Settings help for AirSense

[sleepyalpha]

Hi all,

I was diagnosed with mild UARS (~15 RDI) and am doing a week-long trial with a CPAP using a AirSense 10 with a nose pillow. I've had 2 nights so far with the default settings set by the clinician. I'm attaching the Oscar reports for the past two nights. I'm looking for help on finding the right min and max settings. Thanks for the help in advance!

       

[Old Steve]

Start by running your min pressure at 7cm and max at 12cm, continue with the EPR at 3.   You may also be having some positional apneas (clusters). Try the new pressures for a few nights and see if it helps with the AHI.  If it does then we will address the positional apneas if necessary.  Also, remove the calendar from your chart it will make more information visible.  

[CPAPfriend]

You're getting what looks like a lot of treatment-emergent central apneas. Your leak is also quite uncontrolled, and you should find a way to resolve that. If you insist on not using a full-faced mask, you can try a soft-cervical collar or chinstrap. The leaks do seem to get much worse with increasing pressure, so there could be a solution there, but it's not clear what pressure treats best for you yet, at least as far as I can see. Please try to post more images of the upcoming nights so that we can reassess. EPR could be largely responsible for your elevated number of CAs too.

[sleepyalpha]

Thank you both! I made the setting changes last night and attaching the data. The only thing to also note was that I had 1 cocktail that night which isn't common and I'm sure made things worse. It does seem leaking was particularly bad. How do I resolve the leak situation? Would it make sense to move up or down a size for the nasal pillow? (I'm currently using a medium). I do feel some air blowing around the points where the straps attach. I don't know what the full face mask feels like and can try it - is the thesis that the leak is out of my mouth? If so, maybe mouth-taping is also an option?

   

[eok361]

you could try a full face mask. or taping your mouth. or a soft cervical collar. i think the spiky leaks are mask leaks (but i could be wrong--not claiming to be an expert on leaks). 

going by your small sample size, you might want to set your range to 8-12.6. you're free to play around with the settings.

[sleepyalpha]

An additional night of data, which was particularly bad . I changed two things: moved min up to 8 from 7 and did some mouth tape. I'll revert to the previous settings and drop the tape.

   

[PeaceLoveAndPizza]

I agree with both Old Steve and CPAPFriend that you need to address the positional apnoea’s with a soft cervical collar and a flatter pillow if you are not using one. I think if you get a properly sized collar you will see a big difference.

[sleepyalpha]

Last night I tried on a soft cervical collar along with the 7/13 pressure settings and indeed it helped a ton! The AHIs went down to 2 for the first time. Here is what it looks like now

   

Should I go steady with these or bump the minimum to try and get rid of the remaining events? Thank you all for such great help

[sleepyalpha]

I skipped 12/19 night because of a runny nose/cold and then did it last night with the collar and the same settings. Much less restful and feeling tired, randomly woke up a few times last night.  Any ideas?

   

[Old Steve]

It appears that you are still having positional apneas.  If you are sleeping on your back, try sleeping on your side, re-adjust your cervical collar.   Once your positional problem is under control you could try setting your EPR at 1 to see if it helps with the central apneas.