[Diagnosis] High CA breakdowns.. What should I do?

[hs8738]

This is my 6th night on CPAP..
I do not feel I am getting better, although I have become acquainted to wearking masks in my sleep..

All 6 nights, there is a high CA (Clean Air) breakdown in my chart.

What change should I make to my setting?

My current setting is.

CPAP fixed 10 pressure
RAMP 20min (starting at 5)
EPR 2 (only during RAMP)
Humidity 7 (out of 8)

Thank you in advance for your support!
You guys rock! (more than my sleep doctor..)

[hs8738]

FYI, Here is a capture of my Sleepyhead..

[eseedhouse]

You have a leak problem, which you need to get fixed. Since you have a nasal mask I assume your mouth is opening, causing the leak. You need to fix this either by learning how to keep your mouth closed or possibly using a chin strap.

You AHI, while a bit high, is not too bad for the first week. Your fixed pressure might be a bit high because it seems to be controlling our OA's and Hypopneas well. Clear air apneas are fairly normal when you begin therapy and usually go down after a few weeks. But you might benefit from changing to a variable pressure which your machine can do - maybe run it from 8 to 12 and see if that helps.

Some people do do better on a fixed pressure, though. You might also try lowering that by a cm or so and see if the CA's fade away. Or you might want to wait a couple of weeks to see if they go away spontaneously as they often do.

For some reason your CA's aren't showing on your screenshots except on the pie chart, so we can't tell when they are starting or stopping. We need to see this plus your flow limitations and snores to make a proper judgement. On steady pressure the machine can't respond to these by seeing them might tell us what might be initiating your events.

[OpalRose]

FYI, Here is a capture of my Sleepyhead..

Hi hs8738,
It would be helpful if we could see the clear airways, snores, and flow limitations on the event graph.

To turn those on, go to the bottom of the sleepyhead screen, to the right, and you will see the Event Flags. Click on arrow, and choose the above to be included in your graph.

[hs8738]

Thank you both for your reply.

I did not know how to provide sleepyhead information on the forum.

I will get back to you with detailed info.

Thank you again.

[vsheline]

Hi hs8738,

As eseedhouse noted, it is not unusual for new users to have central apneas and for the central apneas to mostly go away within the first weeks or months of treatment. Higher pressures often tend to make central apneas more frequent, so you might want to consider lowering the pressure slightly, like to 9.

A pressure of 10 was probably prescribed to prevent obstructive events when sleeping on your back, which is usually the worst sleep position for obstructive sleep apnea. If you can totally avoid sleeping on your back, you might not need the pressure to be as high as 10.

Your leaks were not so bad that the machine was unable to maintain treatment pressure, but when unintended leaks are greater than around 30 L/minute, the machine will not any longer be able to reliably distinguish between central apnea (CA) versus obstructive apnea (OA), and any apneas will be marked unknown type apnea (UA).