[CPAP] Still snoring with Auto Cpap

[Tahera11979]

Hi all,

I am the spouse of a CPAP user and we have started therapy 5 months back. Initially my dh was prescribed the CPAP Pro but even after going back and forth to the doctor changing the pressure levels he has still been snoring so most recently we swapped to the Auto CPAP. 

The pressure is now set to 6-12 but the snores still persist and we can't seem to be able to interpret the results. I have attached last night's summary. 

I would highly appreciate your advise and suggestions on if we are on the right track as well as reading the results as the doctor has been very unhelpful unfortunetly. 

Thank you very much!

[OpalRose]

Hello Tahera11979,
The 90% pressure is at 12cm for a good portion of the night, along with the snoring and flow limitation, obstructives and hypopneas, these all point to the pressure range needing some adjustment. I don't see much in the way of clear airway events right now, so I would move the minimum pressure to 10cm and the maximum pressure to 15cm for now, and see where that goes.  Also try a flex setting of 2.

The next time you post a screenshot, use the tutorials in my signature line below, and eliminate the pie chart and calendar.  This way, we can see more of the information below the statistics. Also, go into preferences in SleepyHead and get rid of the VS2, these aren't real snores. Leave the VS.

[Tahera11979]

Hi Opal Rose,

Thank you very much for your comment. In regards of the screenshot and VS2, noted. We will post it that way next time.

We will put up the pressure and see if it makes any difference. Is it common to still snore with the CPAP? I keep reading success stories that the snoring has stopped but in our case it has been months and we were struggled with it as there has been no night where there my dh didn't snore.

Does the mask/ leak rate look ok to you? We had a nose mask before but the leakage was very high so we swapped to the full face one.

With the previous machine (We changed it two days ago to the Auto Cpap) we also had a squiring sound whenever the filters were in, do you have any experience with this and wether this is normal? I am a very light sleeper and it has been very difficult for me to get rest in the last months hence I am very grateful for all your comments.

[OpalRose]

Snoring normally indicates that the pressure is too low. The same holds true with high
Flow Limation readings and Rera's.

Give it a few days once you adjust pressure. If you start to see more clear airway events, then we can take another look.

I can't see your leak rate, as it is cut off under the stats. section. You can look at it and let us know what the readings say.

I don't use the DreamStation, but have not had that issue with filters and noise on my machine.
I'm sure others will chime in and be able to offer additional advice.

[Tahera11979]

I really hope that putting up the pressure and flex to 2 will help. I will definitely keep you posted on this.

I have attached the leak rate below.

Let me know if you think there is anything else we could do at this stage.

Thank you for your support.

Leak RateRate of detected mask leakage (L/min)
W-Avg: 1.97
0.00 Min
1.00 Med
6.00 95%
13.00 Max
Total LeaksDetected mask leakage including natural Mask leakages (L/min)
W-Avg: 35.31
20.00 Min
36.00 Med
41.00 95%
48.00 Max

[Sleeprider]

Leak data looks okay. I just want to offer a second to pretty much everything OpalRose has suggested here. Everything point to continuing obstruction and your maximum pressure is insufficient to overcome it. One addition is that this kind of airway obstruction is often relieved by using a soft cervical collar to keep you from flexing your neck (dropping chin to chest). A good airway position is important for those that have obstructive events, even with CPAP pressure. OpalRose is a user of this approach as are many others. You can test this for yourself. While sitting comfortably change let your head drop forward. Notice any change in airway resistance?

[OpalRose]

Leak rates look good.  The Phillips Respironics machines report "total" leak rates.

Here is some information on leak rates from the Beginners Guide to SleepyHead..

http://www.apneaboard.com/wiki/index.php...Head#Leaks

[Tahera11979]

Thank you very much for the replies.

The cervical collar suggestion is a good one as my dh head does tilt when sleeping.

Furthermore, I have read about CPAP friendly pillows that hold the hose in place. Does anyone of you have experience with it and would recommend it?

In term of the pressure we will try the proposed but in case he still snores would we put it up more after a week or so?

[Sleeprider]

Snores are an indication of obstruction, usually caused by impingement of tissues in the pharynx. In auto CPAP snoring will cause pressure to rise automatically unless you limit it by setting a maximum pressure. some people snore and don't have more severe obstructive events like hypopnea or OA. In those cases the maximum pressure needs to be limited because higher pressure is not really needed. If you really want to see if snoring can be extinguished, set the maximum pressure to 20. If that causes problems like air ingestion, discomfort, sleep disruption or central apnea, then a limit is needed, and you just live with the snores. IMO use of a soft cervical collar with a therapeutic level of CPAP should alleviate most snoring; there are exceptions.

[Tahera11979]

Thank you Sleeprider. I sincerely hope that increasing the pressure will help but we need to watch and see. A cervical collar is certainly an option. We will try to increase the upper pressure for a few days and see if it makes any difference. How many days do you suggest to try it for in order to see if it has any impact?