Is this UARS?

[psreiser]

For context, I'm a highly active, 24 y/o, 5'11" 158lb

I started CPAP therapy a little over a week ago with the Resmed Airsense 11 Autoset to try to combat the morning headaches and daytime fatigue I have been feeling for a while.

I've been lurking this forum and scouring the internet for information on UARS and think it might be the case based on my flow rate waveforms and my initial Watchpat sleep test which showed AHI of 4.8 and RDI of 10 with oxygen nadir of 91%.

I've been experimenting with the settings a bit to try to even out my breathing curve and reduce flow limits, which from my understanding is the main thing causing you to not have totally restful sleep with UARS.

I'd be so grateful for any insights on how I should go about tweaking the machine to help deal with this. Thanks so much!

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And here's a screenshot from when there was more flow limit

[Sleeprider]

Just follow the flow limits. Upper airway resistance is nearly synonymous with flow limitation. The 01:00 segment looks pretty normal, but the 05:25 clearly shows a flattening of the inspiratory flow rate. Basically, the resistance in the airway overcomes increasing respiratory effort and limits peak flow. You are already using EPR at 3 which acts like pressure support in a bilevel. The increasing pressure as inspiration begins does overcome some of the airway resistance that would be present without EPR, but a bilevel which has higher pressure support is able to nearly eliminate this effect. I don't think higher pressure will help a lot, but if you want to go to Autoset mode and set your range from 8.0 to 10.0 with EPR 3, then you can compare that qualitatively and see if it helps reduce the 95% flow limit at 0.06 in your current chart.

[psreiser]

Thanks for your reply! I'll give APAP mode a try with your suggested pressure settings. If this doesn't help bring it down, would the next step have to be getting a bilevel machine?

[Sleeprider]

Well, if you can get bilevel, it is a whole different world in treating UARS, flow limits and other issues. I started CPAP in 2008 made that change in 2014 and never looked back. If you need or benefit from the increased pressure support it makes a big difference.

[psreiser]

Here's a night with the new settings. It seems to have eliminated flow limits, at least at the 95% level. Are the other pockets of flow limits/the 99.5% flow limit something that should be addressed or could it be explained by movement/changing positions or something?

 Subjectively, I don't feel horrible today, no morning headache. I did deal with a bit of aerophagia during around the first hour I woke up, wondering if that will go away as I adjust to the new pressure.

I also bought a soft cervical collar to try tonight and see if that helps keep things more open.

Would be very grateful for your thoughts on this matter. Thank you!

[gainerfull]

Results look great - what happened @ 2:40a w/ the large leak and the restart of the machine? Another vital component of maximizing your therapy is minimizing your sleep fragmentation as much as possible.

[psreiser]

I think somehow my mask came off or I unconsciously took if off then it ran for a second before it auto-shutoff'ed. I've been able to sleep through the night with it previously at lower pressures so hopefully that was just unlucky