[CPAP] Just started

[Internetstranger]

So I was diagnosed a week ago with severe sleep apnea. Doc seemed mostly concerned about oxygen levels dropping very low in REM sleep and taking a while to come back up. He’s referred me to the hospital for a further sleep study to get the pressures right but meanwhile started APAP with resmed 10. (He marked referral urgent but who knows how long it will take, it’s been a week and I haven’t heard anything yet).

I had to purchase it myself so am reluctant (and a bit broke lol) to buy an oximeter that records overnight to check levels but am feeling fantastic. Absolutely life changing! Yeah I have some highly mask leaks I’m dealing with but I haven’t had a single involuntary nap since I started and according to the machine my ahi has been between 2-6 each night (last night at 5.9 was the only night over 4).

So question…..is it safe to assume, for now, based on how I’m feeling that my overnight oxygen levels are being corrected with treatment?
    oxygen levels from sleep study
    ahi info from study
    graphs from study

[gainerfull]

Glad to hear you're feeling better! Unfortunately, it's hard to be able to tell what your sp02 is doing overnight without measuring it especially considering your AHI is still relatively high on CPAP. Would you mind sharing a couple of nights of your OSCAR data with us so we can make some recommendation for further improvement?

It's likely that you're still experiencing desaturations but they are not as frequent or severe. Have you looked at the Wellue O2 ring? $150 on Amazon and pretty great. With significant and prolonged desats to the 70's you're risking your brain health.

As an aside, your hypnogram looks a lot like mine so to save you some time & frustration, I've found the best results by using a soft cervical collar and a bunch of pressure support on a bilevel. I'm currently getting great results at 16/9 w/ PS 7 w/ a Resmed Aircurve 10 VAUTO.

[BoxcarPete]

Holy mackerel! I can't believe that result. As soon as they saw you drop to 70 they should have woken you up with a CPAP machine in their hand and said, "put this mask on your face, we're going to start titrating your pressures while you're here" and then you'd have some info on how your O2 levels are doing on CPAP. That's what they did with my father, he was only asleep for like an hour or two and they started him on CPAP in the middle of the night. You dropped below 70 before 2 am, they should for sure have done this for you.

Glad to hear you are doing well and it's life changing so far! Without an O2 sensor on you, nobody can say for sure, but it's likely that you are much improved. Post some OSCAR charts and some of the helpful members here can chip in with feedback and recommendations on fine tuning your settings.

[Internetstranger]

I was wired up at the office then home to sleep which is why I wasn’t woken. At the moment a home sleep study was a much faster option. Clearly those results went with an urgent referral to the hospital for sleep study to sort pressures a week ago and I’m still waiting to hear back. It will be covered by public health but at the moment I’m not sure of the waiting period..,they triage but others may be more urgent.

This is last nights Oscar charts. I thought I had the leaks in hand as neither myself or my partner was aware of any through the night but awoke to water gurgling in my heated tubing. Still trying to figure out how to dry it and prevent it from happening again

[Internetstranger]

   

[Gideon]

Welcome to the forum. Thanks for posting here. I was helping you on Reddit.

Without question your therapy is helping you. What we cannot tell is how much.

Your starting point was extremely bad based on your sleep study.

Are you paying for the additional sleep study, what is your cost share? With an Oximeter the additional sleep study I believe could be eliminated. IMHO the purpose of your second sleep study is to see what it takes to get your oxygen levels to normal. This my push, and others here, to get a recording oximeter.

Your OSCAR charts show very significant restriction in your breathing. Look at the FL chart and 95% stat which is 0.25. While there is no medical standard we consider a value of 0.10 to be bad.

To fix this set your EPR=3.

Additionally your events are somewhat clustered together meaning you could be experiencing a form of positional apnea we refer to as chin tucking. For now look at your pillows. Use one instead of two, or less firm or flatter. As a test Tuck your chin to your chest. I suspect you will have an increased difficulty breathing.

Your leaks are likely a combination of a mask leaks, the spikey tops on the leak chart. Flatter/ smooth tops indicate mouth breathing.

You should also consider an increase in your min pressure but I want to see what the EPR does first. Why wait ? Because flow limits are the main driver increasing your pressure and an EPR increase should significantly reduce your flow limits.

[gainerfull]

I'd recommend setting your climate controls to auto unless you're experiencing a dry, irritated nose on CPAP. That should keep the gurgling to a minimum - if it continues to gurgle then you can go back to manual and try a lower setting or buy a hose cover.

Also, you'll want to increase your minimum pressure to 7cmH20 so you can take advantage of EPR 3 full-time.

[Internetstranger]

Whilst the at home one cost me $250 (plus out of pocket fees for doc) the hospital one is free as it’s a public hospital, the downside is the wait time.

I read somewhere the wellue ring requires additional paid subscription to access the data too which put me off, as well as the fact that having purchased the resmed10 money is now a little tight. I do feel so much better since I got it but have to fix the water in pipe issue or no one will be sleeping!

I’ve just set the epr to 3 - that decreases the pressure when breathing out is that correct? Will let you know in 24hrs or so how that went. Thanks

[gainerfull]

Whilst the at home one cost me $250 (plus out of pocket fees for doc) the hospital one is free as it’s a public hospital, the downside is the wait time.

I read somewhere the wellue ring requires additional paid subscription to access the data too which put me off, as well as the fact that having purchased the resmed10 money is now a little tight. I do feel so much better since I got it but have to fix the water in pipe issue or no one will be sleeping!

I’ve just set the epr to 3 - that decreases the pressure when breathing out is that correct? Will let you know in 24hrs or so how that went. Thanks

Yes, EPR is expiratory pressure relief and will lower the pressure by 3cmH20 upon exhale.

There's no additional cost associated with accessing the Wellue O2 ring data. I just air drop it from my phone to my macbook then import it into OSCAR as needed.

[Gideon]

There are several oximeters that OSCAR can read, just be sure to get one of them.