CPAP journey start - please help (thread)

[Negligee1136]

My S10 Autoset is coming shortly by mail, and would like to use this thread to optimize the treatment and get the best out of it. And would like to stick to this thread to keep the journey in this thread. 

Starting from the sleep test, this is it attached while I wait for the CPAP. What do you think about these sleep tests results? (attached). These were not enough for the sleep specialist to diagnose OSA or UARS, but to be honest I disagree with that quite a bit.

Note that I used a wedge pillow during the test which I did observe helps somewhat (but not a lot). 

Thanks to everyone that will reply! OSCAR data next week...

[Sleeprider]

Mild OSA with predominately hypopnea events, and mainly in the supine position, The clustering of events suggests some cervical positional apnea may be present (chin-tucking). Start therapy with minimum pressure 7.0, maximum pressure 10.0 and EPR on full-time at setting 3. This will provide relatively low starting pressure of 7.0/4.0 (inhale/exhale), and the pressure support or EPR will treat flow limitation and hypopnea more effectively than constant CPAP pressure. Lose the wedge and avoid any pillows that cause your chin to tuck or sag into your chest which obstructs the airway.

[Negligee1136]

Mild OSA with predominately hypopnea events, and mainly in the supine position, The clustering of events suggests some cervical positional apnea may be present (chin-tucking).  Start therapy with minimum pressure 7.0, maximum pressure 10.0 and EPR on full-time at setting 3. This will provide relatively low starting pressure of 7.0/4.0 (inhale/exhale), and the pressure support or EPR will treat flow limitation and hypopnea more effectively than constant CPAP pressure.  Lose the wedge and avoid any pillows that cause your chin to tuck or sag into your chest which obstructs the airway.

Thank you! So maybe soft cervical collar or some cervical support pillow for the win here?

[Sleeprider]

I would hold off on any aids for now and watch for the data to show a need for anything. I use a medium fill down pillow which offers just enough loft, and is flexible enough to be pulled between my shoulder and jaw when laying on my side. Some people need the aids, while others do fine with just the pressure and avoiding excessive pillows.

[Negligee1136]

Over the last few weeks, been experimenting with masks and trying to get it to work. I had some initial problems with masks so that I didn't upload any data - no point anyway as the nights were that bad in terms of sleeping through it.

I started with a full face Vitera - not great. I understand why it's not recommended to start FFM. Leaks everywhere and woke up with bad nose bridge sores. Even had strong headaches (not the sleep apnea kind, it was different; maybe the CO2 rebreathing kind?). Ditched that, however noted that I could sleep a whole night with that on and did woke up with more energy, only problems were sores and headaches.

I eventually set on the Airfit P10 nasal pillows. Comfort is amazing. However I seem to take it off during the night. Anyone can help me read the data for any flags here? I think data looks fine except that this mask clearly comes off over the course of the night. Today woke up at like 4am and it was already almost off and I took it off and continued to sleep. The data below is with the P10

I have also a Eson 2 from F&P - usually with F&P my mask stays on the whole night so think I will try that next night, tonight, and see if I can make it through to 8am.

[Sleeprider]

I agree the therapy looks very good. I have used the P10 for years and while I don't take it off at night, it will often slip to where it will detach from my face. I have not personally done anything about this beyond spreading the straps so the lower one is low on my head, but the solution has to be to find how to secure the mask so it simply does not slip off. Other members have come up with various solutions for this, and maybe revive this thread if you can't find a solution there that works http://www.apneaboard.com/forums/Thread-...-Fine-Hair . A couple ideas from that thread include attaching a piece of Velcro (the hook side) on the top of the lower strap to keep it from sliding over your hair. A dew rage, hair net or soft cap. Take a look at the thread and post your question there to solicit more ideas.

[Negligee1136]

Update on this old thread.

It went terribly. The CPAP therapy "looks good" but I still feel terrible; even worse.

AHI at this point was below 1 so really something about more complex breathing events here.

Strongly suspecting UARS. About to pull the trigger on a ResMed S10 AirCurve ASV.

I have read threads that I do not need an ASV (BIPAP would be enough). However, I have also read that for some ASV is later discovered to be needed. I would therefore plan to buy an ASV, turn off the ASV portion (use it like a BIPAP) and see if it works well for therapy in BIPAP mode; then, if a need becomes evident for ASV later on, at least that's there to turn on again.


Any advice?

[Crimson Nape]

Have you tried experimenting with using the Positive End-Expiratory Pressure (PEEP) theory? If you are unfamiliar with this, here is a link to a more detailed explanation.

https://www.ncbi.nlm.nih.gov/books/NBK441904/

Short description: Elevate the EPAP pressure (IPAP too) to force the patient to expel more CO₂ due to a stronger exhale response.

-- Red

[Negligee1136]

So like turning down EPR basically?

[Negligee1136]

Posting some SleepHQ share links to dig further. Can any kind soul here help out looking at these flow rates? I see lots of weird that I don't know what it is and I guess responsible for me feeling bad

https://sleephq.com/public/8a92b82d-6a51...b77a72bae8

https://sleephq.com/public/ac10fcf6-e0fb...fbed36e03e

https://sleephq.com/public/ac10fcf6-e0fb...fbed36e03e