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Hello. I'm new here and new to using my APAP which is a RezMed AirSense 11 with a N30i Nasal cushion. I completed an at home study (results below) and am currently on day 9 or 10 of daily APAP use. Things seem to be going well so far (I'm definitely still in an adjustment period) but I'd really like to understand my results (independently) before my follow-up with the Dr in mid-February. Any feedback would be appreciated. Thanks!!
My at-home study results:
Recording time
Start time: 10:39:49 PM.
Stop time: 06:09:13 AM.
Duration of recording time: 456.1 minutes.
Monitoring Time: 449.1 minutes.
Sleep related events
REI 13.1 /hr.
OAI 0.1 /hr.
CAI 0.0.
Total Obstructive Apneas: 1
Total Hypopneas: 97
Pulse oximetry nadir
Pulse oximeter nadir: 84 %.
Time below 90%: 5.0 minutes.
Time below 85%: 0.1 minutes.
Heart rate
Minimum: 57 beats per minute.
Maximum: 105 beats per minute.
Mean: 69.2 beats per minute.
I would raise your minimum pressure to 7cm to start. A 3 EPR setting needs at least 7cm minimum pressure to work properly. You also need to watch your leaks, they are not real bad, but small leaks can cause arousals. All and all I would say for just starting out are doing quite well. Adjust you pressure and work on the leaks then post some more charts. Good luck with your treatment.
Awesome. I will give the min pressure a go tonight. I think I need to tighten up my mast a little as it does tend to shift when I roll over for side sleeping. Maybe that will help with the leak rate. Thanks for the feedback.
Okay, so the more I'm learning about this, the more I am realizing I don't like the EPR feature. I feel like I'm sub-consciously(?) trying to time my breaths as I don't think the machine is registering/reacting fast enough and I feel like I'm not getting air when I expect to get air, which seems to happen around 230-3am every morning. It feels like there is a tapering off effect, and I'm struggling to get the right amount of air, which is disrupting my last couple of hours.
I'm considering turning down EPR (from 3) or just disabling it for 1 night, and I think my preference being to disable it. I think I would prefer constant pressure vs oscillating between to rich and to lean. I guess that would turn it into a CPAP. If I'm reading my data correctly, my median pressure of the course of the night was 7.4. What would be a good place to set the constant pressure for one night to give it a try? Before bed I might need to give the 'test drive' feature a go with the number and see how the constant pressure feels.
(Yesterday, 10:17 AM)dasbeard Wrote: Awesome. I will give the min pressure a go tonight. I think I need to tighten up my mast a little as it does tend to shift when I roll over for side sleeping. Maybe that will help with the leak rate. Thanks for the feedback.
I wouldn't tighten the mask, it is counter-intuitive, as this can cause more leaks or discomfort.
Also, iIf you need to lower EPR, consider doing it in stages as your flow limitations might increase, leading to possible arousals.
I am glad to hear "Things seem to be going well so far", info like that is important. You can right click on the left side of the leak graph and choose to override the Y-axis and lower the maximum and ignore the cutoff of that 1 large leak. This would give you a better look at your leak chart. IMO. Though the leaks are not large, they may impact your therapy, for me this is true in nasal/pillow masks more so than full face masks. Good luck!
(Yesterday, 01:16 PM)jdougc Wrote: I wouldn't tighten the mask, it is counter-intuitive, as this can cause more leaks or discomfort.
Also, iIf you need to lower EPR, consider doing it in stages as your flow limitations might increase, leading to possible arousals.
I am glad to hear "Things seem to be going well so far", info like that is important. You can right click on the left side of the leak graph and choose to override the Y-axis and lower the maximum and ignore the cutoff of that 1 large leak. This would give you a better look at your leak chart. IMO. Though the leaks are not large, they may impact your therapy, for me this is true in nasal/pillow masks more so than full face masks. Good luck!
All really good info there. Thank you. After applying the override I'm going to compare last night to the previous week. The last 3 nights I have been slightly stuffy so I know I tried to adjust the nasal pillow a good bit.
I did post a follow-up that I was considering disabling EPR, now that I know what it is, in favor of constant pressure. I'm looking for feedback on a good pressure to try for a night, should I chose to go that route. I wonder if there is a EPR/Min Pressure table I can find. EG EPR 3 / Min Pressure = 7, EPR 2 / Min Pressure = x, and so on as a rule of thumb.
Some folks prefer to be in CPAP mode only, That is all I used for perhaps 18 years. I still use CPAP mode, although I also use 2 EPR and that is what works for me. If you set up for CPAP mode only you need to set your minimum pressure high enough to eliminate as many apneas as you can. You will most likely see an increase in your flow limits due to no EPR. Flow limits are almost like mini apneas, although usually not long enough to register as an apnea. The secret is trying to fine tune the CPAP machine. You want minimal number of apneas and low flow limits and quality sleep. If you feel good and are rested that's as good as it gets. Anyway, I would start at 8cm in CPAP mode. If your flow limits get out of hand (and they might) start adjusting you pressure up. With out the EPR the pressure increase is all that you can do. As an example here was my flow limits last night...@ 95% was 0.01. at 99.5% it was 0.10, if I turn the EPR off they have been known to run up to 0.15 @95% and 0.35 @99.5% so EPR does make a difference. Try the CPAP mode only and see how you feel. Good luck.
(Yesterday, 05:36 PM)Old Steve Wrote: Anyway, I would start at 8cm in CPAP mode. If your flow limits get out of hand (and they might) start adjusting you pressure up.
Thanks for that advice. And also what jdougc provided I think that next few nights I'm going to try the following.
Tonight - Set Min Pressure to 7 (up from 6), keep EPR at 3
Tomorrow - Set Min Pressure to back to 6 and try EPR at 2
Following night - CPAP Mode, Min Pressure 8
Future - Observe flow limits and decide a game plan for possible CPAP only mode. Also may try EPR 1. Got a little bit of experimenting to do.
Importantly, keep track on how you feel, rested, clear headed or unfortunately maybe worse.
But remember these are just steps in a journey and what works tonight, might not work tomorrow.
I wish there were hard and fast answers, but there are guidelines that the good people here will share.
