First time poster, long time CPAP user with an OSCAR report.

[Afasterme]

Hi all,

I was directed here from the good people at Reddit, I'm so thankful this forum exists!

I've been using a CPAP for about 20 years now, it definitely helped me but since using the CPAP I've always had problems with waking up in the middle of the night.  I attributed it to just waking up to pee, but recently heard that the need to pee is actually caused by sleep apnea.

More recently, I've noticed that I've been waking up and needing to burp.  I decided to do some research which led me here.  I attached a daily report and a screenshot of the OSCAR report and I'm hoping someone can help interpret it and let me know if there's anything I can do to eliminate the waking and burping episodes.

Please let me know if you need any additional details.  Thank you!

[Gideon]

Welcome to the forum,  good to see you here.  

First your numbers are awesome, there is no improving anything there. so we will tackle comfort.

The first is obvious, your pressure is climbing to about 13 which is likely causing your Aerophagia or burping all because of your Flow Limits so we need to tackle them. This also is obviously a cause of your waking.
For this we use PS or Pressure Support or on an AutoSet, EPR.

Set EPR = 2, fulltime.  This should bring down the flow Limits and in turn your aerophagia.
Set Min Pressure = 6.  This is needed to give the EPR room to work. 
Set Max Pressure = 9.  This is an extra measure to reduce your 'high' pressure and reduce your Aerophagia. 

Your BR breaks are tougher.  We need to eliminate the obvious causes of waking and making your night smoother.  You have had apnea for years and you no that most fixes do not occur overnight.

[Afasterme]

Thank you so much! I greatly appreciate your insight and suggestions. I’ll give the settings a try tonight.

Also, I noticed on the OSCAR report that EFR was turned off in July, however this is the first time I’ve ever gone into the clinical settings and I’ve never had anyone check out the CPAP. Could this have been done remotely?

[Gideon]

Yes, By your doctor or dme possibly done remotely

[Afasterme]

Hi bonjour and all.  I wanted to post a follow up from last night.

I ended up adjusting down the starting pressure to 4.0 because 6.0 felt a bit strong; overall the new settings took some getting used to.  I noticed I had a significantly AHI last night, does this mean I should adjust the max pressure higher?

Thanks again!

[Gideon]

Try this
Get a tall glass of water and a straw.
Now just Blow bubbles

Any issues?


didn't think so.

Assuming you actually did it an that the straw was 8 inches into the glass, you just exhaled against the maximum press that the CPAP is capable of, 20 cmw.
I really don't think its the pressure, so the question is what is it. Can you be VERY SPECIFIC about what is bothering you?

A pressure of 6 means that you are inhaling at 6 cmw and exhaling at 4 cmw. you are higher than this for most of the night. How was the aerophagia last night?

[Afasterme]

Think you again, bonjour. It just may be that I need to get used to used to the change in starting pressure, it felt a little like my lungs were expanding more than I was used to. And a couple times as I drifted off to sleep, I jolted awake because it felt like the machine was turning off as I exhaled, I’m not sure if that was because of the EFR setting. Again I just may need to get used to the settings.

All that said, I did not have aerophagia and I didn’t wake mid-sleep like I normally do. I would call that a success! I am wondering if the Max pressure is a bit low, seeing I had several apneic events last night which is more than usual.

Thanks again for your help, bonjour.

[Gideon]

Start dialing back yout ramp, maybe 5 minutes at a time, no hurry.

I cannot handle any pressure under 10, I feel starved for air. Most adults get that feeling with pressures under 6.
Try slowly bumping your min pressure up to 6, we don't need to do it over night.
Once you are comfortable bump EPR up to 1. (assuming it is zero) sometime later bump up to 2. This is to resolve the flow limits that you have. it is important therapeutically.
On raising max pressure over 9, I'd wait a week at least. We apparently have your aerophagia managed.

Your numbers are still very good, you should focus more of how you feel. For example, would you rather continue with the original settings and the serophagia or these without it?

[Afasterme]

Thanks again bonjour. Yes I think I must have rushed into it a bit too zealously.

Certainly I'd rather not wake up in the middle of the night. I'll take it slow and keep you posted, thank you again!