[CPAP] New to cpap, lost and confused

[Sophia]

Hello, I've been on cpap for about 6 weeks and would love some advice re cpap settings. My machine did not come with an sd card from the DME, so all of my information has come through Internet searches. It's day 1 of downloading Oscar stats and finding this forum. Thank You!

Good news - I've stopped snoring like a neanderthal (23andme claims I am more neanderthal than most), and have stopped having daily headaches. As a habitual mouth breather at night, I was pleasantly surprised that I had way more issues initially using a full face mask, enjoying the freedom of a nasal mask

Questions - 
Any initial observations?
Is it weird that my pressure range stays low a couple of hours after I fall asleep?
Can I start at a higher pressure than 5?
Why doesn't my machine go up to the highest pressure level during the night?
What does my CA score of 0.69 hours mean? (I was not dx w central apnea)

Thanks in advance, Sophia

       

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[SarcasticDave94]

Welcome to Apnea Board,

I suppose you've gotten an SD card for the CPAP, as you're able to post OSCAR. In case you'd like the info about the SD card requirement for the ResMed, standard form factor, 2-32 GB capacity, and formatted to FAT32, any brand.

You can set pressure on the CPAP yourself without issues. I would suggest increasing Min pressure to 7 for now. This opens up EPR 3 to work fully. Right now, starting at 5 means you need to wait for events to cause a pressure increase to 7 before EPR 3 drops to 4. EPR means Exhale Pressure Relief, dropping off Min pressure by the setting number. Both pressure and EPR are cmH2O values.

Min pressure 5 EPR 1 drops to 4
Min pressure 6 EPR 2 drops to 4
Min pressure 7 EPR 3 drops to 4

4 is the lowest physical pressure this CPAP machine will go.

CA is clear airway or Central Apnea, referring to a breath pause or cessation for at least 10 seconds, without an airway restriction like in Obstructive based Apnea. Most people have a few CA, but since you're seeing Oscar, you are aware of them. The CPAP therapy may increase CA for a short time, it's due to the fact your CO2 exhalation is more efficient than without. Lower CO2 means delays in the next breath signal.

On the staying low pressure, I think it could be considered normal with your data. Flow Limits seemingly low, which is a key data point for driving higher pressure.

[Deborah K.]

Sophia

Your therapy and comfort will improve if you change your lower-pressure setting to 7 instead of 5.  This is more comfortable for most adults and will allow your pressure relief setting (EPR) to work properly.

You don't go to your upper-pressure setting unless your body needs that much pressure.  At least for now, you don't need it.  Since you did not have CAs in your sleep study the ones you presently have are treatment-emergent and will lessen or go away as time passes.  You are still adjusting to pap use, and the CAs are normal during your adjustment period.

OOPS! I see that Dave and I were writing at the same time.

[Sophia]

Thanks for both replies and for helping all of this feel a little more normal. That explanation of pressure & EPR is helpful with so many new acronyms and Oscar data, and it's good for me to have a little focus. I looked at the cpap settings for the first time, not actually realizing I could change them. 

Lower pressure now set at 7.

Going to sleep is such an adventure. Thank you!

[SarcasticDave94]

You're welcome and best to your success.