Santiago Figarola - Therapy Thread

[Deborah K.]

Your beginning pressure is too low.  Raise it to 7

On your chart, we don't need to see Snore, but we do need to see Flow Rate right under Pressure.

Start there and we can help more later.

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

[staceyburke]

Your central apnea is the worst and we don't know if that is something you had during your sleep study or if it is treatment emergent.  If you have your sleep study please get rid of personal data and put it on your next post.  It is important that we know if you had centrals during your study of if they started when you began using your machine.

I would suggest that you raise your min to 8.  4 is to low for an adult in fact it is for small children...

[Santiago Figarola]

Hi! Thank you
Alright. You can see the Flow Rate above Pressure, not sure if the order of the charts matters

[Santiago Figarola]

Hi! I posted part of the Sleep Study in a previous post: https://www.apneaboard.com/forums/Thread...RDI-16-AHI (#4).
Summary: In that study, I only got hypopneas with a max duration of 62. 51% efficiency of sleep.
94% saturation awake, 94% saturation while resting, and a minimum of 92% saturation. RDI of 16, 16 AHI (no RERA). No Centrals either.

[Deborah K.]

Since your study showed no Central Apneas your present CAs are treatment-emergent and will lessen as time passes. I would ignore them.

[Santiago Figarola]

Hello! Yesterday I posted the results on OSCAR of my first night of sleep with the new CPAP I bought. Previously I had used a low quality Chinese one for 15 days.
Well, I got the recommendation of increasing RPE to 3, in order to improve hypopneas and flow limitation. That seemed like it worked, although today I got a bit of RERA. I also decreased the Large Leak from 0.87% to 0.03%, as also recommended.
My AHI went from 7.47 to 3.96. 
I was wondering how could I further improve it, though? My goal is to be below an AHI of 1. For now, the biggest culprit seems to be Central Apneas, although I didn't get any when I got my sleep study done. (link: https://www.apneaboard.com/forums/Thread...RDI-16-AHI #4).

Should I further decrease the pressure to see if that helps, or simply wait, as it might be because of my body getting used to the machine?

[SeePak]

Santiago.

CA events.
I have had those for at least 2 yrs of Oscar charts, and probably for 30 + yrs of CPAP use
So, for me, they did NOT go away due to getting used to therapy etc.

Not to say it wont for you, but i have watched others here and most if not all are still happening as well.

so,....

In my case , here's what has just happened in the last week, since DEc 19/2024

It may be a perfect storm of changes i have made , so i list them all...

I got a new APAP machine Nov 21, i have never had auto in 35 yrs

I kept using a set pressure however, of 7 cm on request of my new DME
On first night i had a crazy amount of CA events etc. 
I installed VCOM device. My respiratory charts are much more consistent with no hi spikes.
Still had a high CA event night.
I started wearing neck collar again. Had issues being too tight i thought so i stopped using, and adjust it better now i think.
Things got noticeably better on Oscar charts
Still had a CA event night.
Suspected i was back sleeping so i tried hard to make sure i NEVER rest on my back during the night. I do this time to time due to sore hips.
Switched from CPAP to APAP auto mode and began to INCREASE my min/max pressure range
Charts began to look better again.
Still had a bad CA night.
I switched to my Full Face Mask.******
CA events are almost gone now!!

I am still getting a grouping or two per night of OA events, Positional i suspect again, but they do not last long, so that is a work in progress ....

So for me, combination of VCOM, HIGHER PRESSURE , Full face mask    got rid of my CA event problem!

The higher pressure really surprised me, i was totally against higher pressures in the past, as when i tried i would get bad results.

I do NOT use EPR, as i thought it contributed to my CA events, but now i'm not so sure?

However, i have better Flow Limits now as well, often less than 0.1
I am getting Rested again during the day and on waking up i feel good.

Still i did have tired day yesterday, will see how it goes.

Hope this was not confusing!?

[Santiago Figarola]

Hi! Thanks for your answer. That seems like a lot of different factors coming into play, haha.
After seeing my charts and data, and reading around, I'll up the min pressure to 7 instead of 6 (in order to help hypopneas), and reduce the max pressure to 9, just in case since up to 8 seemed to be enough. And reducing it will probably help my central apneas.
And I'll maintain the EPR 3. I'll see how it goes.
Further down the line, I'll consider all the info you shared if necessary, haha

https://www.apneaboard.com/wiki/index.ph...ng_therapy Btw, take a look at this link if you haven't already. I found it very helpful!

[SeePak]

Yup, i agree with those pressure settings, a logical step for sure.

If CA events remain, make sure to try EPR settting adjust before trying all my stuff !

Optimization, read that many times, may look again just in case i missed something.

Best of Luck!
Happy New Year!

[OpalRose]

Santiago,

I have merged your threads. This will keep your history in one place, and helps those that wish to offer advice.

Going forward, please continue to use this thread for your therapy questions and chart posting.

Thanks!