02-02-2024, 12:35 PM
(This post was last modified: 02-02-2024, 12:41 PM by mcrick.)
RE: How can I treat primarily "Clear Airway" events?
(02-02-2024, 09:19 AM)PeaceLoveAndPizza Wrote: Your symptoms are likely related to the ongoing flow limitations that are contributing to arousals along with the need for more pressure to handle them. SleepRider’s suggestion is a good one, but if you want to stay with fixed pressure you can try increasing it to 12 and set EPR to 3.
Could you elaborate on "the need for more pressure to handle them?" What needs more pressure to be handled; the arousals?
I think I will go back to auto mode with a range around 10-13 with EPR at 3 and no ramp to see how I respond, and particularly to note what happens to arousals, events, and flow limitations as the pressure fluctuates; and I can hopefully dial in the best pressure level from that.
I like the constant pressure mode to address possibly waking up from the pressure changes themselves, which I think was a culprit back when I started treatment.
Thanks all for your input!
Also, here's last night's data after trying some different settings... I went auto mode, pressure range 9-12, EPR of 2.
Had a lot of CAs, a couple hypopneas, one OA.
It doesn't seem like most of the events were driven by flow limitations or leaks, which is troubling.
https://imgur.com/a/Q9sqmoM
02-02-2024, 01:16 PM
RE: How can I treat primarily "Clear Airway" events?
Correct, the arousals may be reduced with more pressure. It works for some, not for all. We will not know until you try it. I am a good case study in that at a pressure of 5-9 PS 4 I was getting good AHI (average < 0,5) but felt like a dogs breakfast. I slowly edged pressure up until I reached my current 8-12 PS 4 (basically fixed pressure EPAP=8 IPAP=12) and arousals are almost completely gone. I can get them to completely go away with higher pressure, but I am not comfortable with it so make the trade-off of a few arousals at lower pressure for a good nights rest.
Last nights chart looks good. Giving a wee bit more pressure a go makes sense.
The dry eye and twitching may be related to air blowing into your eyes from the nasal pillows exhaust bouncing off your pillow. Some have issues with air from the nasal pillows working its way into the tear ducts, but take the easier path of air from the pillows first. An eye mask or other device over the eyes should tell you which it may be.
Something to keep an “eye” on.
RE: How can I treat primarily "Clear Airway" events?
Ramp and Central Apnea, I've noticed an increase in CA while on Ramp and I've noticed it in others. After I eliminated ramp myself on a DreamStation 1 BPAP where I'd get lots of CA, it did reduce slightly without Ramp use. I'd advised others in the past about it, and a similar thing was noted. As I recall, Centrals can have a susceptibility to the pressure swings (changes).
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: How can I treat primarily "Clear Airway" events?
IMO you can treat the dry eye and twitching very inexpensively and see if that helps. It could just be from mask air. I recall the same thing happening to me at some point. I use the OTC goop you put on your eyelids at night. To me, it seems like a refined version of vaseline, and I was reluctant at first, but it works. I tried several. I settled on a cheap tube intended for styes, since the goop was a bit thinner than others. I can put a dab on during the day if I'm using the computer, and it doesn't glop up my eyes like some varieties.
