[Diagnosis] Looking for some guidance

[Cg30sailor]

was wondering if someone could check this out and give me some ideas. I'm currently battling a leak issue(not on this night).

[Old Steve]

I would set your minimum pressure to at least 9cm,  as you are averaging a little more that anyway.  Put your maximum pressure to perhaps 14cm. Also your flow rates are too high, full time EPR can help with that I would start with the EPR set at 2, if that helps try 3.

Search for flow limits on this site for more info...

[Cg30sailor]

Thanks for reaching out. I have tinkered with the EPR in the past and felt worse. Would increasing the minimum pressure and eliminating the ramp help that situation? I'm also dealing with some serious leaks (not shown in this screenshot).

[Cg30sailor]

        this is last nights nightmare. Ive been on cpap for 19 years and never had numbers like this

[Old Steve]

I have been on CPAP since 2000 and over the years I have had nights like that, way too many of them.  

Your leaks are bad on your last chart for sure.  I would jack the minimum pressure up to ten, shut off the ramp and see how you do, obviously it isn't going to help with the leaks.   Have you ever tried just running in CPAP mode?  That is what I use, although I also use full time EPR set at 3, to control my flow limits, anyway that is what works for me.  In CPAP mode you don't have all the up and down pressure fluctuations like you do in APAP.   Just get your min pressure up high enough to stop the vast majority of your Obstructive Apneas and you should be good to go.  

[Cg30sailor]

I will gladly take your suggestion!! Thank you very much.

[Cg30sailor]

made some changes... still having issues

[Old Steve]

I think that you may be having some Positional Apnea in your last chart. Caused by chin tucking, sleeping on your back or any position that causes your airway to close.  Imagine folding over a garden hose to shut the water off, same situation.  The only way I could stop my positional apnea was to sleep on my side.  Search the forum for more information.  

Did you have CA's in your sleep test?  Also, what were your original pressure settings?  

Try these settings for another night or two and try changing your sleep position and see what happens.  

Good Luck.

[Cg30sailor]

My sleep test in 05' was RDI 55. No central apnea. Most were supine. My settings were CPAP at 8. I've used an APAP for 16-18 years with little issues. I am 21 pounds heavier ?