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[Pressure] Right pressure to reduce CA and easier breathing
#1
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Right pressure to reduce CA and easier breathing
Hi, I've been using my CPAP for about a month and treatment seems to be getting mildly harder in terms of comfort. I haven't changed my settings very much, but I wake up about 3-4 times a night and find my breathing to be shallow and like my breath rate is higher than normal. I feel somewhat anxious when I wake up and try to breathe slowly, but find that this is hard using my CPAP. I am wondering if there is anything in my settings that I should try to adjust. My Oura ring consistently tells me that my heart rate takes a long time to go lower and I can see that it doesn't really ever dip that much. This feels on par with how tired I feel in the morning. 

I have tried different EPR settings, such as 7 and 2 EPR and even 8 and 3 EPR, but I find that the higher EPR and pressure settings feel too much and I find it hard to take a deep breath in. Exhales feel okay, it's just the breath in feels cut off at the tail end and that causes me anxiety. 

Is there anything someone can see obviously in my chart that I can try? Thank you!


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#2
RE: Right pressure to reduce CA and easier breathing
Welcome! A few observations. You had cluster of CAs at the beginning of the night and right after the break in therapy. These appear to have occurred before you were asleep, so you should bracket them when you think about how things went by the numbers. Once you do that, by the numbers things are going well.

So the question is how to make your sleep more restful and refreshing, with breathing that feels natural. I see that you are using the "for her" mode and the soft response setting. If you can hack it, I'd suggestion the following series of experiments:

1. Start with a few nights of max = min = 7 and EPR of 3. Don't change anything else. This will give us a base line.

2. Turn of the "for her" mode and use the regular APAP mode. Try that for a few nights.

3. Also turn off the "soft response" setting and try that for a few nights.

The reason I'm suggesting max = min = 7 with EPR of 3 for all three experiments is that you aren't having obstructive events at low pressures, but your pressures are moving around in response to flow limitations. It's *possible* the pressure fluctuations bother you, so it might be useful to eliminate them from the picture. Also, 7 is the lowest you can go while still getting the benefits of EPR of 3. (The machine can't go lower than 4.)

About those flow limitations: do you have a stuffy nose?
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#3
RE: Right pressure to reduce CA and easier breathing
Hey, thanks for this! I notice that one of my nostrils is typically plugged up at night, but the other one is working fine. I've wondered if not having good flow through both nostrils could be contributing to my issues.

Just to confirm, you are suggesting I try setting a fixed pressure of 7 with an EPR of 3?

Could you elaborate a little bit on why the "for her" mode or the "soft response" mode might be helpful to try turning off?

Thank you so much for all of your help!!
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#4
RE: Right pressure to reduce CA and easier breathing
It's possible that having one nostril closed up gives you the feeling that you can't breathe enough. Is it always the same nostril? Does it feel closed up during the day? Are you doing anything to try unclogging your nose?

Yes, I'm suggesting setting your min to 7 and your max to 7. That's effectively a constant pressure, though without going into CPAP mode, which in some machines can limit the data that are reported.

You report a specific sensation of getting your breath cut off before you finish inhaling, and that makes me wonder whether the subtle effects produced by the For Her and/or soft response algorithms are bothering you.
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