Help with machine settings

[ttwhite1]

I just started treatment this week. I'm trying to see if I need to lower my pressure or change anything.  It's an APAP Resmed Airsense 10 I'm on and I only have one day of data.  Any advice or tips are welcome.

[Jay51]

Welcome to ApneaBoard.  You have some significant flow limitations.  I can't tell if you have EPR on. If your EPR is off, you can try turning it on with pressure at 1, 2, then 3 full time and see if that lowers your flow limitations.  

1st things 1st though - you have some significant large leads.  Here is a link to try to stop these  Mask Primer

You are also bumping against your max pressure of 20 during sleep.  I don't know if you can go any higher than 20 for a max EPAP though.  Possibly, lowering you pillow height, changing sleeping positioin (from sleeping on back to side, etc.) and even trying a soft cervical collar may help to bring this pressure down some.

[ttwhite1]

Thanks.  Would shaving my beard help with the leaks?

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EPR is set to three.

[gainerfull]

Did you get a cpap titration done? What pressure resolved your obstructive events?

I'd be inclined to recommend raising your minimum pressure to 10 if you want to keep EPR 3. 4cmH20 is not going to keep your airway open as evidenced by your flow limit chart.

[Sleeprider]

You appear to be using your Airsense 10 Autoset with minimum pressure 7.0, maximum pressure 20 and EPR full-time at 3. Significant flow limitations occur in clusters with much lower flow limits rarely happening. I think we definitely need a higher minimum pressure and I suspect you're using more than one pillow or are in some way sleeping in a position that obstructs your airway as suggested by Jay51. Read this wiki and see if any of this looks like a possibility. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

As far as shaving, a proven alternative is to use nasal pillows, like the Resmed Airfit P10 mask. There are others that are also minimalist and do not rely on a facial seal to prevent leaks. If you can't use a nasal interface, shaving may be in your future, but I really recommend you try nasal pillows to prove they don't work. Most people that call themselves "mouth breathers" do adapt and have very successful therapy much more comfortably.

Take your minimum pressure to 10.0, Maximum pressure 18.0 and keep EPR at 3. Check out the potential for positional apnea, and I'm pretty sure you will see where we are going with that.

[ttwhite1]

No CPAP titration done. I’ll up it to 10

[ttwhite1]

            I'm back to see if any more changes (pressure wise) need to be made.  I'm getting way fewer leaks wearing my mask.  I just had to get comfortable with it.  With the pressure where it is, 10 min 18 max with an EPR of 3, my AHI has creeped up slightly.  I was using two pillows, but now only using one.  I at least start off the night sleeping on my side.  I had started to sleep on my back but not anymore.  I also may have had my chin down as I slept, so I'm trying to stop that.

[Sleeprider]

I would move minimum pressure closer to your median pressure of 13, however I strongly suspect a positional apnea issue here. Working on prevent preventing chin-tucking or whatever is contributing to the high flow limits and clusters of obstructive apnea, may allow you to get better results at lower pressure. I previously linked to the Positional Apnea wiki, and my opinion is unchanged.

[ivorpetkov]

Hi ttwhite1,
In relation to the high Flow Limit values and my experience from yesterday and today, I am wondering what is the your value of the Response parameter in?
In Device Settings - Response: Standard or Soft?

[staceyburke]

You said you have EPR set to 3, check it is turned on and it is set to FULL TIME.