Need help understanding my results

[Mysti]

Hi, I am new to CPAP, got my ResMed Auto 11 around May 1st and have been using ever since. I am a female, late 40's, been overweight pretty much my entire life but no real health problems (good cholesterol, blood sugar, etc) but had a weird episode in October that put me on blood pressure meds. I've been trying to figure out the cause of my dizzy spells ever since. They still don't know, but part of the diagnostic process led me to an ENT and later sleep Dr. ENT determined I had sinus issues, a small throat, enlarged tonsils and deviated septum. Asked if I snored and of course yes, husband even worried about it.

Anyhow, sleep study determined AHI of 30.2, with SPO2 dropping to 75%, and spending a good bit of time below 90%. I was not happy about CPAP, but doctor scared me into it, and hubby was happy I wasn't snoring (after making a few pig snout and elephant jokes first). After the chat with the doctor, I was excited to use CPAP, as I thought it was going to make me feel so much better! I'm still waiting for that feeling. Actually, for the first couple weeks I was discouraged because I actually felt worse and then had this stupid mask to wear on top of it.  But I've stuck with it, because I've read it can take a while to feel results.

In the meantime, I would love if someone could look at my info and give me a little insight as far as any tweaks, suggestions, or observations. I lost insurance right after being diagnosed (paid for the machine out of pocket), and new insurance doesn't kick in for another month. So I've been reading up on my own.

Also, I read a study where many actually GAIN weight on CPAP, which has me worried. I've fought hard to lose the 15 lbs I've lost in the past several months, the idea of it leading to weight gain has me concerned. My doctor feels it will have the opposite effect on me, but I'm feeling no different any which way so far.

Thanks!

[gainerfull]

How are you feeling after waking up with the current settings most mornings? Overall your results look great and you can make no changes and still be fine. If you're interested in opportunities to improve here are a couple:

1. Your mask leaks could use some work, considering you're using a nasal mask you'll want to consider switching to something like an Resmed F20 full face, use a chin strap or tape your mouth at night to avoid the pressure blowing your both open, or your chin dropping causing leaks out of your mouth. Ideally you'd want your 95% leak rate to be 0.00
2. Your APAP minimum might be a little too low considering the rare remaining obstructive events and your maximum a little too high. You may consider 10 minimum, 18 maximum

When you had your sleep study, what constant pressure resolved all obstructive events / was recommended to use?

[Gideon]

Welcome to the forum.


First your AHI is what doctors will glance at and say you are doing great and see ya next year. Right now you aren't missing much being without insurance, at least in regard to your apnea.

Yout study said an O2 Sat of 75%, all this means is you need to look deeper. What does "a good bit of time" mean. O2 Sats at or below 88% for 5 or more cumulative minutes IS the Medicare criteria for supplemental oxygen. Most insurance companies follow the Medicare guidelines. This has me somewhat concerned. I expect that your CPAP therapy will raise your O2 Levels to acceptable levels. Since your O2 levels are proven to go into these low levels I'd suggest that you get a recording pulse oximeter to prove that is the case. Low O2 levels could definitely cause your symptoms so let's prove that isn't the case.

What I see is a pressure that wants to bounce around. I'd like to even that out. Your OA and H events are not significant, your Flow Limitations, think of them as mini apneas and hypopneas that for whatever reason were not considered bad enough to qualify for those events, are quite high. The level we call outright bad is a 95% FL stat of 0.10, just a touch above your level. We like to see 0.02 or 0.03 on the high side, we don't always get there.

The best treatment for these flow limitations is a differential pressure between inhale and exhale such as the Pressure Support of a BiLevel. Don't have one of those you say, Oh but you do. This is exactly what the EPR, Expiratory Pressure Relief, does.

Please set EPR=3, Fulltime (NOT Ramp Only). That should make a big difference. This may, not will, ewquire an increase in pressure but if so we can address that once we see the results. Try this then repost your daily charts. This is the only change I'd suggest for now.