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I'm a 27-year old active male, weighing 147 pounds. I have recently resumed using my Resmed Airsense 10 machine with a pressure setting of 4-20 APAP, and EPR set at 3. I'm using the Philips Dreamwear pillows mask, and I sleep on my side with my mouth taped. However, my flow chart pattern looks quite strange. I'm getting an unexpectedly high number of Clear Airways for 28, 18, 13 seconds and Hypoapnea events, which I'm struggling to understand. I was initially treated for Mild OSA when sleeping on my back only, so clear airways for that long don't not any sense to me. I've attached zoomed-in screenshots of my flow charts for reference.
Any insights or advice on what might be causing these anomalies would be greatly appreciated.
RE: Help Needed with CPAP Flow Chart Interpretation
The Hypopnea are roughly a 50-75% Obstructive Apnea event.
You need more base pressure for several reasons. The Hypopnea, and you're attempting to use EPR 3. EPR 3 will not kick in until your pressure rises with events to 7, so just edit your pressure to Min 7.
Consider changing to standard response.
What did your detailed sleep study report tell you on your events type and count table? If you didn't request it, call the doctor's office and do so. HIPAA law gives you the right to request and receive it.
Your Clear Airway/Central Apnea may be treatment emergent due to extra CO2 flushing from CPAP pressures. This is pretty normal. However, if there's an elevated level of CA on the test, then it might be a different scenario. We'll cross that bridge sheet the info on the test. Please post that redacted of your personal info.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Help Needed with CPAP Flow Chart Interpretation
Dave is bang on.
One thing I will add is one may have a good AHI whilst being at too low a pressure. It may be enough to resolve many apnoea events, but not enough to give a good nights rest. I also suggest reducing EPR to 2 and seeing how you respond.
Mode APAP
Min pressure 7
Max pressure 12
EPR 2 full-time
No ramp
Response Standard
Post some results after a few nights and folks can help from there.
RE: Help Needed with CPAP Flow Chart Interpretation
I couldn’t agree more! I have low AHI, but do not have a good night rest. I will try the settings and let you guys know.
I am getting a sleep study done tonight with LOFTA Watch PAT test before my in lab Polysomnograph test. My previous sleep study was in April 19, 2022. It resulted in Mild OSA in supine position AHI 11. Non-supine 4.6. It didn’t give me any details of the actual apneas.
RE: Help Needed with CPAP Flow Chart Interpretation
After seeing persistent Clear Airway events, I decided to try the ResMed AirCurve 10 ASV before continuing my therapy with the APAP. I managed to get only 50 minutes use of it. Do the charts look normal? I am still waiting for the Sleep Study results from LOFTA. If anything jumps at you from this chart, please let me know.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
RE: Help Needed with CPAP Flow Chart Interpretation
It looks like you breathe normally (awake breathing) until about 12:00 or so. Then you fall asleep and the pressure support kicks in and bounces up and down from 6.5 to 11.5 (PS of about 5 or so).
You could raise your PS max a little bit to maybe 10 just to try.
A little low tidal volume, but not bad.
I was diagnosed with complex apnea, and my ASV OSCAR charts looked similar to yours (except with higher epap and ipap pressures).
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11-03-2024, 09:14 PM (This post was last modified: 11-03-2024, 09:14 PM by SarcasticDave94.)
RE: Help Needed with CPAP Flow Chart Interpretation
The Hypopnea indicate EPAP needs to be turned up. You should get yourself weaned off Ramp of cmH20 4 at 30 minutes. It'll rob therapy time, can disrupt sleep and add CA by way of the disruption.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
11-05-2024, 05:16 PM (This post was last modified: 11-05-2024, 05:22 PM by HijolG.)
RE: Help Needed with CPAP Flow Chart Interpretation
(11-03-2024, 08:38 PM)Jay51 Wrote: It looks like you breathe normally (awake breathing) until about 12:00 or so. Then you fall asleep and the pressure support kicks in and bounces up and down from 6.5 to 11.5 (PS of about 5 or so).
You could raise your PS max a little bit to maybe 10 just to try.
A little low tidal volume, but not bad.
I was diagnosed with complex apnea, and my ASV OSCAR charts looked similar to yours (except with higher epap and ipap pressures).
That is very interesting. I am wondering what could be causing that fluctuation in breathing. I just got my results from LOFTA Sleep Study, and it shows Mild OSA of 7. I don't think I have Central Apnea as I have suspected. Nonetheless, the sleep study does not Respiratory Disturbance Index being high. I am not sure what could be causing that. It is a weird breathing pattern.
(11-03-2024, 09:14 PM)SarcasticDave94 Wrote: The Hypopnea indicate EPAP needs to be turned up. You should get yourself weaned off Ramp of cmH20 4 at 30 minutes. It'll rob therapy time, can disrupt sleep and add CA by way of the disruption.
I just switched from using the ASV back to the APAP since I just got my new LOFTA sleep study, resulted in Mild OSA of 7. Please see the report: LOFTA Sleep Study. After receiving this report, I started sleeping with a shirt containing 3 tennis balls in the back to prevent me from sleeping on my back. Last night, I tried the APAP again, turned off ramp, changed response to standard and gradually trying the 5-20 pressure. I probably took the mask off at some point in the sleep. Afterward, put it back on at 4am, so now I am getting lots of CAs. I don't know what to do right now. My sleep study does show respiratory disturbance index being high. I am not sure if it is because of some kind of obstruction or UARS. If so, how can APAP correct these? My sinus XRay came back today with clear nasal airways.
I attached screenshots of these weird pattern, I would love if someone can shine some light on what is causing these to appear on almost all my OSCAR charts.
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.
