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New CPAP user here. Ready to learn. Please advise how I can improve!
Hello. I’m a new CPAP user. I was diagnosed a couple weeks ago. I do not know the number of events during my at home sleep test. They just called me and said I need a CPAP machine and referred me to the local pharmacy. I was set up with it last Wednesday and have been using it for a total of 6 nights.
My first night AHI was 27.1 followed by 19.9, 13.4 and 10.3. The night before last was 18.2 and last night was back at 14.84.
I’m using a ResMed Airsense 11 machine with a ResMed F20 full face mask. Pressure set at 5-15.
Can you please take a look at my attached stats and help me understand them and how to improve.
RE: New CPAP user here. Ready to learn. Please advise how I can improve!
1. Most of your apnea are positional which means you're sleeping in a way that is cutting off your airway. This is likely because you're transitioning to your back, your muscles are relaxing in REM and your chin drops to your chest. I use the soft cervical collar from Walgreens and it's worked well for me and would recommend you do the same. Just make sure you wear it loose but not too lose that you can tuck your chin inside the collar.
2. Raise your minimum pressure to 7cmH20 and turn on EPR (expiratory pressure relief) to 3 full-time.
3. Overall your leak rate looks good but you'll probably want to tighten your mask straps 10% to avoid the large leaks you're getting as you change positions. When I'm tightening my mask I tuck my chin to my chest and make sure it's tight there. The large leaks are most likely disturbing your sleep.
RE: New CPAP user here. Ready to learn. Please advise how I can improve!
(12-13-2023, 01:50 PM)gainerfull Wrote: 1. Most of your apnea are positional which means you're sleeping in a way that is cutting off your airway. This is likely because you're transitioning to your back, your muscles are relaxing in REM and your chin drops to your chest. I use the soft cervical collar from Walgreens and it's worked well for me and would recommend you do the same. Just make sure you wear it loose but not too lose that you can tuck your chin inside the collar.
2. Raise your minimum pressure to 7cmH20 and turn on EPR (expiratory pressure relief) to 3 full-time.
3. Overall your leak rate looks good but you'll probably want to tighten your mask straps 10% to avoid the large leaks you're getting as you change positions. When I'm tightening my mask I tuck my chin to my chest and make sure it's tight there. The large leaks are most likely disturbing your sleep.
Thanks a lot for your insight! Can you explain to me what you see in the chart that tells you the apnea is positional? I'm just trying to understand. Thanks!
RE: New CPAP user here. Ready to learn. Please advise how I can improve!
When events are tightly clustered, we tend to suspect positional causes. Add the excessive flow limitations that happen at the same time, and positional apnea is even more likely to be the cause.
RE: New CPAP user here. Ready to learn. Please advise how I can improve!
Continuing on from GainerFull’s excellent response…
4. Do you still need ramp? If not, turn it off as you get no therapy during that time and as soon as you get to pressure hypopnoea’s kick in.
5. I would raise your minimum to 11 as that is the median pressure. I would also raise you maximum to 16. For now leave EPR as is.
6. Get a soft cervical collar as it will make an enormous difference in your sleep quality. You may have to get a few to find one you like. If it is any help I use the Caldera Releaf and have done so for years.
7. Depending on how things go we should consider a fixed pressure with EPR to stop the wild swings that must be uncomfortable. For now just something keep it in your memory as a possible next step.
Hang in there. Every new bit of information will help folks help you.
