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It appears that the 5/1 was just a couple good nights AHI wise. At this 6/1 you are still consistently having 10-15 AHI and also having significantly worse flow limitation than when using higher EPR.
Lets try high EPR again for a few nights just to see how it compares. Main focus will be on how it feels to you (if you feel you sleep better or worse with it) and also if AHI gets noticeably worse. Min/max = 8 cm and 3 cm EPR is what I would try.
04-15-2022, 06:54 PM (This post was last modified: 04-15-2022, 07:04 PM by pearlpearl.)
RE: Round 2 Sleep Test
This was last night 041522. Despite these numbers. I don't feel significant difference with or without the machine. If i am to compare, to include the machine to my sleep was a distraction.
(04-15-2022, 12:04 PM)Geer1 Wrote: Lets try high EPR again for a few nights just to see how it compares. Main focus will be on how it feels to you (if you feel you sleep better or worse with it) and also if AHI gets noticeably worse. Min/max = 8 cm and 3 cm EPR is what I would try.
I can try this new setting tonight and see how i feel for the next 6 nights. Shall i change the mode and ramp time?
Machine: Air Sense 10 AUTOSET For Her Mode: APAP or CPAP Set Pressure: 8 Ramp Time: ? Start Pressure: 8 EPR Type: Full Time or Ramp Only (?) EPR: 3
Use APAP with min/max = 8, if you use CPAP mode then flow limitations are not recorded so we always use APAP mode to collect that extra data.
You shouldn't need ramp at these pressures.
A good test would be to not look at your data during this time unless you feel obviously worse (in which case look at data and if AHI is really high then it is confirmation you feel bad when AHI gets exaggerated by the higher EPR). The reason for this is because I am trying to determine if you feel better or worse with these settings compared to what you have been using and I don't want your opinion to be swayed by the numbers.
(04-15-2022, 09:41 PM)Geer1 Wrote: Use APAP with min/max = 8, if you use CPAP mode then flow limitations are not recorded so we always use APAP mode to collect that extra data.
You shouldn't need ramp at these pressures.
A good test would be to not look at your data during this time unless you feel obviously worse (in which case look at data and if AHI is really high then it is confirmation you feel bad when AHI gets exaggerated by the higher EPR). The reason for this is because I am trying to determine if you feel better or worse with these settings compared to what you have been using and I don't want your opinion to be swayed by the numbers.
Thanks Geer1 for your advice and recommendation. Oh i did not looked at the machine till i wanted to download the data for this forum. I apparently quite good at not looking even on the screen of the machine these days. However, i can be quite amuse when i finally has a chance to look at it.
04-16-2022, 09:03 PM (This post was last modified: 04-16-2022, 09:05 PM by pearlpearl.)
RE: Round 2 Sleep Test
(04-15-2022, 09:41 PM)Geer1 Wrote: Use APAP with min/max = 8, if you use CPAP mode then flow limitations are not recorded so we always use APAP mode to collect that extra data.
You shouldn't need ramp at these pressures.
My sleep was not comfortable last night. I somehow couldn't tolerate after a couple of hours and i took my mask off. My heart or lungs were kind of heavy feeling and couldn't breathe properly. I never had this experience before since experimental with the apap. Having say that this was also my first time without the Ramp with pressure above 6.
May i have a suggestion that will make me feel more comfortable with this setting of min/max8/EPR3? Thanks!
You can try ramp if you think it is needed, you have already used similar and higher pressures so can't really think of any reason this would seem off.
If you slept during that first time you could look at oscar data to see if it indicated lots of central apnea.
(04-16-2022, 09:39 PM)Geer1 Wrote: You can try ramp if you think it is needed, you have already used similar and higher pressures so can't really think of any reason this would seem off.
If you slept during that first time you could look at oscar data to see if it indicated lots of central apnea.
I tried without the ramp last night again. I felt my heart or lungs had overworked. I experienced kind of insufficient breathe during the day that i need to take in deep inhalation! Here the result of last night. High central apnea as what you had anticipated.
Some of your data definitely looks better at higher EPR but centrals are always made worse and based on your reports these past couple nights you do not sleep well because of this.
Frankly I don't think you will get sufficient treatment without ASV and you will probably never feel good when having the high amounts of restriction present at low EPR or the centrals present at high EPR. Singapore healthcare guidelines do not change the fact that you have central apnea (both with and without CPAP use) or that this machine is not capable of treating your apnea (ahi is almost never under 10). Most doctors don't consider apnea treated unless ahi is consistently below 5 and many patients do not feel good until ahi is under 2 or 3 most nights.
Your only options imo are
A) Stop using machine. Potentially something like a mandibular advancement device could be tried and would help. Since tooth wear is what is believed to have started thus investigation an oral appliance like that may make sense in your case and provide tooth protection as well as help with apnea (assuming you can get a device that does both).
B) Keep using machine at what setting seems most comfortable to you.
C) Figure out a way to get ASV and see if you feel better when treating apnea.
