Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.
Login or Create an Account
Good morning, in the attached chart it shows a lot of CA events. My previews charts show a lot of positional apnea, so I now lay flat on my back and use a cervical collar to prevent the chin tilting down.
Last night I was having some trouble with a blocked nose, and eventually used a nasal spray which helped, probably about 1am
Would anyone please care to comment about the CA events, and the number of them?
Hi gainerful, yes, I am new to CPAP. I have attached the previous night's chart for comparison. This was achieved using the same pillow and collar as last night.
In the initial study, there were zero CA events, 100 x OA and 337 x H with the average and lowest Sp02 being 92% and 82% respectively.
Definitely looks much better. Well done getting the numbers down.
Consider increasing your base pressure and using EPR. Maybe start with pressure set 7-20 and use an EPR of 1, 2, or 3. The increase in pressure should clean up the OA’s and EPR should help with the CA’s. Note that EPR could possibly cause more CA’s, but they typically clear up as you get used to the new EPR.
I also suggest turning off ramp it does not look to be doing much.
Hi again gainerfull, have attached a zoom shot of the 27 CA events around 00.40 until 1.10am. They are mostly CA events.
I am wondering why all these CA events occur, considering I only had two the previous night.
Does it mean I am having difficulty breathing ?
Hi Joe, I think you're running into three problems:
1. Your minimum pressure is too low as evidenced by the obstructive events (light blue) persisting despite using APAP - increase your minimum pressure to 7cmH20 and maximum down to 15cmH20.
2. Your EPR setting is too high and may be causing c02 wash out which leads to you holding your breath - try lowering EPR to 2 then 1 then off if central apneas persist. You can see the central events start happening right after ramp finishes and the minimum pressure reaches 7cmH20 which is the lowest pressure EPR 3 can work at.
3. Turn off ramp, it's not providing therapy for 45 minutes at the start of your night
If you'd like immediate improvement, I'd turn EPR off for one night after raising minimum pressure and lowering maximum pressure.
10-10-2023, 03:40 PM (This post was last modified: 10-10-2023, 03:42 PM by JoeS01.)
RE: Excessive CA Events
thanks for this info and suggestions, gainerfull, I really appreciate this. I have been reluctant to change anything, relying on the sleep apnea technician to set the CPAP machine, which she does remotely. But will give it a go tonight.
Huge improvement last night ( see attached). I ended up putting lip balm on my sticky lips at 00.40 hrs ( thank goodness for daughters ), and that made a difference. If I have any nasal blockage during the night, It is easier to breathe through the mouth.
Looking forward to getting it consistently right
Your Ramp is set to 5.0 cm and is set to last 45 minutes. You get NO therapy during ramp. Turn it off or turn it to Auto so it ends once sleep is detected. Your EPR is set to ramp-only. It needs to be set to Full Time. At this point you are not getting any EPR because it turns off when ramp ends. I agree a minimum pressure of 7.0 is needed. A CPAP technician will not change pressure settings without instructions from the doctor. It's just a basic fact that we all do our own optimization here, because no one else will.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
1. Follow sleeprider's advice above and adjust RAMP to off our auto
2. Increase minimum pressure to 7cmH20 to help with obstructive events
3. Decrease maximum pressure to 15cmH20
4. If you'd like to experiment with EPR, turn it on full-time and try a setting of "1" to see if it's helpful and doesn't cause clusters of central apneas again.
