[CPAP] anthonydf - Therapy Thread

[anthonydf]

Just started using APAP about a week ago but this should have been one of my best nights yet considering the super low AHI yet tracking my sleep on apple watch it was actually a super restless night and got hardly any deep sleep, as well as feeling like a zombie upon waking. Even worse then normal so maybe APAP just isnt for me considering I have UARS? If anybody had some advice that would be great.
(3-4 was awake)

[SarcasticDave94]

Welcome to AB,

A few things I'm seeing is first pressure settings can be made better by an edit. You have occasional leaks that will probably be disruptive. Flow limits are at .23, again can take away from the effectiveness of the therapy. And you have many fragments of sleep therapy.

I think a setting edit will make a big difference. Let's review the math for a moment. You're attempting to use EPR at 3, but starting pressure was 4. You're not getting EPR 3 until pressure passed 7 automatically. EPR reduces pressure by the number settings, and in ResMed this is the same cmH2O measurement as your therapy pressure. And your machine cannot go below 4 anyway. Sorry for the long explanation, but I want you to understand why I say you need to move min pressure up.

If you want EPR 3, your min must be 7.
If EPR 2, then min must be 6.
If EPR 1, then min must be 5.
If not, EPR doesn't work to its full potential in relieving pressure.

I would keep EPR 3 and change Min 4 to 7. BTW 4 is likely too low for an adult to start out as well. Lots of people report air starved at 4.

And if I have it correct, EPR helps with flow limits due to pressure differential and making your CPAP act like a bilevel BPAP. Last thing, top treatment for UARS is CPAP.

[PeaceLoveAndPizza]

Agree with Dave that your mouth leaks and flow limitations are impacting sleep quality. To see how things line up set the scale on your flow limit graph via the override switch to a max of 0.50. You will see how many events line up with mouth leaks and flow limitations.

All the spiky things are likely arousals/RERAs, which impact sleep quality. Some could be from tossing and turning, but most are likely from you just getting used to using CPAP. It usually takes weeks to a few months for you to get used to it, so give yourself some time. Do not be surprised if you start having events flagged as centrals, but most will likely be treatment emergent central sleep apneas (TECSA). If they do crop up most will go away over time.

Consider setting your min to 9, leave max at 15, and EPR at 3. That should have smooth things out a bit. Avoid making too many changes over successive nights and not giving things a chance to settle in.

Give it a few nights and post an update.

[anthonydf]

Hey Guys, thanks for the responses very much appreciated. A couple things my profile is showing wrong pressure settings as i’m not sure how to change I do have it set as min8-max15 epr 3 you can see it in the left hand side of the attachment. and as far as mouth leaks I started mouth taping. So I guess pressures at where it should be I’ll jus need to get used to it. Kinda frustrating how it’s making my sleep worse but all part of the process i guess.

[PeaceLoveAndPizza]

You can change your info in the “User CP” screens. Click on “User CP” (upper right), then “Edit Profile” (on middle left), then update your info.

Your median is at 8.70, so you can simply stay at 8-15 or try 9-15. Your therapy, your choice. I tend to like things a bit higher as I get easily disturbed from frequent pressure changes. Everyone is different so try things out as you get used to it.

With CPAP there is rarely any pixie dust or magical incantations. It takes time to adjust, so patience is essential.

[SarcasticDave94]

The info about pressure settings I'd mentioned were by looking at your profile, so I was incorrect on that starting at 4. Your other thread has a similar setting discussion to what PeaceLoveAndPizza suggests.

[anthonydf]

Just changed it thanks for that! and yea i’m gonna take a small break for a few nights to see if I can somewhat catch up on sleep bc past nights with machine have been pretty awful but for the most part I’ll keep settings as is and continue to wear throughout day for help getting used too it as someone else suggested and see how it goes from there. Thanks to everyone again.

[SarcasticDave94]

Welcome.

You're free to do that, however I've tried similar on then off therapy years ago, and it tends to undo the process of getting used to CPAP. Getting acclimated during the day will benefit.

My biggest hurdle was the right mask, right size, right adjustment. Benefits of getting that right is low leak rates and higher comfort. How many of us were born with an octopus suctioned onto our face, and attached to a blower with the 6 foot umbilical cord? It's going to feel odd.

[anthonydf]

Attached is data from a nap I just took. All those little spikes in my breathing was from me changing position and normally my nights look similar too this.  I noticed the leak rate would go up a bit before I would wind up waking (slightly) n changing position ending in disturbing my sleep. Am wondering if that has anything to do with mouth breathing? Using APAP I mouth tape because air starts leaking out of mouth later throughout night (entering REM? not sure) if I don't.

[Crimson Nape]

anthonydf - Since your previous 3 threads deal with your therapy, I have merged them into one. I renamed it, "anthonydf - Therapy Thread". Please use this thread for all your therapy related posts.

- Red