Help Needed with CPAP Flow Chart Interpretation

[HijolG]

Access is denied to your data.
- Red

Sorry it had a password, please try again. I reuploaded the file. Thanks.


I am researching on this, could the weird patterns on the flow rate be sleep on-set Clear Airway events? I did wake up at 4:10am that night and then slept at 5:04am according to my Apple Watch. Thanks

[HijolG]

This link should work: Raw Sleep Study Report

Please let me know if you guys can review it. Thanks

[Jay51]

It could be "sleep wake junk" if it occurs when you are either trying to fall asleep or wake up.  Sometimes the brain does not do a perfect job of handing off voluntary control of breathing to involuntary breathing and vice versa.  Some glitches can occur.  

Also, when low or no CA's are present on the sleep study, then the CA's can be treatment emergent as well.  This type resolves in the majority of cases withing a few weeks or even months of the brain adapting to the new air pressure.

[HijolG]

Thanks for the input Jay. I agree that could be what is causing the CAs.

I slept with the following settings: 7-20 cmH2O, EPR 3 full time.  Ever since I changed the response to standard, unconsciously I started taking the mask off during the night. Anything else I can adjust? I am still not feeling well, daytime fatigue and sleepiness is still there. Any other recommendations? Screenshot attached from last night.

[SarcasticDave94]

Ramp of 6 cmH20 robbed you therapy time on every one of those 6 session starts.

[HijolG]

Ramp of 6 cmH20 robbed you therapy time on every one of those 6 session starts.

Ok Dave, I will turn off ramp and see how it goes. Any other recommendations on the pressure settings or EPR, response mode? Thanks

[HijolG]

I wanted to update everyone on my progress with the AirCurve 10 VAuto for treating my low AHI and high RDI. I am suspecting UARS. My Sinus X Ray came back clear, so I the focus could possibly on the throat. Despite my efforts, I've noticed that the EPAP pressure still tends to increase higher, but it hasn't effectively resolved my hypopneas and RERAs. I'm still experiencing a lot of microarousals, even without flow limitations.
My AHI was 7.1, with an RDI of 18, and I'm trying to understand the best way to adjust the settings on the Bilevel. Could you guys please provide any recommendations on what to do with the EPAP and/or Pressure Support to better manage these issues? I've attached the flow rate data for reference with these numerous arousals that I have no clue why they are occurring without flow limitations .I would appreciate some guidance on this issue. I do my have PSG sleep study coming up on the 25th of this month.

My sleep hygiene has been clean: 

1. Mouth Taping with Nasal Pillow Mask.
2. Using a shirt with tennis balls attached to my back to keep me on my side.
3. Keeping room dark and noise free.
4. Keeping consistent bedtime routine.

[SarcasticDave94]

Had you tried PS 3 yet? How did it go if you did.

[HijolG]

Had you tried PS 3 yet? How did it go if you did.

Yes Dave, I tried it last Friday, but with minimum EPAP 6, PS 3 (screenshots attached). However, it resulted in more CAs, so I recently I increased EPAP to 7, decreased PS to 2.0 and increased the Trigger to Very High, which lowered CAs, but HAs and these micro arousals and weird breathing patterns remain. 

I will be getting a Evora Full Face Mask soon, don't know if that will make a difference. Any changes you recommend?

[HijolG]

An update,

I tried mouth taping with the Dream Pillows Nasal Mask again, since it is the most comfortable. I did not attached tennis ball on my back this time, so I must have slept on my back a bit during the night, but in small amounts. I tried with PS 3, EPAP 8 and IPAP 15, with Ramp On, since I could not fall asleep with the high EPAP. I still woke up a few times middle of the night. My sleep is still not good and my heart rate has increased during the day. The flow rate does not look even, looks like there are still a lots of arousals. I am suspecting these are UARS related or because of my tongue. I attached some screenshots of the night. 


I would appreciate some insight into this.