Lowering AHI - Analyzing OSCAR Data

[getzall]

       

Hi! I've been using my Airsense 11 for a week now and was hoping to get some assistance lowering my AHI. I started first with the P10 and it made it feel like I was punched in the nose with a constant headache, although I was getting a low AHI. I switched to the N30 this week which is much more comfortable for me, but my AHI numbers aren't where I would like. I would me much appreciative of some assistance. Thank you!

[OpalRose]

Hi getzall,
Did you have a sleep study done? Looking to see if your study showed Central Sleep Apnea?

Sometimes, folk will experience clear airway events after starting Cpap therapy, which usually lessen after time. But the charts you show have quite a few CA's.

If you have a copy of your study, post it here so we can take a look.

[getzall]

     

I did indeed. The central apnea index was 8.7 times per hour.

[quiescence at last]

your last two posted charts seem to show pressure micro-adjustments due to flow limitations. some EPR generally helps that, and it can bring on more CAs.

I would do this if it were my machine.
Make sure I got an EPAP value of about 7.8 (close to the median EPAP value).
I would make sure I had some EPR to help fight the flow limitations. I would select EPR full time at 1.
I would limit the machine from going to the higher pressures (above 10).
The starting pressure I would make sure was at least 8.8 cmh2o min to ensure EPAP stays above the 7.8 value.
I would Ramp pressure just a bit below 8.8 cm to allow start at a lower pressure. I would pick 7.0.

settings 8.8 min 10.0 max, EPR=1 Ramp pressure 7.0

I don't expect that all the CAs would go away, or even reduce by half. But, who knows. It might.

QAL

[OpalRose]

Thanks getzall for posting your sleep study.  

I would go ahead and follow QAL's advice.  

Here's what you need to know... your current machine cannot treat central sleep apnea.
Only a ASV can treat CSA.  

Using EPR usually aggravates and causes more clear airway events, but some EPR is needed to tame Flow limitation and Hypopneas.   So this may be a balancing act.

Keeping the EPAP high enough will keep the airway open and hopefully take care of Obstructives.

So yes, QAL's settings recommendation is sound.  

The only thing I don't like is Ramp.  Use it for now, but eventually try to wean off using it.

Post another chart after a day or two.

[getzall]

Thanks, guys. I appreciate it and will do.

[getzall]

       

Hey guys, I attached two pictures. The first is the last day keeping the settings the same and then the second is my first night following the settings you both recommended.

[Sleeprider]

As predicted the use of EPR did increase the occurrence of central apnea, and surprisingly also made flow limits worse. Since you're working with QAL and Rose, I'm going to drop a link to the Resmed Clinical Titration Protocol so you can do some research on how ASV (adaptive servo ventilation) works. Starting on page 28. Something tells me you're gong to need this. https://document.resmed.com/en-us/docume...er_eng.pdf

[getzall]

Thanks, Sleeprider. I will take a look!