Should I worry my Clear Airways?

[AlanAb]

]First of all, thanks for all the helpful info you've provided in this amazing forum.

I had suffered from snoring for a long time before I bought a Resmed S10 auto. I have used CAPA for two nights and have never taken any Doc sleeping tests. The AHIs have dropped below 5, which I think is good, but the CAs in these two nights are very high, 30 times the first night and 17 times the second night. 

       

[CorruptAlligator]

Since your CA is below 5 and differs depending on the day and drops to 2.3 (or maybe even lower), it's not a significant issue that would be worry some by the medical community.

How long have you been on CPAP therapy? If you are fairly new user, it will be higher starting out due to less CO2 the body is sensing. Also, your pressure range is very wide that will cause CA due to high range of pressure fluctuations. It would make sense to eventually narrow down your pressure within a narrower range once that's figured out. I'm at fixed pressure to prevent any pressure fluctuations. It would be best if you can find a good fixed pressure that doesn't cause hardly any to very minor OA.

Try minimum pressure of 7 and max of 10 for now (and keep looking at your results over time to narrow it down to even more, and then at some point a fixed pressure). It seems you are fine with lower pressure ranges looking at your OA. As far as EPR setting, you got lower CA with higher EPR? Perhaps somebody can help you out with this aspect.

If 7 is too much, try 6.

[SarcasticDave94]

Welcome to the Apnea Board,

Your Centrals may or may not be an issue. It depends on you and your answering do you feel worse when they are higher. Note that Central Apnea/CA will be consistently inconsistent, fluctuating nightly. You have to link that high CA means feeling worse in some way, less rest, higher fatigue, etc.

A few things that can help lower your CA right now: turn off Ramp. You're starting at 4 already, it's a pediatric level so why bother with a Ramp that locks pressure too low, robs therapy time, adds a sometimes disruption when it ends, and Ramp time restarts every press of the start button, and may add CA.

Next, the min 4 pressure again: EPR/Exhale Pressure Relief of 1 has nowhere to go, 4 is lowest there is, raise Min pressure to 5 so EPR 1 works fully. You need EPR full time not ramp only. EPR has never been felt yet by you. EPR 1 at ramp only, ramp pressure 4 means mathematically you can't ever have had EPR helping. 4 again is the lowest your PAP goes ever. Pressure 4 minus EPR 1 equals 4.

Suggested changes, Min pressure 5 to get EPR 1 doing something, EPR full time, Ramp off.

Pressures and EPR can be edited again as needed, according to how you feel and due to OSCAR data.

[CorruptAlligator]

I think it's the max pressure being so high is contributing significantly. The high max cap is not helping. I would work on bringing it down as lowest you can without it affecting OA much (but also watch your flow limitations and see how it's decreasing, you want it the lowest). Play around with what lowest pressure is most comfortable to you and keeps OA at bay (which doesn't seem difficult in your case). I recommend starting at 7 pressure so that you see if that brings down your flow limitations since that might have greater significance to quality of your sleep. As you adjust your pressure watch the flow limitations, and see what brings it down the lowest.

[Gideon]

I saw the higher pressures in the first chart, but with flow limits driving them there. Correct the flow limits, which will correct the higher pressures.
2nd chart had better numbers and showed EPR=3 fulltime trying to do a better job but handcuffed.
Set min pressure=7
Max =12
EPR=3, fulltime

The higher min will allow EPR to fully work and minimize the flow limits and thus removing the cause of the increasing pressure

[AlanAb]

Thank you sir!

[AlanAb]

Thank you for your very helpful advice @Gideon @CorruptAlligator and @SarcasticDave94!

I adjusted the setting to 7 to 10 with EPR full-time at 3. I haven't had the chance to look at the new data but I felt much better for the last 2-3 nights.

thanks again for your help!

[SarcasticDave94]

OK, sounds like therapy is headed right. Keep us updated.