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09-21-2020, 01:02 PM (This post was last modified: 09-21-2020, 01:03 PM by Johnnyde94.)
Do I need a Bi-Pap or higher pressure APAP?
Hello I’m very new to the sleep apnea world and am wondering if I/ my doctor made a mistake. My AHI over a two day I home sleep study way 84. I have been using my Dreamstation APAP for two weeks now and feel much better. My question is that my average pressure and 90% pressures are aproching the 20cm h20 limit of the machine. I am acclimating to therapy very well. My mask as of now is the f20 air touch with a liner to catch moisture.
I will attach attach my sleep study information later. I was going to do it now but the photo size limit is too small and when I compressed the photo on my iPhone it is now unreadable lol. I have OSCAR, but I just don’t know what information would be most useful. I did see some Periodic breathing and some central apnea’s too. Please let me know what data you guys need, I really appreciate having a second option.
Note: I did not have a titration study and I have my minimum pressure set to 10 (I’m odd I find it easer to tolerate therapy at a higher number, plus I feel I apnea right when I fall asleep.
I can post my OSCAR data later in the day like 4ish.
Welcome to the forum. It's hard to answer your question without data. I was glad to see you have OSCAR.See the links below for organizing and posting your daily charts. We need to see event flags, flow rate, pressure (not mask pressure), leak rate and snore.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
That’s fine for a sleep report but OSCAR is set up to use F12. There is also a setup as to what to post in the data tab. I’m on an iPhone so I cannot see my computer but I think it’s under reset charts sets it up.
I'll leave it to others to comment on settings (post some oscar charts to facilitate this) but I'll offer a few general thoughts. your test summary shows a lot of obstructive apnea. I thought my 204 oa in about 6 hours was a lot but yours is twice that. and if I'm reading it correctly, your desats were significant. feeling more comfortable at higher pressure is not unusual; apparently that's what it takes for you to breathe better. it's possible your machine can be adjusted to alleviate it, but bumping up against 20 cmw may forecast the need for bilevel that's capable of reaching 25 cmw (at least for resmed vauto, not sure about PR machines). posting some oscar charts will enable some better responses.
Here are my results for last night, My worst Clear Breathing night, and my worst periodic breathing. Please let me know if there is any more data I can provide. Also, let me note that I am sleeping on a bed with a 50 or so incline and I changed masks from dreamware full face to f20 airfit large on the 15th, the 17th Airtouch large, and last night Airtouch medium. I also use a remzzz liner.
Johnnyde welcome to Apnea Board. With pressure settings of 10.0 to 20.0 and Flex at 3, you are getting acceptable AHI / RDI results, but your pressures are consistently approaching the maximum capability of your Philips auto CPAP. We can help you to get better results with bilevel pressure, and at the same time do it with LOWER pressure, due to the use of "Pressure Support" (PS), which is the difference in pressure between IPAP and EPAP. Most of all, I want you to get away from your Philips machine and insist on Resmed. Even the Resmed auto CPAP (Autoset) uses a bilevel pressure approach that would have been more effective and more comfortable. I think it would be a great idea for you to talk with your doctor about your results with the objective of moving to bilevel for greater comfort, but also to get a Resmed. The Resmed Aircurve 10 Vauto is the machine you want to target. Even if you can persuade your doctor to move you to a Resmed Airsense 10 Autoset, you'd be better off because the Autoset provides up to 3-cm of pressure support.
Okay, that is my pitch to ditch the Philips and get better Resmed. We can improve your results on your current machine. First turn the Flex level down to 2 and set your minimum pressure to 12.0. That should cut AHI in half and be more comfortable. I still think you'd find the Resmed is a whole new level of therapy comfort.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
There is no such thing as a higher pressure capable APAP/CPAP.
Your RERAs and Flow Limits indicate that you would likely do better with a BiLevel (preferred) or a ResMed AutoSet. We prefer the ResMed VAuto for the BiLevel.
Why are you sleeping on that much of an incline? What other breathing issues do you have, cardiac too. I would like to determine which BiLevel would be best for you and if you need a backup rate.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
