New to cpap

[BazeBaze]

Hello. New to cpap and having trouble adjusting to it. Moderate sleep apnea. I first started with nasal pillows, but I felt pressure in my ears and then a nasal mask which pushed up against my nose and now started using a full mask. My prescription is autoset 4-20 with autoramp.  my resmed 10 says for the last three continuous days I’ve used it. My pressure is 11.4, I believe this would be my average pressure. My main issue is falling asleep with the CPAP on and it appears I’m waking up during possible apnea episodes but I’m not sure exactly why. If it’s too much pressure or not enough pressure? I’m thinking of turning on EPR and maybe level two? Any other recommendations for comfort? Or change and pressure settings?   Thank you.

[staceyburke]

Welcome to the board and we can help most problems.  We need data to help, however and the data we use is from oscar.  oscar is a totally free download that gives us a huge amount of information.  You need an SD card 2 to 32 GB what ever is the lowest price.  The card needs to be in the machine while you sleep and then downloaded to a computer from the SD card.

[BazeBaze]

hello. Here is a pic from the report generated in Oscar. Thanks 

[img]blob:https://www.apneaboard.com/4d118fd2-8ee0-42d0-9328-a435ffb8b553[/img]

[BazeBaze]

don't think the pic could be opened so i screen shot this info. appreciate the help,. thanks
   
   
   

[BobFromAccounting]

I turned off ramp myself and bumped my min up to 8 from 6 and it improved for me. But someone here will likely have better info. Im brand new too.

[staceyburke]

You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

[Deborah K.]

It is normal to have adjustment problems when you are new to pap use.  It's quite a challenge to suddenly have a foreign object stuck to your face and have air blowing up your nose.

I agree that your starting pressure is too low.  I suggest that you move it up to at least 7, a little more if you like, and that you turn off ramp altogether.

You have a lot of CA events.  Were there lots of CAs in your sleep study report?  CAs can be treatment-emergent but it would help us help you if you could let us know what the sleep study said.  If you have a copy, posting a redacted copy of it would be good.

In my case, I was able to eliminate positional apnea by buying a child-sized pillow that had a good ridge at the front of the pillow that holds my head tipped back slightly.  My pillow is no longer made but I found some that are similar on Amazon that I think would provide the same kind of support.  Here are two:

https://www.amazon.com/Hcore-Adjustable-...r=8-2&th=1

https://www.amazon.com/MLILY-Adjustable-...r=8-5&th=1

These are both made with three layers, so you can make them thinner yet if you want.  I used collars for a while but like my pillow way more and get a better result.

[BazeBaze]

Hello. No not much central. Diagnosis was just moderate obstructive; didn’t meet the criteria for central. I believe it is treatment emergent. All my apnea events before cpap were during rem sleep. I attached a copy of the sleep report. I was debating switching from autopap to a fixed pap setting. Thanks for all the help.

[Deborah K.]

Yes, your high CAs look like they are treatment-emergent and will lessen in time.

Make your settings changes and post an Oscar report tomorrow.  I think you will feel better soon.  

[BazeBaze]

Will be uploading some new oscar reports but pretty much all my events are now treatment emergent ca and appears obstructive ahi is very minimal after making a change in the pillow and decreasing the incline of the bed. Total ahi now around 5 or less the last couple days. They are annoying because they wake me up (around 3x a night) and difficult to go back to sleep. Does anyone know of any natural ways to speed up the resolution of these treatment emergent central apneas? thank you