Need help optimising treatment

[trenton78]

Ok, I'll give the P10 a few more nights and see how things develop. Thanks for taking a look at the charts.

[trenton78]

I've now been using the P10 mask since Monday. It's very comfortable but I seem more tired in the mornings. Am I right in thinking the leak rate might be responsible for the higher AHI (compared with the N30i)?

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[Gideon]

Your slightly increased AHI is from the slightly increased CA events resulting from the higher EPR. These will diminish over time as your body adjusts to CPAP treatment. As SR said they are caused, in this case, by occasionally flushing CO2 out of your system to below your apneic threshold. Watch these events as we don't want them to be too high.

Also note that central apneas are what we like to call consistently inconsistent.

I would stay the course with EPR=3 for a good while.

[trenton78]

Thanks Gideon, Sleeprider, Staceyburke and everyone else who has commented so far. Your advice has been very helpful. I'll wait and see how the CAs develop over the next two months.

I have a question regarding trt. I get a shot (nebido) every 8 to 10 weeks and my sleep apnea seems to get noticeably worse after that for a week or so. My nose feels congested and I snore quite loudly in the days after the shot. I also feel much less rested than usual. Would you recommend I alter my CPAP settings after a testosterone shot? I tried increasing the max setting to 15 but it doesn't seem to be doing much good yet.

   

   

   

[Sleeprider]

I think if you want to effect an increase in pressure, it is the minimum pressure that is more important. Leave the maximum pressure at 15 and titrate upward on minimum pressure to get the results you feel work for you. I'm not familiar with the long-term release TRT Nebido product. I get ideal stability with T-cypionate which I administer weekly with a small 5/8" needle sub-subcutaneously. For a product that has a 10-12 week injection frequency, it would be interesting to see how consistent hormone levels are through that time. If you are feeling higher apnea and other side-effects initially after a shot, perhaps your T levels are spiking too much and a different product with more stable action may be better.

[trenton78]

Thanks Sleeprider, I'll see if a higher minimum pressure yields better results. I already raised the maximum from 13 to 15 and will leave it like that for now.

As for changing my trt treatment that's definitely something I'll keep in mind. But it's more of a mid to long term project.

[trenton78]

I'm going to be trying out an Aircurve Vauto next week. I've been using an Airsense 10 Autoset since I started CPAP two months ago. What settings would you recommend I start with on the Vauto? Should I be using a separate SD card and Oscar profile so I can evaluate the differences between the machines?

The Autoset is currently set at 11-15 with an EPR of 3. I'm trying out the Aircurve because my sleep is still very fragmented, even though my numbers seem quite good (to my unschooled eyes). I have trouble falling asleep and wake up frequently. I also have trouble falling asleep with an EPAP over 6 at the moment. 

   
   
   

[Gideon]

Min EPAP = 8
Max IPAP = 20 (you will not get there)
PS = 3
If this is a used machine perform a Factory Reset First to make sure ALL settings are at the default before you even start setting your settings.
The above should fairly closely match your AutoSet to set a baseline. Then we can work on your comfort.

[Crimson Nape]

If the AirCurve is used and comes with an SD card, make sure to format it prior to use. This will erase in prior data that may be on the card. Also, prior to your first use, check the date and time settings. This can save a lot of aggravation later.

[trenton78]

Thanks for the advice. I’ll try the recommended settings.