some nights, but one for others. I'll have to see wahy that is. 

Re insert, I thought I had done that.


Regards,
Steve

[SteveC]

        Hi,

The clinician at Resmed changed some settings, set the machine to CPAP with a pressure of 10.2 with a ramp. EPR full time at 3. I set that, not the clinician.
Last night's AHI was CA 16.2 with a generally low leak rate. This is still high.
The clinician said if it does not come down to go back to them in a week.
I do feel more refreshed than usual this morning though.

Suggestions?

Regards,
Steve

[quiescence at last]

yeah, well. it's not going to go down in a week, besides down onto the floor and across the room.  that many CAs is wonderous.  seen alot of traffic about this on the forum.  the clinician set the pressure at 10.2, but also turned on the EPR, and set it to 3.  Absolutely the worst situation, the higher the EPR the worse the CAs usually are.

The suggestion Crimson Nape shared is what I would initially do, and we usually leave the auto titrating on, because it will show you flow limitations info.  If you want, set the min at 7, set the max at 7.4 and the EPR OFF. That should really reduce the CAs.

QAL

[SteveC]

Hi, 

It was myself that turned on the EPR. I will turn it off tonight and reset to auto instead of cpap.

Crimson suggested set to min 7 and max 7, wouldn't that be the same as CPAP set to 7?

Regards,
Steve

[Crimson Nape]

Setting some models to the CPAP mode will disable the reporting of certain parameters. Instead of trying to keep up with which do and which don't, it is easier to leave it in Auto mode and set the min and max to the same pressure.

- Red

[OpalRose]

The reason for the suggestion to set 7 min - 7 max on Auto mode is to be able to see flow limitations, which aren't reported in Cpap mode on your S9.

[Gideon]

EPR=3 made little to no difference so leave it for now.
So Set a single, low pressure to attempt to avoid centrals. Min=Max=7 is good. Pressure fluctuations and higher pressures can cause centrals.

When did the centrals start, do you know? Do you have copies of your sleep tests? Can you post them.

Take a screenshot of your Overview page and your summary page to see if they indicate when you started having issues,

Also because EPR=3 did not result in a significant increase post a 20 minute zoomed image of the CA clusters. Let's see what that tells us.

Guys, I'm going out of town tomorrow so please cover me on responses here.

[SteveC]

I'm confused.

Someone said leave EPR on, another said of!