[CPAP] xirokx - Therapy Thread

[G. Szabo]

how does a cluster of CAs indicate positional apnea? 

If CAs are clustered, they are probably misdiagnosed as OAs. Because of the temporary CO2 imbalance, one can also observe CAs immediately following RAs.

[xirokx]

You still have clustered CAs indicating positional apnea. It would be best if you worked on your position.
The decreased EPR from 3 to 2 did not improve your CAs. You can try the EPR OFF setting to be sure that the EPR cannot resolve the issue. A different instrument can. 

Your latest result still supports a minimum pressure setting of 10 cm, but you should change one parameter at a time.  

Can I double check what's the correct position for me to be? Flat on my back?

Ok I set the EPR to OFF and then report back in couple of days. 

I will not change the minimum pressure yet.

Or would you recommend changing the minimum pressure now from 8.6 to 10cm and then see how that goes then switching the EPR off?

Please clarify 

Thanks for your help

Really appreciate it

[G. Szabo]

You should not chage your minimum pressure yet to see the effect of EPR on your figures.

[G. Szabo]

Can I double check what's the correct position for me to be? Flat on my back?

The best thing would be to sleep on your side with a pillow that keeps your neck straight. However, if you turn to your back, the previously described pillow will be deemed too thick for back sleeping. Hence, if you cannot guarantee side sleeping, use a thin pillow that does not bend your neck forward. A cervical collar can also be beneficial.

[xirokx]

The best thing would be to sleep on your side with a pillow that keeps your neck straight. However, if you turn to your back, the previously described pillow will be deemed too thick for back sleeping. Hence, if you cannot guarantee side sleeping, use a thin pillow that does not bend your neck forward. A cervical collar can also be beneficial.

Thanks for this..

I used a wedged pillow and start off sleeping on my back and then move side to side. I am a messy sleeper.

Not sure how to work through that habit of a lifetime

Any thoughts?

[G. Szabo]

https://www.apneaboard.com/forums/Thread...#pid504275
https://www.apneaboard.com/forums/Thread...#pid511291

[xirokx]

Thank you very much 

I have attached data from last night, I felt like the amount of air coming through the hose was too much in volume and as a result I had bad dry mouth twice that I woke up and drank some water.

I have also attached data from 27th Aug when my CAs were lower but I did have some rainout issues then. Just to compare and contrast to my values last night.

It would be appreciated to have your feedback. 

Thanks

[G. Szabo]

Let's first compare the reports where only one parameter was changed:
You had EPR=2 and pressure 8.6/12 on Sept 7, 8, and 9. These days, you had CAs about 5-6.
On September 7, 8, and 9, you had EPR=0 and pressure 8.6/12. This day, you had CA ~2.
Hence, one might suggest that EPR increased your CAs. However, it is striking that CAs about 5-6 cases emerged because of the high number of CA clusters, while CA~ 2 had no or minor clusters. Therefore, the alternative suggestion is that clustering is the problem and not the EPR.

Now, you also attached Aug 27 with EPR=3 and pressure 7/12. This day, you had CA lower than 1, with no clustering whatsoever.

Therfore, the reasonable conclusion is that your CA is not an EPR issue.

Therefore, I suggest returning EPR = 3 and increasing the minimum pressure to 9. Most importantly, monitor your sleeping position and correlate it with your CAs. The high EPR might mitigate your complaints about the high volume feeling, too.

[xirokx]

Thank you appreciate the analysis between the 2 screenshots and your explanation.

Ok I will give EPR 3 a go but regarding minimum pressure I believe previously we said we would try 10, or do you want to increase in small increments hence going for min pressure at 9?

Also I didn't feel the large air volume at EPR 2 , just saying so do you think we can go back to that instead of EPR3?

Also, when I sleep on my side my mask easily becomes dislodged and I get leaks etc but when I sleep on my back it's less chance of mask becoming loosened. 

I start of sleeping on my back and then often move to my side...I will try starting and staying asleep on my side instead but cannot keep my neck straight without those devices you posted especially as I use a wedged pillow.

Thank you I'm so grateful for your help , it's most appreciated.

[G. Szabo]

do you want to increase in small increments hence going for min pressure at 9?

Yes, do it slowly. 
You can try EPR 2, but the 3 would give you more benefits, especially under increased pressure.