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10-11-2023, 01:14 PM (This post was last modified: 10-11-2023, 01:18 PM by JoeS01.)
RE: Excessive CA Events
Thanks for this advice gainerfull. I decided to have another go with the current settings to make sure the results of the 10 Oct ( AHI = 2.05) were not a fluke. Last night I got AHI = 0.68 over 4.5 hours duration, as shown in the attached sheet.
At 3.54am, I was wide awake, thinking it was about 6am. So I abandoned any attempt at further sleep.
Was sleeping with a single flat pillow with a cervical collar and at the start of the evening some lip balm, which I ended up wiping off at 1.42am as my lips were sticking with it.
Do you think the suggested changes to the settings will make for a more comfortable sleep given the results of the past 2 nights? It would be good to sleep 7 hours undisturbed.
Congrats on the seemingly best ever results so far. Right now, my hunch is you're sleep apnea is being treated ok but there is room for improvement. Even though the machine isn't marking many events I can tell from the lack of uniformity to your macro flow rate graph (the thick black bar) that you're having events that are not flagged. The good news is, these can be resolved with more pressure.
The reason I recommend a higher minimum pressure is because you'll notice the green pressure line shooting up towards the end of your sleep and it's able to resolve the obstruction around 7.5-8cmH20 but you spent most of the night at 5cmH20. What I also notice is the rapid increase in pressure afterwards could have caused the central apnea event (purple) which is typically associated with a micro-awakening called an arousal. This will bring you into a lighter stage of sleep and make you more likely to wake up. If you wanted to keep it simple, I'd say just increase your minimum pressure to 7cmH20 and see how you do overnight.
If we no longer see obstructive events (light blue) after raising the minimum pressure then we know we're good and depending on how you're feeling we can make more recommendations.
Many thanks gainfuller, very much appreciate you sticking with me on this. Will bump the minimum pressure up tonight, and reduce the maximum making the range (7,15) as you initially recommended.
You certainly touched on a valid point with your analysis. I feel like I am sleeping with one eye open, or half asleep, not a very deep sleep and I don't think I am having dreams like before I started on this CPAP on 15 September. I am certainly waking up more alert and doing things on the computer etc, unlike previously where the brain was a bit foggy and took time to get going. I suppose with typically 68 AHI and dropping to 82% O2 saturation in the initial study, that oxygen depletion and its effects was to be expected. But I am still tired during the day from lack of sleep.
With regards EPR, I see a lot of value in dropping the CPAP pressure by 3cm H2O on expiration to make it easier to breathe out. What is the thinking behind reducing that number to 2cm?
I know ramping is a comfort feature from reading the Resmed website. The way the sleep technician explained it when setting up the machine was that it waits 45 minutes at a set pressure of 5cm H2O before starting to increase and start applying the set pressure therapy of 5-20 cm H2O.
And every time I wake up and lift the mask to better adjust it, or stop the CPAP machine to take a toilet break, this ramping time kicks in again and it takes another 45 minutes to start the therapy. It is assuming that I take 45 minutes to get to sleep and then it starts the therapy. Is this correct?
If that is the case, there is a lot of time I am not getting therapy during the night? Only the 5cm that the ramp is set to. And during that time the EPR is not reducing the pressure to help breathing out in this time? Is this why 'Sleeprider' previously recommended setting the Ramp to Auto ( so that therapy starts when I fall asleep) and setting EPR to full time?
Tonight I am only going to adjust the pressure range for starters, one thing at a time
Please bear with me as I try to understand the mechanics and the settings of a CPAP machine
10-12-2023, 01:24 PM (This post was last modified: 10-12-2023, 01:27 PM by JoeS01.)
RE: Excessive CA Events
Hi all. I changed my pressure setting range from (5,20) to (7,17), and changed my EPR setting from Ramp Only to Full time.
Found it a bit harder to breathe against the increased pressure. Also had a slight headache to start with. I don't normally have headaches.
There is a large difference in the Pressure chart, in that there are now two lines, one for EPAP and one for Pressure. Never seen that before on this chart.
The three Large Leakages occur when I adjusted the mask by lifting it off my face momentarily
Have attached today and yesterday's charts for comparison.
I would welcome any comments on the impact of the change to the settings, and any suggestions on further changes if necessary
Hi Joe - thanks for the updated charts. Aside from the headache before sleep how did you feel when you woke up this morning? It looks like the new minimum and maximum worked out well but full time EPR at 3 is not enough pressure to keep your airway open, hence the obstructive events. Did you find it difficult to breathe out even with EPR 3 on?
Good morning gainerfull. I felt really bright and alert on waking at 4am. No point in trying to go back to sleep. I did get 4.75 hours of therapy
It was certainly harder to breathe out than before
Hi gainerfull, tonight, 24 hours after I increased the minimum pressure to 7cm, I am experiencing very painful wind in the bowel regions. I forgot to mention I am 80 years old.
Should I persist with increased pressure at my age?
more than one post in this thread it has been mentioned that you should either reduce--or eliminate--the ramp time.
i don't know why your dr would set it to 45 minutes. lower it to 5 minutes, or just start the therapy at your minimum pressure. if nothing else, you'll get a clearer reading of the therapy data.
