New member Help!

[americasclassics]

First of all thank you for having a forum that educates you on using a CPAP machine. I thought Kaiser and CPAP vendors like Apria health would make things more seamless. I was so completely WRONG, I’ve been a CPAP user 2 yrs now and over the last 6 months I’ve been getting worse
I went down from 7-8hrs usage to 4 hrs full face mask P20 and F&P Vitera. Recently I’ve gotten improvement usage with nasal pillow P10 back up to 6-7hrs 
Symptoms low O2 lowest 76 Viatom O2ring 
(Thank God for technology)
Heart palpitations at night with spikes above 110bpm
Acid reflex 
I still stop breathing at night but thanks to O2 ring im able to stay above 92 most day

I’m new to OSCAR ( Thank God and God bless the app creator ) 
I know I will get better, But PLEASE HELP!
Thank you again Apnea board

[americasclassics]

Adding Oscar photo

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I was able to improve my leak rate substantially, but only after I could not sleep on my side or my back. I end up up placing my wedge pillow under my chest in a probing position was I able to sleep.

[americasclassics]

What concerns me the most is the low O2 and my tidal volume. If I can get those numbers to improve I should be Golden

[PeaceLoveAndPizza]

Tidal volume is not something you impact directly unless you go to very high pressures, which will be quite uncomfortable. Your respiration rate is fine, so just ignore it for now.

Have you discussed your o2 levels with your doctor?

You do have a bit of positional apnoea with chin-tucking on the 7/10/24 chart around 22:30. Finding a way to keep the airway open will do wonders for things.

I would add a bit more pressure to see how things go.

Mode APAP
Min pressure 12
Max pressure 16
EPR 3 full-time
No ramp

Also, please read the link in my signature “Formatting OSCAR Charts”. Those are the charts we need to see to understand things.

[americasclassics]

Wow I was hoping you would respond 
With tears ? in my eyes thank you

[Phaleronic]

Leak rate isn't bad and EPR 3 needs more pressure to help with how it dips during comeback from exhalation so I'd recommend setting it to 14.6cm in cpap mode with EPR on 2 and try it tonight for 30 minutes or so, it's more comfortable than apap mode and leads to less arousals and lower ahi/rdi.

[americasclassics]

Thanks again @peaceloveandpizza
Here was my first nights rest with new settings
I kept being woken up by my O2 ring with low Oxy warnings below 92%
So I quickly made a mask change to my P20 w/foam cushion set up kept the lowest pressure at 12 and increased the highest pressure to 18
Apap, EPG 3, no ramp

I do feel more rested and my tital readings look better 

FYI I sleep on a wedge pillow with another pillow under my head, after the 1:40Am readings I slept on left side, results feel and appear positive 

Do you suggest adjusting pressure? 
How can I improve clear airway score? Several events I see more than 10 last night 

Thank you Thank you Thank you

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Here is the other half of my OSCAR CHART

[americasclassics]

Thank you @phaleronic
CPAP mode is set to one pressure setting only, correct? 

EPG of 2 with make it more difficult to exhale 

But I will try also from 30min-1hr 
My main focus now is to avoid clear airway, issues 
These are what cause my ring to go off at night and wake me up if they go below 92

[PeaceLoveAndPizza]

One challenge is with the wedge and the pillow, your neck angle may be cutting off your airway. If you have a flatter pillow around to try, it is worth giving it a go. 

What we want to see is whether reducing EPR will reduce the CA’s. Let’s try another experiment.

Mode APAP
Min pressure 10
Max pressure 16
EPR 2 Full-time
No ramp

This way you reduce EPR by 1, but we are also dropping the min pressure by 1 to help compensate.

[americasclassics]

Ok I will try full face mask with the following settings
Mode APAP
Min pressure 10
Max pressure 16
EPR 2 Full-time
No ramp
Thank you