[CPAP] Looking for some guidance, new user trouble passing 1 or 2hr mark at night

[CpapNewbFern]

Hi all,

New cpap user about 3 weeks. Originally had the F20 mask but found it hard to adjust to it, then I got the F30 and I find it super comfortable like I can actually sleep longer with it. However, trying to figure out why I get so many CAs before dosing off. I feel like I am breathing just fine, maybe I subconsciously hold my breath when switching from side to side, mainly a side sleeper. I should say I am a mouth breather probably 10 or more years who knows, but with the F30 I feel like I can breath with my nose fine so I have been forcing myself to nose breath the last few days. That brings me to my next question there at the end around 11:32 there is a weird flow and physically I woke up can't remember much but I think I was feeling air hunger because right after that I took the mask off. Should I just try to go back to mouth breathing? Any suggestions on settings. Let me know if there is more data to screenshot, and thanks in advance.

[SarcasticDave94]

Welcome to Apnea Board,

Typically we start off with an OSCAR chart not zoomed for overall view. No big deal, just add one later.

If the "CA" happened while you're awake, then they can't be defined as Apnea. As you say yourself, holding your breath maybe while moving applies.

How about your sleep study report? Do you have it or not? If no, request the detailed full report from the prescribing doctor. In the US, you request it, you will get it via HIPAA law. No isn't acceptable. If the doctor refuses, report this to your nearby medical board.

You'll want this report in your own personal file. For one, it's part of your medical history. And if needed later but you don't have it, you're not guaranteed to get it. Why? Doctors close offices, retire, die. Then it's possibly not available. This avoids a retest.

Also, you should post this report redacted of personal info on a post here. This gives the background on your therapy needs.

[CpapNewbFern]

Hey Dave,

Attaching full screenshots, not sure if I will be able to attach report I am close to 2MB already and report is 3.2MB already reduced size, not sure what to do. Thanks for the tip on the tests, just saved on my dropbox for my records.

[CpapNewbFern]

Report attached, need to add one more page, I removed page 2 it was just the doc's signature. I had to print each page as jpg because can't attach pdf files.

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Last report page

[CpapNewbFern]

I should add that prescription or rather computerized suggestion was 6-18, ENT doc gave me 6-16, but one day I woke up and was burping air for like 3 to 5min. So, I lowered the pressure, I was going to keep upping one at a time on the max pressure but I never saw any OA or any apneas with 6-9 on OSCAR when I do fall asleep. I did have tons of issues with the F20 mask so maybe the seal was causing higher flow than needed, not sure.

[SarcasticDave94]

OK copy and thanks much.

It doesn't specify CA distinctly, however they're reported. See image 2, which is page 3 of 5. Look at the lower left box, Respiratory Indices. There's an item labeled pAHIc 3% with 26 events and pAHIc 4% with 103 events. This little "c" flags these events as Central. Even so, there's a moderate portion of CA involved.

Admitted, they're not as high as half your overall events to qualify for special therapy like an ASV, but you do need to watch CA events, as this info to me indicates you're sensitive to CA events.

If you cross the bridge where CA hinder your therapy progress, you need to address this with the doctor. Then you may need to consider requesting the ResMed AirCurve 10 VAuto which has a timing trick with the Trigger to help avoid more CA.

But let's not get ahead of ourselves. Use this to be prepared though. Let's see how therapy goes with what you've got.

What you're probably going to need in edits to the current therapy is reduce EPR to 2 to contrast EPR 3 in help to avoid some CA. You might have a bit more flow limits though. Pressure setting otherwise might be OK as is.

[staceyburke]

The  cpap machines are made for everyone, from children to the oldest members.  Usually 8 to 9 would be a normal adult while you are at 6.4.  Your min is to low for an adult, try moving the min up.  I need around 11 not to feel air starved.

[CpapNewbFern]

I should also add the night of the sleep test, was terrible as hell. I didn't get much sleep at all + watch and finger were uncomfortable, around that time I was fighting acid reflux which I didn't know that's what it was at the time but I went ahead and did the test just to see if it would be enough data. I have a good feeling most of the CA are me tossing and turning all night, wondering if I should do another sleep test now that I have reflux under control after visiting a digestive doc.

I will set EPR to 2 and monitor. I can also increase lower pressure a bit, although I don't particularly feel air hunger. But maybe I don't know what air hunger feels. I do know when they gave me the machine with auto ramp starting at 4 it felt awful that's why I turned ramp off.

[CpapNewbFern]

Thanks for the suggestions, will post oscar screenshots next week.

[SarcasticDave94]

An option maybe is to talk with your doctor and ask for the in lab sleep study to get more accurate data.

Almost nobody sleeps well for these sleep studies. Who sleeps with the wire bundle hooked up every night?