Fine tuning CPAP

[newman08]

Hello all,

After many years of being exhausted, I tried an at-home sleep test. It gave me around a 50 AHI if I remember correctly - something ridiculous. I assume they gave me a generic pressure range on APAP. 

I slept through my alarm the first night I used it and was shaking the next morning with energy. But, it seems I have slowly declined. After using it for a couple weeks, my nose started to become raw and I had to switch masks. I have been switching back and forth depending on how my nose feels. Right now, I use the DreamWisp. I prefer to DreamWear nasal, but it seems to leak too much. 

For the past few weeks, I keep waking up around 130 and again at 4. I am usually right back to sleep at 130 and barely remember it. But the 4 o clock wake up seems like pressure is high and my mask is leaking. Then, the clear airway events start happening, and I am not sure what this means to me. 

Also worth noting I live at altitude of 9,300 ft.

Any advice is greatly appreciated. I had to upload two screenshots because I could not figure out how to get the full left hand column showing.

[PeaceLoveAndPizza]

It looks to me that there is quite a bit of positional apnoea going on (chin-tucking to be specific). A flatter pillow should help, but you may need a soft cervical collar as well to keep your chin up at least until you get used to it. I am ignoring the CA’s at the end at the moment as well. One problem at a time.

For settings, I think a bit more min pressure and capping the max may be more comfortable. Worth a try.

Try this:

Mode APAP
Min pressure 8
Max pressure 14
EPR 2 full-time
No ramp

I am not worried about the leaks at the moment, but something to keep an eye on. Watch some YouTube videos from LankyLefty27 on fitting your mask as it may be one of the triggers. When the mask moves and leaks, the machine responds with more pressure to a point.

[newman08]

Thanks - will give it a whirl. Already made the change earlier after reading your responses to others.

[newman08]

So my clear airway went bonkers last night. The chart is going to look a little funky because I started the machine later afternoon to play with different masks I had and different pillows to see what is the most comfortable. I am sure the clear airway isn't good....

However, on the next post, I will attach a night where I thought I had decent results. I have a Microsoft Surface and it is not allowing me to squeeze the left pane, but maybe a good night might provide a different point of view.

---

Here is a night with good results.

[PeaceLoveAndPizza]

Thanks. It is worth giving those settings a chance for one night, but I expect it will not go well. Best to rule it out though.

Did you exhibit any CA's during a sleep study? If not they are EPR related.

After you give the EPR=2 a go, try this next.

Mode CPAP
Pressure 11
EPR off
No ramp

and let's see how things look. I expect it will be better, but FL's will remain high. We can discuss after giving the two settings a go.

[newman08]

No worries - I still feel more rested than without the machine. 

Unfortunately, I did an at home test and I attached what they provided, doesn't classify the apnea. My wife did say I would stop breathing and then gasp for air at times during the night. Or slowly wheeze out. But now that is not happening with the machine anymore. 

I will give it a try tonight, but am going to a happy hour, so it might be skewed. Might have to report back on Monday.

[newman08]

Just to be sure - the October 10th charts were with the new settings and then that other chart was here I had good results from a couple weeks ago. 

I will try CPAP mode tonight.

[newman08]

Whatever is happening at 430am happened again. It seems fine up until that point of the night, and it's always around 4-430am when I wake up. 

I still say I am more rested than without the machine.

[Phaleronic]

Hello newman08,

Your sleep is going sideways when your leaks start to spike, you're using pillows so you need to please tape or use a chin strap, or go full facemask if you are able to do that, I like that you're on cpap mode. I would mitigate leaks by also sleeping on your sides as much as possible and using a flat pillow and a second flat long pillow to use to wedge under you chin and chest and shoulder to curtail chin tucking.

[newman08]

I used a flatter pillow last night, along keeping my head straight instead of somewhat tucking as I like to sleep like that, but I will break the habit. 

I also used the Phillips pillows instead of ResMed pillows. The Phillips were much more comfortable so maybe that played a part as well.

Ignore after 8am, I was awake with it on.