Self-Treating Sleep Apnea | First Night with CPAP = 0,87 AHI | Central Apnea?

[Dumdi]

Hi guys,

I got diagnosed with Obstructive Sleep Apnea after a sleep study in a hospital. 

- My AHI was 6,5 

- I had 0 apneas and 29 hypopneas 

- lowest oxygen level was 92%, mean saturation was 96%

- Arousal Index 19,5 

I decided to self-treat the sleep apnea with an Airsense 10 Autoset and just finished my first night with the dream-wear nasal cushion mask. The first half of the night I used no chin mask so I got full air in the cheeks a couple of times. The other part of the night I used a chin strap which was better I think.

- I set minimum pressure to 6, maximum pressure to 20 for the first night, ERP 2

- I didn't feel terrible the next morning but also not much better than normal. I usually feel best when I only sleep light during the night (which was 
the case here since I woke a couple of times because of the mask) so hard to say if improvement occured.

RESULTS: 

- My AHI came back 0,97 in OSCAR 

- What irritates me is that according to OSCAR I have mostly central apnea which wasn't diagnosed in the hospital. I hope I didnt buy the wrong machine.

I have attached the relevant OSCAR data.

Should I attach my sleep study too? (Quite a few pages).

How should I go from here? 

Any advice is appreciated!

[Melman]

I wouldn't worry about the centrals. There are very few and it is not unusual for new users to have a few centrals upon beginning therapy. They should disappear as you adapt. You have EPR turned on during ramp only. I suggest you change that to full time. Your AHI is low so there is no need for any pressure changes.

[Dumdi]

Hi there, 

okay, thank you. I will turn on ERP full-time, thanks for the hint.

[Sleeprider]

I suggest a minimum pressure of 7.0, maximum pressure of 12.0 with EPR on full-time at 2. We may increase EPR to 3 based on tolerance. These settings should be comfortable. As suggested by Melman, the CA events are not important and often represent nothing more than a brief pause in breathing when turning in bed or an arousal.

[multicast]

Also, switch to reaction "Soft". Makes the machine react less aggressively.

[Dumdi]

Thank you, I will try the suggested settings. 

Last two nights my AHI increased a bit to 1 and 1,1 with almost all central apneas according to OSCAR.

I naturally turn around a lot in bed so that is definitely a possible explanation for the central apneas.

[Dumdi]

I suggest a minimum pressure of 7.0, maximum pressure of 12.0 with EPR on full-time at 2.  We may increase EPR to 3 based on tolerance.  These settings should be comfortable. As suggested by Melman, the CA events are not important and often represent nothing more than a brief pause in breathing when turning in bed or an arousal.

At what point should I increase EPR to 3? Should I just try it?

[Sleeprider]

Go ahead and use EPR 3 and let us know how it feels. We have not seen any results from the last changes you quoted above, so it's been out of mind for me.

[Geer1]

CAs consistently under 2 ahi are usually falsely flagged events happening after arousal or while awake. They are simply periods where you hold your breath for whatever reason (common if changing sleeping position as an example).

[staceyburke]

Welcome to the board.  Everything looks ok, you are doing a good job.  The only thing I see is a min of 6 may be low.  The min is the inhale pressure and for many people they just need more air than 6 would provide.  If you ever seem to be air starved move the min up.  For instance I need at least 9 or I am pulling my mask off to get more air. 

Again, if 6 seems good to you don't worry about it but if you feel like you need more are move the min up.