Do you think I should increase my pressure based on this OSCAR data?

[mallowsweet]

Hello all!

Based on the advice of some kind and friendly folks here a few days ago, I adjusted my pressure range on my CPAP from 5-15 to 6-10 and reducing the EPR to 2 from 3. I'm noticing some slight improvement overall, but my AHI continues to be plagued by Clear Airway events and very few OA events. I also noticed my median pressure has gone up the last few nights. Does anyone think it would be worth adjusting the pressure and EPR again? Thanks so much! I posed Feb 11 and Feb 12 for data.

[Sleeprider]

Mallowsweet, I merged your new thread with your previous therapy thread and revised the title. We need members to keep their therapy question in a single thread so we don't lose track of the history which is important in helping us respond to your questions.

With EPR reduced from 3 to 2 your flow limits are not remarkably different, however your event rate has nearly doubled. I think the increase in pressure from 5.0 to 6.0 was the correct move, but we can't tease out the impact of the change in pressure from the change in EPR from 3 to 2. I think most of your events come from arousals, and even the CA events are happening when flow limitation is higher, pressure increases and your sleep is more disrupted. I'd like to see you return to EPR 3 to see if that helps. Try to avoid making other changes so we can see the results of that change alone.

[mallowsweet]

Thank you Sleeprider! I really appreciate it. I decided to change the EPR back to 3 (pressure remained the same - 6-10) and gave it another good week to see if it helped. So far, my AHI has stayed low but my feelings after sleep have stayed consistent - low energy, foggy, not great. I am starting to feel like CPAP might be a lost cause, or at least the type of therapy I'm on now. It's been nearly a full month with excellent compliance on my part and no improvement. If anything, I still feel worse! But, I will keep trying and I'm not giving up. I do see an ENT in mid-March, and I am cautiously optimistic that he will shed light on the situation. Who knows?

However, I did take 3 nights off OSCAR for you all fine, wonderful people to see if there's anything that I could still be doing differently. Changing the pressure, EPR, etc? Does anyone have any suggestions?  My AHI is quite low, so I feel like I should be seeing some results. If anyone can take a look, I'd be so grateful.


Thank you - you all have helped me feel SO much less alone in this 

Edited because I posted the wrong nights! Just fixed the attachments

[mallowsweet]

Hello, all!

I last posted here about a month ago or so. Since then, I have continued to feel no better using CPAP. I purchased a Wellue pulse oximeter, and it consistently shows that my O2 still drop into the 80s several nights a week. I have an appointment with a sleep medicine specialist in a few months, but I thought I'd take one last stab and post a few nights of OSCAR data here in hopes anyone sees pressure tweaks that can be made. Considering AHI is normal and very well managed most nights, I'm a little discouraged that I feel no different since starting CPAP therapy 2 months ago.

Let me know what you all think! My pressure is set at 6-10mm and my EPR is 4.

[Dormeo]

When your O2 drops below 90, how long does it stay there?

Your charts look pretty good. As Sleeprider has mentioned, the CAs are probably the result of arousal breathing, and possibly you're not getting restful sleep because arousals are disrupting your sleep architecture. (That's the pattern of sleep stages we ideally go through during the night.)

In the interests of trying to get your CPAP therapy to disrupt your sleep as little as possible, I'd like to suggest you set min = max =7, with EPR of 3. Your pressures are almost always driven up by your flow limitations, but I'm skeptical whether higher pressures do very much to prevent FLs. If you're willing to try this experiment, we can see whether you get an uptick in obstructive apneas with a steady inhale pressure of 7 and exhale pressure of 4 or whether OAs stay about the same.

Of course it's well worth consulting with any doctor who might be able to help you. If you haven't already, you might ask your primary care physician to have you tested for thyroid, iron panel, Lyme disease, B12 and D deficiencies, and autoimmune disease panel, especially in the connective-tissue-disease family. Sometimes daytime tiredness has multiple causes; you can fix one but still have problems from another.

Finally, do think carefully about following the basic guidelines for better sleep:

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

I notice that the charts you've posted in recent weeks show a lot of different bedtimes and getting-up times, so that's one area you might want to try to regularize for sure.