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I've been on cpap therapy for nearly two yrs. Its been unsuccessful. Dr has had me on the Dream station 2 which died. I am now on the AirSense 10. I'm attaching a screen shot of a typical night of my therapy on the AirSense 10. I'm at a loss on what to do and I am hoping I can get some help and guidance here. My dr just gave me the new machine and there has been no follow up or support. A friend suggested that I join this forum because of all the knowledge and support provided here.
Your AHI is comprised of mostly Clear Airway events. Did your sleep study show mostly CA events? You may need a different kind of pap machine. I hope some of the people who know the most about such matters will reply soon with good advice for you. The Apnea Board Monitors are your best source of information, but some others can help you too. Good luck!
First, your use of a ramp time of 30 mins at a pressure of 6. Do you need ramp at all? If you can go without it that may be best. Your CA’s start when ramp takes you up to therapy pressure, so if you can turn off ramp it should be less of a shock to your body.More EPR should help with the pressure swings by reducing flow limitations.
Next, the clustering of CA’s looks a lot like chin-tucking. Not deep enough to cause the typical positional apnea OA’s one would see, but just enough to cause the CA’s. Using a soft cervical collar should stop chin-tucking. Even though you don’t have a lot of flow limitations, you have enough to drive up the pressure, which causes a series of CA’s in response. Wash, rinse, repeat.
Finally, you have response set to soft, but I’ve never used it so cannot comment. I assume you started with standard and switched for a good reason.
Otherwise your numbers look good, but you also have what looks like rapid breathing at times (99.5% resp rate at 32.2), but we’ll need someone more experienced to comment on that. It’s probably related to the clusters of CA’s, but worth keeping an eye on.
I suggest setting your min to 7, max to 15, EPR 3 full-time, no ramp. A good baseline to begin. If you are open to it, get a soft cervical collar to see if it helps. Will be interesting to see what others see and suggestions offered. Report back when you give it a few days. Hopefully will help point things in the right direction. As Deborah K. said, you may eventually need a bilevel to get more pressure support and finer tuning of parameters, but there are a lot of things to try first.
