Opinions on my data

[kelliboo]

Hi, I am new here. I was diagnosed with Obstructive Sleep Apnea in October, and I've been using my machine since Nov. 3rd. My AHI was 9.3 / RDI 12.7. I think I finally got my mask to fit pretty well, and I didn't take it off numerous times during the night, so yay! I started off at 5-15 pressure, and my doctor changed the settings on Friday to 8-17. I also turned off the ramp, because I didn't feel like I was getting enough air at the beginning of a sleep session. Looking at the data through my newb eyes, I think that I should at least be at 10-17, but please let me know what settings y'all think may work better for me. Thanks!

https://imgur.com/a/OXoMi

Kelli


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[ajack]

Not too bad, I would try min 15 max 20, to try and clean up those flow limits and the few hypopnea.
I would use an epr of 2 or 3 for easier breathing out. See what you think.

[DeepBreathing]

G'day kelliboo. Welcome to Apnea Board.

Your events seem to be concentrated in two main clusters, and everything is fine in between. This makes me think the problem might be positional. In particular, it's possible you were sleeping on your back with your chin tucked down to your chest. This will narrow your airway sufficient to cause flow limitations and/or hypopneas. You can test this easily enough by sitting upright in your chair and take a few deep even breaths. As you breathe in and out, slowly let your head fall forward until your chin touches your chest - feel (and hear) the difference?

Ways to overcome this include changing your pillow so that your neck is supported and your head tilted slightly back, sleep on your side, or try a soft cervical collar to support your jaw and stop it falling forward. I'd try these tactics first, then review the pressure requirements.

[HalfAsleep]

You managed to go that high with pressure and keep the leaks that low? You go, Guurl! That's quite the talent.  

[Sleeprider]

This is a good start, although pressure gets pretty high as a result of the flow limitation. I'm with Ajack that EPR at 3 can kick those flow limitations and hypopnea out of the picture, but I'd also like to see minimum pressure at 10-11. Great start!

[kelliboo]

Thank you all for the quick replies!

Not too bad, I would try min 15 max 20, to try and clean up those flow limits and the few hypopnea.
I would use an epr of 2 or 3 for easier breathing out. See what you think.

I will add an epr of 2.

Your events seem to be concentrated in two main clusters, and everything is fine in between. This makes me think the problem might be positional...
Ways to overcome this include changing your pillow so that your neck is supported and your head tilted slightly back, sleep on your side, or try a soft cervical collar to support your jaw and stop it falling forward.  I'd try these tactics first, then review the pressure requirements.

I bought a pillow (boooo, I loved my old pillow) yesterday to help with this, as I know that I like to sleep with my chin tucked in there. Probably because my old pillow was very firm and tall. I had read about the soft cervical collar, and will give that a try as well.

You managed to go that high with pressure and keep the leaks that low? You go, Guurl! That's quite the talent.  

It was not without indentions in my face upon waking! LOL I will try to loosen up a bit, but yeah I was happy about the lack of leakage!

This is a good start, although pressure gets pretty high as a result of the flow limitation.  I'm with Ajack that EPR at 3 can kick those flow limitations and hypopnea out of the picture, but I'd also like to see minimum pressure at 10-11.  Great start!

I think I like the minimum pressure at 10 as well. But again, I'm new so I'm open to suggestions from all y'all that have been doing this for more than one month! Going for 10-20 pressure (seems wide, but I sat at 17 for a while?) EPR of 2 tonight. We'll see how things go!

Y'all are awesome!

[trish6hundred]

Hi kelliboo,
WELCOME! to the forum.!
Good luck with CPAP therapy and getting it fine-tuned to meet your needs.

[kelliboo]

Well, here is last night's data as well as some other days:

https://imgur.com/a/KVVka

I'm not sure how things went so south. The first few nights were actually pretty good...

Night 2 humidity 0 / 5-15 no epr - 0.84 AHI
Night 3 humidity 1 / 5-15 no epr - 0.50 AHI
Nov 11 humidity 1 / 5-15 no epr - 1.65 AHI
New Dr Settings Nov 18 humid 2 / 8-17 no epr - 3.27 AHI
Last night humidity 2 / 10-20 epr 2 - 3.42 AHI

I'd like to take that AHI in the other direction. Please let me know if the pics aren't readable.

Thanks!

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Hi kelliboo,
WELCOME! to the forum.!
Good luck with CPAP therapy and getting it fine-tuned to meet your needs.

Thank you, Trish! 


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[ajack]

I'll go with chin tucking still, the med swing is 10-17 the 95% swing is from 14 to 20. I'd say this is positional.
raising the min to 10 epr 2 shouldn't cause it to have med 17 max, 95% 20
I think it's time to use the cheap foam collar as a test to see. You are looking to get your chin up and head back, not as severe, but like mouth to mouth resus.

Also all the charts have a higher breath per min and lower tidal volume with normal minute vent, we can look at that later, if it doesn't fix up, also the machine can miscount.

[kelliboo]

I'll go with chin tucking still, the med swing is 10-17 the 95% swing is from 14 to 20. I'd say this is positional.
raising the min to 10 epr 2 shouldn't cause it to have med 17 max, 95% 20
I think it's time to use the cheap foam collar as a test to see. You are looking to get your chin up and head back, not as severe, but like mouth to mouth resus.

Also all the charts have a higher breath per min and lower tidal volume with normal minute vent, we can look at that later, if it doesn't fix up, also the machine can miscount.

Ok, I'll pick up a collar soon and get back to y'all with the new results. For now, I think I'll go with 14-19 with 3 epr and bump the humidity back down to 1. Thanks, ajack!