Clear Airway Events

[Brucpap]

Hi Everyone,

I have moderate sleep apnea and always wake up fatigued and unrested. My concentration is poor and it's hard to think at times because I am so exhausted.

I've been on CPAP for about 30 days and even sleeping 7-8 hours with it, I still wake up feeling super tired & fatigued. My doctor said CPAP is working and I showed no central sleep apnea during my sleep study, only obstructive. I see these clear airway events, does that mean I might have central sleep apnea?

ResMes Airsense 10
- CPAP 8
- EPR 3
- Pressure relief on
- No Ramp
- Mouth taped shut
- Humidty/heated line on

What machine adjustments should I make to help me feel more rested?

[Sleeprider]

It would really help to see the full night, but based on what I see here, you should be in Autoset mode not fixed pressure CPAP. This would address the obstructive element of your sleep disordered breathing. Without seeing the full night, it's hard to say if there is any positional element to this, and using a variable pressure would help us to see if there is a relationship to pressure and events. Try minimum 8.0, maximum 12.0, EPR 3 and let's see where that puts you. It may increase centrals, but no way to know without seeing it. Leaks appear chronically high, so I suspect that might be an issue.

[Brucpap]

Thanks for your input, I will try that tonight.

Last night was not great, the mask was on and off a few times and the machine may have been running while it was off my face for some reason.

Thursday (below) IIRC my mask was on for the full duration. Maybe this will paint a better picture, I had it set at CPAP 8.8 (EPR 3/Pressure relief off) this night.

[Sleeprider]

I think the variable pressure may help. I guess we will know tomorrow. Please minimize the monthly calendar.

[Brucpap]

Please see below. Correction, I actually had EPR off on Thursday to see if that made me feel better.

[Brucpap]

Here's another screen shot from Tuesday.

I tried 9.8 this night, on paper everything looks good but felt like crap when I woke up. My events are mostly all CA.

- 12 CA
- 1 H
- 3 OA

[Sleeprider]

Your last chart at 9.8 fixed pressure with EPR 3 looks better than without EPR and fixed pressure at 8.8. I'd like you to try these settings:

Mode: Autoset
Minimum pressure: 7.0
Maximum pressure 9.0
EPR: Full-time, Setting 2

[Brucpap]

Thanks Sleeprider, I really appreciate your help.

I tried the other settings you mentioned last night:

• Mode: Autoset
  
• Minimum pressure: 8.0
  
• Maximum pressure: 12.0
  
• EPR: Full-time, Setting: 3
  
• Mouth taped with Cover-Roll stretch 
  

And... I feel pretty good this morning. Not 100% but much better than normal. My eye lids are fully open and light, they usually feel heavy and are 20% closed when I wake up. I'd say I feel pretty dang good for only ~6 hours of continuous use. I struggled to fall asleep for the first hour (most likely not CPAP related) so I excluded that from the screen shots.

Please see screen shots below. Any thoughts on this?

When I woke up my jaw was slacked and cheeks were puffed out like a blow fish (tape held it shut). Should I use a chinstrap or soft collar too?

Should I still try these settings tonight given the new info in the screen shots?

• Mode: Autoset
  
• Minimum pressure: 7.0
  
• Maximum pressure: 9.0
  
• EPR: Full-time, Setting: 2
  

[Brucpap]

• Mode: Autoset
  
  
• Minimum pressure: 7.0
  
  
• Maximum pressure: 10.0
  
  
• EPR: Full-time, Setting: 2
  

[Sleeprider]

Looks good. It's up to you if you would like to use a higher maximum pressure. Looking a this last chart I think EPR 2 pretty much eliminates the CA events. It seems like you would be better with 8.0 minimum and 11.0 maximum. Hopefully still comfortable. As expected there is an increase in flow limit with EPR 2 vs 3