New CPAP User

[heyitsme]

Totally agree, I can't thank you enough. To go out of your way to help another and with experienced feedback is grade a in my book. Thank you

[heyitsme]

I wasn't sure what Min = Max = 4 meant when setting the CPAP so I ran the second settings Min = 5, Max = 15, EPR = 1 last night. Does the Min = Max =4 just mean to set both to 4 and EPR off please? If I can figure that out I'll run that tonight.

I noticed it was easier to exhale and felt like near normal breathing. I barely notice I'm using the CPAP anymore especially with the EPR on. Definitely feeling more awake in the morning.

Attached are the results.

   
[attachment=19276]

[DaveL]

You're making great progress! It's so good to see!

(Night before last I had to get up in the middle of night. Disconnected my hose from my N20 mask, and went; came back. Back in bed...slept. Woke up later and my hose was disconnected. I hadn't connected it.) Life happens. Laughing at myself.

[Gideon]

Min = max = 4 does mean min 4, max =4
Again that is setting the CPAP to provide it's minimum just to see how bad it gets, as close as we can get to the sleep test without actually doing one

Follow that with
EPR=2
Min =6
Max=15
I expect your CA to get worse.

[heyitsme]

Haha, thank you.

I've gone through a lot of forums to review and figure out the issues everyone else as had to avoid if possible. Definitely love the Dreamwear Nasal mask, tube on top of the head is simply awesome. Probably helps that I'm used to scuba diving as well so CPAP feels normal and somewhat peaceful to me.

Looking forward to getting everything dialed in and see if the solution can help, it seems like it is though still getting past I actually need it. Thinking the minimum setting Bonjour suggested will help a bit with that. May opt for a SleepStudy at some point just to see that data.

[heyitsme]

Pretty sure the nasal mask came off at near 1AM, I'm not sure why though guess it's due to the obstructive. Current plan is to attempt same settings again tonight.

   

   

[Gideon]

That is sufficient info to definitively state that you do have OSA in the mild to moderate severity. Actually I can't say that because I am not a Doctor.
Now we go back to making you feel better.

Now go to
EPR=2
Min =6
Max=15

[heyitsme]

Awesome, thank you. Looking forward to going back to the helpful settings. Thank you

[Sleeprider]

You have some flow limitations, but the more prominent aspect of your therapy is an AHI over 6 per hour of central apnea. In my opinion your real problem is treatment onset complex or central apnea, and adding EPR s going to increase events. I am far less concerned with with the flow limits than the fact, trying to address them will likely make apnea worse. Some centrals may eventually resolve as you use CPAP, but in my opinion the current path to lower event rates is to use fixed CPAP pressure without EPR. To minimize events, I would set the machine at minimum pressure 7.0, maximum pressure 7.0 and EPR off. My suggestion is conservative and based on your need to address CA events, not to treat flow limitation which is increasing your pressure to chase prevent an obstruction that does not exist, thus the fixed pressure.

On the other hand, Fred may be wanting to see what happens with EPR at higher levels, and I'm sure if increases the CA event rate, he will probably back-out the EPR and inform you of ASV therapy. Just FYI, if you increase EPR, you will likely see higher or much higher CA.

[Gideon]

Exactly, CA goes up with EPR and we either back off or explore ASV (traditional) or EERS which I feel will be less disruptive. EPR is what should work with flow limits.