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I am a new member of the site, though I have looked at some messages on here in the past. I am trying CPAP agin after having tried in the past but having had issues with blocked ears (due to TMJ?), tinnitus and not great results with how I feel (I have ME/CFS also, so not sure that this will be a panacea).
I recently restarted therapy and have been getting AHIs of c. 1.9 - 3.2 at the lowest setting of 4cm H2O, which seems to be pretty good but am wondering if I can do better. So I would like to titrate and, last night, tried a range of 4.0 - 8.6. As you can see from the results, there was no change.
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Welcome. A cpap machine is made for children as well as adults. 4 is the setting for a child. You are never near the min 4 you have set. I would change both the min and max to help with your therapy.
Min 8 max 11
I would try at some point EPR (exhale pressure relief) but it does cause some people to have more central apnea. Because of that I won't suggest that until we set your min and max correctly.
Thank you for the feedback. I see that the pressure did go below 5 during the night. Is that not valid?
I am a little concerned about putting the pressure higher than necessary because I had problems with blocked ears from CPAP in the past, and get it now also, since recommencing treatment.
A setting of 8cm isn't higher than necessary, you are having Apneas and need to stop as many of them as possible. I would feel as if i was suffocating at 4cm or 5cm, they are settings for a child.
A setting of 4cm is not enough pressure to keep your airway open. I would suggest that you take staceyburke's advice and to start, raise your pressure to 8cm and max to 11.
Also, you are having some leaks, they are not real bad but as your pressure increases so may your leaks. Leaks can cause some arousals due to the pressure changes. Looking at your last chart it appears that you might be having a little positional apnea. This is normally caused by chin tucking, sleeping on your back or any sleeping position where your neck gets in a position that it starts cutting off your air. Imagine a water hose that you bend to cut off the water. I have to sleep on my side to stop positional apnea some folks use a soft cervical collar to help stop the chin tucking. As to the Clear Airways, how many did your sleep test show? If not many they are most likely treatment related and most should go away in time. Give the new settings a few days and post some more charts.
So I tried increasing the settings last night. At first I was struggling with breathing, so went to sleep without the machine. I then woke up needing to clear my throat - a sure sign of apnea I am guessing. So I tried again. So not a full night, but looks promising. (I am, however, trying to evaluate whether my tinnitus has gone up with the increased pressure.)
I attach my results. I am guessing I should bump up the pressures to the recommended 8-11 tonight to see how it goes.
I think the leaks are me adjusting the mask and the fact that the one I used last night has a tear in one of the nasal cutouts of the cushion (N30i). I will try to get a replacement
10-02-2024, 08:33 AM (This post was last modified: 10-02-2024, 08:39 AM by staceyburke. Edited 2 times in total.)
RE: Help Interpreting Oscar data
We do see central apnea rise when we use EPR in some people BUT your EPR is off so that is not the cause. In fact I don’t think all of those were centrals. The machine tries to determine if it Is a central or obstructive by pulsing a burst of air and if it senses no obstruction it gives it a central. This method is not foolproof and sometimes misidentifies them. When your sleep study is done they use a belt that goes around you chest and sensors on your body to identify centrals and obstruction.
Anyway, I would look at your sleep position and make sure that is not the problem. That type of apnea is called positional apnea. It happens when your chin drops down to your sternum and cuts off your own airway. It most happens when sleeping on your back or your pillows are to high. Did you use new or different pillows or sleep on your back…
If it is NOT positional apnea, they COULD BE mostly treatment emergent. Which means it will take a while for your body to get use to the therapy and will largely go away as your body adjusts to therapy
If you had the central in your sleep study you may need a different type of pap machine. Problem is they are higher price and harder to get. You usually have to fail cpap to get the Dr. to give the other type of machine.
