Oscar Help - Analysis after 3 Weeks, Improvements!

[ef8mk]

Hi All,

Just seeking minor guidance for adjustments on my CPAP Machine. First two weeks ranged from highest of 13, to 5, last now average 1-2 AHIs. No mask seal issues with my F20 (minor nose bridge mark), I sleep on my side entirely. Huge improvement from AHIs of 45 during sleep study, no snoring whatsoever. I do notice I regularly wake up early at 6:30-7:30 despite sleeping late. Way more focus and being refreshed through day. 

Adjusted my pressures from 4-12 to 5-14 given that the limit kept hitting 12 first two weeks. EPR is off. Few Questions:

1) Normal to wake up maybe 1-2 a night with the CPAP? Before I'd sleep like a rock immediately till wake up.
2) Should I bump my minimum pressure to 6? 

Any other recommendations are greatly appreciated, hopefully have all the required data in the pictures to follow. Thanks for all your help!

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Sleep Study info below.

[Deborah K.]

You have made a great start!     Your Oscar chart is set up just right, and your numbers are good.  I have a couple of suggestions for you:

Raise your starting pressure to 7.  Most adults are less comfortable with less than 7.

Turn EPR on full-time, set at 3.  This will help with your high flow limits and will make your breathing more comfortable.

If you can, turn your ramp off.  You don't get any therapy while it is on.  If you really need it set the pressure to 6 instead of 4.

[ef8mk]

You have made a great start!     Your Oscar chart is set up just right, and your numbers are good.  I have a couple of suggestions for you:

Raise your starting pressure to 7.  Most adults are less comfortable with less than 7.

Turn EPR on full-time, set at 3.  This will help with your high flow limits and will make your breathing more comfortable.

If you can, turn your ramp off.  You don't get any therapy while it is on.  If you really need it set the pressure to 6 instead of 4.

Thanks! I will try the EPR, ramp off, and minimum starting pressure.

[ef8mk]

Well updates after two weeks. EPR set at 1 has helped immensely, don't find the pressure too strong at times. I fluctuate between 1 - 2 AHIs daily, a lot has to deal with pillow choice and positioning during sleep. Any other improvements I can make? I will most likely set ramp to off and starting pressure at 7.

[ef8mk]

[staceyburke]

Your flow limits are high. They make your pressure go higher and stop you from getting in a deep sleep. 

To help with flow limits we use EPR. Right now yours is set to the lowest setting (1). 

I would suggest 2 changes to help. 

Min 7
EPR 3

[Dormeo]

I agree 100% with staceyburke. You can sneak up on those settings by first leaving your min at 6 and increasing your EPR to 2. Once you're used to that, you can increase your min to 7 and your EPR to 3. Note that you won't get the full benefit of EPR of 3 with a min less that 7. That's because 4 is the lowest pressure the machine can deliver.

EPR drops your pressure when you exhale; by the same token, it increases your pressure when you inhale. That little boost can support a smoother, less disruptive, inhalation for many people.

[ef8mk]

Your flow limits are high. They make your pressure go higher and stop you from getting in a deep sleep. 

To help with flow limits we use EPR. Right now yours is set to the lowest setting (1). 

I would suggest 2 changes to help. 

Min 7
EPR 3

Thanks, did both last night.

I agree 100% with staceyburke.  You can sneak up on those settings by first leaving your min at 6 and increasing your EPR to 2.  Once you're used to that, you can increase your min to 7 and your EPR to 3.  Note that you won't get the full benefit of EPR of 3 with a min less that 7.  That's because 4 is the lowest pressure the machine can deliver.

EPR drops your pressure when you exhale; by the same token, it increases your pressure when you inhale.  That little boost can support a smoother, less disruptive, inhalation for many people.

I went ahead and changed both settings. Slightly harder to get use to with the EPR but I'll give it 1-2 weeks. 

Thanks everyone for their help!

[ef8mk]

Hi All, I've had varied AHis from 1 - 4 regularly for last 2 weeks. (only hitting below 1 AHi maybe once). I do move around off my side which can affect things in terms of airway. Considering reducing EPR to see if that would help anything. 

[Dormeo]

When you say "off your side" do you mean on your back? That can certainly boost the number of OAs you have. So can tucking your chin down toward your chest even on your side:

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

Although we can't see your FL graph, the numbers in the left panel suggest they've responded well to EPR. Are you finding the EPR of 3 fairly comfortable?

So I think addressing positional issues is your next order of business. Do you think you could arrange a pillow behind your back that would keep you from shifting into a supine position?

I also see that you don't get much sleep most nights. Almost everyone needs at least 7 hours of actual sleep to function decently during the day. Any chance you could work on your schedule to leave more time for sleep?