Requesting help w/ CPAP adjustments

[SarcasticDave94]

Setting up at 4 or 5 (possibly w/o EPR) means they're going cheap and trying to use CPAP therapy and not inducing centrals at low pressure. They are failing to help. You will not get proper therapy IMO.

Yes, for ASV you're needing a heart echocardiogram due to a misguided report. This is a test that takes ultrasound images recording both audio and visual of the heart. It'll be possible to get one at a local hospital at or near the radiology dept. once a doctor orders it. You'll lie on an exam table where the tech moves a cold gel coated wand pressed into your chest over your heart. A cardiologist will do a write-up on results. The needed info for ASV is % LVEF of 45 or higher number to pass. Mine was 55%.

[flatlander]

Honestly I have not used CPAP in about 2 weeks. I tried the settings suggested for about a week and was still getting AHIs 5-10 and was still feeling tired. Should I try CPAP with your suggested settings for another few weeks? 

I don't know what else to do until I see the sleep doctor.

[flatlander]

I don't get why a hospital would try to go "cheap" as they are not the ones paying the end price, its myself of the insurance. 

I was wondering if it was a poor sleep study bc I could not sleep great. I went to sleep around 10:30 and woke up at 3am to use restroom and did not go back to sleep. 

Would you recommend I just keep using CPAP set at 5 w/o EPR until I can see sleep doc?

[SarcasticDave94]

Honestly I have not used CPAP in about 2 weeks. I tried the settings suggested for about a week and was still getting AHIs 5-10 and was still feeling tired. Should I try CPAP with your suggested settings for another few weeks? 

I don't know what else to do until I see the sleep doctor.

If you were asking me, I was mulling over the test implications, I was not suggesting you use 4-5 w/o EPR. Sorry if there's any confusion. I may not have stated that clearly earlier.

[flatlander]

I guess my concern is how I would progress to the ASV if that is needed if this sleep study is saying my apnea can be treated with low pressure CPAP.

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Sorry I think that was supposed to go to Bonjour. Still getting used to this board.

[flatlander]

Honestly I have not used CPAP in about 2 weeks. I tried the settings suggested for about a week and was still getting AHIs 5-10 and was still feeling tired. Should I try CPAP with your suggested settings for another few weeks? 

[Gideon]

With us Try for a night and post. That let's us know what is and leads to how to improve.

The RT suggested a pressure of 4 but with a Flex of 3. That is funny because Flex at any setting, or EPR at any setting with a pressure of 4 is identical to EPR of 0. CPAP pressure cannot go below 4.

[flatlander]

The RT suggested a pressure of 4 but with a Flex of 3. That is funny because Flex at any setting, or EPR at any setting with a pressure of 4 is identical to EPR of 0. CPAP pressure cannot go below 4.

Can you elaborate more on this statement please? 

OK I will get back on the wagon and post more info. Thank you all so much for the help. Feeling lost right now.

[Sleeprider]

A titration at 4 infers that the apnea will be central at higher pressure. You will not get Flex or EPR when the pressure is already at the minimum.  I think you need to talk to your doctor and take the position this is not a successful titration but only a mitigation of CPAP therapy that results in central apnea and should be treated with ASV.  You need to get the cardiac echocardiogram out of the way proving left ventricular ejection fraction is outside the risk group for ASV.  

I can assure you that such a low pressure will become uncomfortable or produce inconsistent results, so we will be revisiting the need for ASV. If you doctor has any sleep disordered breathing chops at all, he will see right through this stop-gap measure by the sleep clinic.  Central apnea is consistently inconsistent, and you will return to double digit event rates.  The titration recommendation is simply not any different than this previous result where pressure varied from 4.0 to 5.5 cm pressure.

[Gideon]

The RT didn't know what he was talking about. With a setting of 4 Flex or EPR will have no/nothing/zero impact on your therapy.