SleepHQ data for someone struggling with CPAP

[PeaceLoveAndPizza]

It is a nomenclature thing. No CPAP can identify true centrals, they simply call any cessation of breathing for > 10 seconds with no flow restriction a “central apnoea”. In reality most are a “clear airway”, which you can see if you do a 2-3 minute zoom on one where you will see the machine pulsing during the time you are not breathing.

[therhile]

Quite a few pressure swings going on from the flow limitations. It would drive me balmy.

Mode APAP
Min pressure 9
Max pressure 15
EPR 3 full-time
No ramp

That should be more comfortable. Give it a go for a few nights and post a chart or two.

So it's been a couple months and things have not improved. I got some more nights of OSCAR data. Tried something new last night that some people over on the CPAP subreddit told me to do with not very good results. Every single night is pretty much a gamble. My flow limitation is all over the place, no idea how to fix that. Turning EPR to 2 gives me a ton of clear airways or central apneas as my machine says. Sleep doctor is not any help.
https://imgur.com/qjYuCka

https://imgur.com/lAsQ89z
https://imgur.com/kouF6PG
https://imgur.com/zpolYOW
https://imgur.com/50KBFAm
https://imgur.com/8fsG7T8

[PeaceLoveAndPizza]

Did you try what was recommended? 

Please read the link in my signature for “Formatting OSCAR Charts”. It makes things more readable when followed.

[therhile]

Did you try what was recommended? 

Please read the link in my signature for “Formatting OSCAR Charts”. It makes things more readable when followed.

Okay I reformatted my OSCAR to make it more readable after following your guide. I noticed when the higher my EPR the more centrals or clear airways I have. Someone on the CPAP subreddit thinks maybe I have central apnea as well as OSA. This is last nights data going from 9.4 fixed CPAP to 7-13 EPR 2 apap mode. I think my flow limitations are better however I woke up feeling pretty bad. 
https://imgur.com/2DARnvS

[PeaceLoveAndPizza]

Thanks, that is helpful. Note that changing pressure in the middle of the night does not tell us as much as using it all night. There could be something going on in the first few hours that goes away once you wake up and change the pressure.

Also, please post your images directly on your posts. Imgur is fine for some, but overall it is easier to read them (for me at least) when posted here. And when you do post images always post the entire night first, then any zoomed in sections you would like someone to review.

Did you have a sleep study and if so did it show central apnoea events? Otherwise I do not think you have central apnoea, you are just very sensitive to pressure support. No comments on what anyone says on Reddit, but getting too much advise is not helpful at best, confusing at the worst.

I would try the following:

Mode APAP
Min pressure 8
Max pressure 9
EPR 1
No ramp

It is fine to trade-off some events for a good nights sleep. We will know more once you post a night or two.

[quiescence at last]

Yes. Thanks for all the charts. You have deduced that the greater the EPR the more CA are present.  That is true for most people.

Your chart (https://imgur.com/8fsG7T8) is interesting as an example of a CA cluster, without any apparent flow restrictions like obstructive events, flow limitations.  I believe this is one of only a few close up shots I've seen, as I think breathing never strayed from a normal sleep breathing pattern.  In other words, I don't think you woke up and all this was the autonomous sleep breathing that auto-corrects, taking CA breathing breaks when the lung physialogy calls for them.

By the way, flow limitations usually get better when increasing EPR.  So, what benefits flow limitations increases CAs.

QAL

[therhile]

Yes. Thanks for all the charts. You have deduced that the greater the EPR the more CA are present.  That is true for most people.

Your chart (https://imgur.com/8fsG7T8) is interesting as an example of a CA cluster, without any apparent flow restrictions like obstructive events, flow limitations.  I believe this is one of only a few close up shots I've seen, as I think breathing never strayed from a normal sleep breathing pattern.  In other words, I don't think you woke up and all this was the autonomous sleep breathing that auto-corrects, taking CA breathing breaks when the lung physialogy calls for them.

By the way, flow limitations usually get better when increasing EPR.  So, what benefits flow limitations increases CAs.

QAL

Thank you for the insight, however I honestly don't understand much of what you're saying. Is there anyway you can explain this more in layman terms? Do you mean I'm getting better sleep than I think I am? Or am I getting really bad sleep?

---

Thanks, that is helpful. Note that changing pressure in the middle of the night does not tell us as much as using it all night. There could be something going on in the first few hours that goes away once you wake up and change the pressure.

Also, please post your images directly on your posts. Imgur is fine for some, but overall it is easier to read them (for me at least) when posted here. And when you do post images always post the entire night first, then any zoomed in sections you would like someone to review.

Did you have a sleep study and if so did it show central apnoea events? Otherwise I do not think you have central apnoea, you are just very sensitive to pressure support. No comments on what anyone says on Reddit, but getting too much advise is not helpful at best, confusing at the worst.

I would try the following:

Mode APAP
Min pressure 8
Max pressure 9
EPR 1
No ramp

It is fine to trade-off some events for a good nights sleep. We will know more once you post a night or two.

Okay, thank you very much. I will try this tonight and not adjust the settings at all. The reason I adjust the settings is because when I wake up in the middle of the night and check and see that my AHI is 10, I kinda freak out and try and change it so my numbers will get lower. I don't want to do anymore damage to my body and I'm wondering if I'm even getting any benefits of using CPAP if my AHI is still so high. Also, on my machine there is a setting called Pressure Relief that is set to on, is that good to keep on or should I turn it off?

[quiescence at last]

My comment was an attempt to confirm your premise that number of CAs is often raised when you make EPR higher.  EPR is the difference between inhale pressure and the exhale pressure.  I think the Pressure Relief being on allows you to set the EPR. If Pressure Relief is off there will be no EPR, so the inhale pressure and the exhale pressure are the same.

In your example chart there were a string of CAs that all occurred while you were sleeping, and my view is that string of events is not disturbing your sleep.  You should not seek to reduce or eliminate these CAs. The lungs and brain are functioning well together.

I meant to conclude that these CAs should not have had a negative impact on your sleep quality.

Good luck,

QAL

[therhile]

My comment was an attempt to confirm your premise that number of CAs is often raised when you make EPR higher.  EPR is the difference between inhale pressure and the exhale pressure.  I think the Pressure Relief being on allows you to set the EPR. If Pressure Relief is off there will be no EPR, so the inhale pressure and the exhale pressure are the same.

In your example chart there were a string of CAs that all occurred while you were sleeping, and my view is that string of events is not disturbing your sleep.  You should not seek to reduce or eliminate these CAs. The lungs and brain are functioning well together.

I meant to conclude that these CAs should not have had a negative impact on your sleep quality.

Good luck,

QAL

Okay perfect. Thank you very much. With the settings that was recommended to me my AHI last night was 3.3, which was an improvement. I'm going to give it a few days and then come back to you guys with oscar charts. Should I also try a night with EPR completely shut off? Thanks for all your help.

[therhile]

Thanks, that is helpful. Note that changing pressure in the middle of the night does not tell us as much as using it all night. There could be something going on in the first few hours that goes away once you wake up and change the pressure.

Also, please post your images directly on your posts. Imgur is fine for some, but overall it is easier to read them (for me at least) when posted here. And when you do post images always post the entire night first, then any zoomed in sections you would like someone to review.

Did you have a sleep study and if so did it show central apnoea events? Otherwise I do not think you have central apnoea, you are just very sensitive to pressure support. No comments on what anyone says on Reddit, but getting too much advise is not helpful at best, confusing at the worst.

I would try the following:

Mode APAP
Min pressure 8
Max pressure 9
EPR 1
No ramp

It is fine to trade-off some events for a good nights sleep. We will know more once you post a night or two.

Okay I tried your settings for the last 3 days, and here is my OSCAR data. The first two nights seemed okay, not sure what happened last night.
day 1
day 2
day 3