New CPAP Owner Questions

[mcman56]

I'm not sure if this should be a new thread or added an old thread.

I now have my own machine and have been using it for a few days.  I'm still getting used to the nose pillow so some leaks are really operator error.  I was getting a stuffy nose so did adjust the humidity from 4 to 2.  I'm reading and trying to understand the data.  My O2 numbers are much more consistent and the average is higher with no low drops.  Data should be attached and I have a few questions.

1. Almost all of the events are CA.  Is that common or concerning?  What do the numbers mean when highlighting the CA event on the graph? 
   
   
2. I notice that the pressure and flow are both low before the CA event is shown.  If the flow is low shouldn't the machine increase pressure?  Isn't that what it is supposed to do?  I also see a change in tidal volume at that time but don't understand how they are related.    
   
   
3. The AHI numbers tend to be clustered together.  This one night is probably the most clustered.  Is that telling me something?
   
   
4. Does the movement graph represent physical movement?  How does the machine sense that?
   
   
5. When I fist start the unit, I sort of feel like I'm not getting enough air.  The nose pillows must create a small restriction.  Is there any negative to letting it start at a higher pressure?    
   
   
6. Are there any recommendations?
   

Thanks,

Dan

   


  Daily_Dan_2021-09-04.pdf (Size: 575.66 KB / Downloads: 5)

[staceyburke]

Dan welcome to the board. To give you any suggestion we need a screenshot of the entire night with the correct charts. In my signature is a link to the charts we need

There are many excellent people on the site that will help.

[staceyburke]

I will give you some answers to your questions.

Centrals can be a problem if you had many in your sleep study. If not then they go away after your body gets use to therapy. Usually 2 to 3 months. The numbers with centrals are the number of seconds it lasted.

Clustered events are something we would like to look at on your daily charts.



Low air flow is not what the Cpap does it helps obstructive apnea and pressure will increase with obstruction.

I don’t know what you mean by a movement chart

Again looking at your chart will give us an idea about your need for increase of pressure.

[mcman56]

How is this?

Is 9 minutes in Apnea bad?

Thanks,
Dan

   

[Gideon]

Reduce your EPR to 1, if needed we will adjust from there. That should lower your CA events.

You are among the (un)lucky individuals that may be suffering from Treatment Emergent Central Apnea. This often occurs with new CPAP users as you CPAP helps you breathe more efficiently, including the flushing of CO2 from your system. Our main drive to breathe is having enough CO2 in our system to require removal. When CO2 levels drop below your apneic threshold a central apnea occurs until your CO2 builds up while you are not breathing. This occurs gradually in a waxing and waning repetitive pattern.

To confirm provide a 10 minute zoomed view of your CA events and
Post your sleep studies, redacted, especially your initial diagnostic study.

[mcman56]

I was only able to get a limited amount of data from the sleep studies.  The second one is with MAD.

Can you explain what the EPR change is intended to do?  Isn't that the exhaust or breathing out pressure? 

Thanks,

Dan

   

   

   

[Gideon]

EPR change is intended to reduce the efficiency of your CPAP and thus decrease the flushing of CO2 from your system. This is very effective at reducing Treatment Emergent Central Apnea or other CO2 induced apnea.

[clownbell]

OP - You mention in post #1 that you are feeling you don't have enough air. Several experts here would note that you minimum starting pressure is 4, which may be OK for adolescents but is not enough for adults, with 7 being a more appropriate minimum for adults. EPR decreases the pressure while you exhale, making it easier to breathe out against the pressure.

[Sleepster]

[*]When I fist start the unit, I sort of feel like I'm not getting enough air.

Turn the feature called "ramp" off.

[mcman56]

Being conservative, I started by going from EPR of 3 to 2 and started the ramp pressure at 5 instead of 4.  CAs are down.  The most impressive part is that minimum SpO2 was 92.  I have never seen anything that good.  I felt more air when I started and it was easier to exhale.  I do continue to have questions.

• Total time in apnea is 6 minutes.  Based on zero knowledge, that seems not good.  Should that be a concern? 
  
• CAs tend to be clustered in the last 1/2 or 1/3 of the night.  Could that mean something?
  

Thanks for all of this support,
Dan