Help with OSCAR, settings and incident-new to CPAP

[jimbawb]

So glad to have found this forum!

I've been using APAP for about a month for mild apnea (8.8 on my at home study, o2sat into the low 80s, almost entirely hypoapneas).  I am having days where I feel better-ish, but am still really fatigued.  Smart watch says my o2sat is staying above 90% most of the time, with occasional dips to the high 80s (not super reliable, but the trend of pre-cpap into the low 80s, then improving to upper 80s with the CPAP is apparent).  

I also know I am dealing with long COVID stuff in addition to apnea, so I'd like to do everything possible to get the apnea improved as much as possible, since that's more in my control.


I have 2 questions:

First, I've had 2....incidents? that I'm trying to explain.  The first time it happened, I was using a poorly fitting nasal pillow, the second time was with my current mask (Airsense F40, which I'm really happy with).  In both instances the pressure ramped to a painful level (to the degree that my nose felt blown up like a balloon and I struggled to exhale against the pressure, even once I'd woken up).  Sorry I don't have the detailed info for the first night, that was before I'd gotten an SD card.  The data from the second incident is uploaded as "cpap bad night."

There was nothing unusual in terms of environment those nights that I'm aware of (I drink infrequently and not those nights, and don't take sleep meds).  Any ideas?


Second, I'm looking for machine tweaks to continue improving my AHI.  I'm thinking I am ready to disable my ramp time (it's at ramp to 4 for 20 minutes, and let's be honest....4 to 5 or 6 is basically nothing).  I'm wondering if my minimum pressure belongs at 6 or 7 instead of 5, based on apneas still occurring at 5, but tapering off at the 6-7ish level?


Please let me know if I should zip and upload more data, the 3 upload limit is understandable but I also wonder if I need to provide more data.


Thanks for any help!

[Old Steve]

I would suggest a minimum pressure of 7cm to start.  This is what should be the minimum for an adult or you can feel starved for air.  Plus you are getting a fair number of OA's and you want to lower them.  Also, on your second night I am fairly sure that you are having some positional apnea.  More pressure will not help it.  It is usually caused by chin tucking.  Imagine a bent over water hose...no water gets through, in our case no air gets through.  If you sleep on your back try sleeping on your side, get a thinner pillow or perhaps try a soft cervical collar.  I have to sleep on my side, that was the only thing that helped me. Try the higher pressure and work on finding a good sleep position then post some more charts.  There is a link lower on this page for more info on positional apnea.

Welcome to the forum and good luck.

[staceyburke]

I don't have anything to add to old Steve, he put down everything I would have said. I will add I have a link to Collars in my signature you should look at.

[jimbawb]

Thanks for taking the time to reply!

I have looked at positional apnea info since your post and that makes a ton of sense, especially for why my nose blew up, and also why it's been a twice in 6 weeks thing and not all the time.  I'll look at collars and the pillows {my pillow situation is horrible.....things you don't think about!) and audition some stuff.

I'll get my machine tweaked for tonight and see how that goes over the next few weeks.  Fingers crossed!!