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Please help with CPAP titration
#1
Please help with CPAP titration
I have been using a Resmed AirSense 11 for a little over a week now. I was diagnosed with a Lofta sleep study and the prescription was not personalized or fine tuned in any way, so I hope to do that myself.

Unfortunately, I am about to go in a trip with family so I need to prepare for that and don't have time to delve into learning all of this just yet, but I am desperate for a good night's sleep!

I have uploaded a screenshot of my most recent sleep, can anyone recommend a place to start? I believe my machine was set at 4 or 5 minimum to 20 cmH20 maximum when I got it. I couldn't breathe in well so I upped the minimum to 7 cmH20 and lowered the max to 15. That was based off of comfort for me and typical results I read on the internet, there was no data involved in the settings.

Thanks!


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#2
RE: Please help with CPAP titration
First, please read the link in my signature "Formatting OSCAR charts". The AHI and time at pressures charts are of no use at the moment, so no reason to include them as well.

For now, try these settings.

Mode APAP
Min pressure 8
Max pressure 15
EPR 2 full-time 
No ramp

That should help with a bit more pressure and pressure support. We will likely have to do more fine-tuning.
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#3
RE: Please help with CPAP titration
Welcome

I see a few things that can be improved.  I suggest you raise your pressures to 8.6 to 17.  This is slightly higher than your median pressure, and you are hitting your 15 so you need a little more headroom.

If you raise your EPR to 3, you will find breathing easier and lower your flow limits. This might slightly increase your CAs, but I think getting the flow limits down is more important than your AHI numbers.

Did your sleep study show a lot of CAs?  If you don't know, please post a copy of your study.  If you don't have it request a copy from your doctor's office.  By US law, they have to provide it to you.

You also have some Positional Apnea, which cannot be fixed by a setting. PA shows up on your chart where you see obstructives and hypopneas clustered together.  This is caused by tucking your chin toward your chest.  This tucking decreases airflow much like a kinked hose decreases water flow.  Sometimes a flatter pillow is enough to correct the problem, but more solve it by wearing a soft cervical collar that's high enough to stop your chin from dropping.  What I see is of course just one night, so you may have more or less PA overall.

Again, welcome, and good luck with your new therapy!  Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#4
RE: Please help with CPAP titration
Thanks for replying. I will try the settings you both suggested for a time and see how they do. I will wait to post updated Oscar data until I have some time with the settings.
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#5
RE: Please help with CPAP titration
(11-09-2024, 10:35 AM)Deborah K. Wrote: Welcome

I see a few things that can be improved.  I suggest you raise your pressures to 8.6 to 17.  This is slightly higher than your median pressure, and you are hitting your 15 so you need a little more headroom.

If you raise your EPR to 3, you will find breathing easier and lower your flow limits. This might slightly increase your CAs, but I think getting the flow limits down is more important than your AHI numbers.

Did your sleep study show a lot of CAs?  If you don't know, please post a copy of your study.  If you don't have it request a copy from your doctor's office.  By US law, they have to provide it to you.

You also have some Positional Apnea, which cannot be fixed by a setting. PA shows up on your chart where you see obstructives and hypopneas clustered together.  This is caused by tucking your chin toward your chest.  This tucking decreases airflow much like a kinked hose decreases water flow.  Sometimes a flatter pillow is enough to correct the problem, but more solve it by wearing a soft cervical collar that's high enough to stop your chin from dropping.  What I see is of course just one night, so you may have more or less PA overall.

Again, welcome, and good luck with your new therapy!  Smile




Thanks for the reply. I will try the settings you both suggested for a time and see how they do.

I took a home sleep test with WatchPAT through Lofta. I am looking over the data again and it doesn't look like there is any mention of central sleep apnea anywhere. I don't think that test can differentiate between them. The prescription at the end has the box checked for OSA, but not for CSA.

I do have a chin tuck problem and I will definitely look into a cervical collar.

I am in the middle of packing for a trip so I can't get as detailed as I want with this for now, but I will as soon as I have the time.
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#6
RE: Please help with CPAP titration
Let us know how it goes!
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#7
RE: Please help with CPAP titration
Hello again.

I ordered a cervical collar and a hose holder and got three night's worth of data, changing a few things each night. I noticed a lot of clear airway events and was trying to change things based off of recommendations I read here.

Here is the data. How do things look? What can I do about the clear airway events?


   

   

   




Any help is greatly appreciated!
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