[CPAP] New User Needing Some Help

[DraftZebra]

Hello. 

Thankful to have found this board since my doc has been no help at all in working out the settings for therapy. I'm using an AirSense 10 with full face mask and have been fighting with inconsistent nights and lousy sleep. The main problem that started a few months ago is that now I'm having problems getting to sleep when wearing the mask. Put it on, hit the hay, try to get comfortable - waste an hour or two - take off the mask after some cussing and snarling a bit. Once the mask is off I'm out like a light. No idea what's going on, but on the nights I can get to sleep with the mask on the sleep apnea is still there. Screen shots attached.

   

[G. Szabo]

You might want to try the following setting to reduce your Hs:
Min/Max pressure 15/20 cm.
EPR=3, full time.

[DraftZebra]

Thank you.

I will give that a try tonight.

[DraftZebra]

Following up from my original post. The 15/20 settings didn't seem to help much and were pretty uncomfortable due to the higher pressure so I backed it off a bit and am considering dialing down the EPR (currently at 3) as see how that affects things. Lowest AHI so far so that's a good thing. I'm considering trying the current settings for awhile and see how things go. Any suggestions welcome.

Last two nights data:

       

[G. Szabo]

Your apneas are clustered, which is an indication of positional apnea. Positional apnea cannot be treated with pressure adjustments. You should not bend your neck forward. You can try a cervical collar. Also, use a thinner pillow. And it's better to sleep on your side. 
As for the pressure adjustments, you are hitting the 18 cm max, so your maximum pressure should be increased.  
You want to reduce the EPR. It is not advised because it helps you tolerate high pressure and reduce your flow limit, which is still high. 

Hence, it would be best if you kept EPR=3.

[Phaleronic]

Hello DraftZebra,

With EPR at 3 (max) you're losing apnea control and since you need higher pressure (99.5 percent pressure is what your max pressure is set to, either 18cm or 20cm), I strongly suggest turning EPR OFF. Your flow limits are spiking because EPR is lagging behind in inspiration pressure delivery and the airway is closing and the FLs are happening.

You are a primary person for bilevel therapy, in the meantime I believe you will feel and breathe easier if you set the machine to cpap mode @ 15cm and use EPR to help you with exhalation pressure relief if you absolutely need it, if you do, turn it up 1 level at a time.

Test this tonight please for 30 minutes to see how it feels.

[DraftZebra]

I'll give that a try. Thank you!