[CPAP] can't seem to get under 7 AHI

[jasonj]

Hi Folks,

so i have spent the last week playing with my settings, originally the doc had it set to 5-15, EPR 3.


8-15 pressure, EPR 3, this resulted in high teens score. 
10-15, EPR off, couldnt tolerate.
8-15 EPR 2, AHI low teens
9-15 EPR 2, AHI 7ish.
10-11 EPR1, AHI 7ish, plus i find the EPR1 setting slightly uncomfortable.

i am a mouth breather so need the full face. i did try a nasal only mask but no good. just wondering if this is what i have to live with or am i way off with my settings adjustments, any advice would be appreciated, i am kinda flailing about without any real clue what i am doing, though it looks like i have the OA's controlled with the current pressure setting. been using the cpap for 1 week.



   

[G. Szabo]

Try the following settings: 
Pressure min/max: 11/13 cm
EPR=2, full time

[Deborah K.]

Did you have a lot of CAs in your sleep study? If you don't know post a copy of your sleep study so we can see what the story is. If you don't have a copy, ask your doctor's office for one. Hopefully, they will provide one.

[jasonj]

   
so those new settings about doubled my central apnea    . and cheyne stokes for the first time ever. i dont recall my sleep study mentioning central apnea's, but i cant find a copy of it so reaching out to the doc office today to see if i can get a copy.

[Expat31]

Hi, 

Can you go into the events tab (next to details tab) and look at the individual central events with the time stamps, to see if they are often packed quite tightly together? 

This could mean some positional apnea, as not so clear from your flow graph.
. 
.

[G. Szabo]

With this setting, you do not hit the pressure ceiling, and your pressure ride is smothered. Hence, I suggest keeping the current pressure setting while reducing your EPR=1 to mitigate CAs. The software misdiagnoses CSRs most of the time.

[jasonj]

i got a copy of my sleep study, it was a two night study, first night 0 central apnea's and second night there was 2 central apnea's. 192 obstuctive apnea events night 1 and 180 night 2.

would it be fair to say the central apnea's are due to starting out on apap and hopefully will fade away after a few months?

will adjust the EPR tonight, might try it again on 0 instead of 1 and see if i can tolerate it, as ive read EPR can be an issue with central apneas.

[G. Szabo]

i got a copy of my sleep study, it was a two night study, first night 0 central apnea's ...

...  as ive read EPR can be an issue with central apneas.

Indeed, EPR can increase CAs, but if you had practically none in your study, it would eventually disappear.
EPR helps with flow limits and aerophagia. Therefore,  it is better to use it if you can tolerate it.