[Symptoms] 2 weeks on cpap, not feeling better

[NomCarver]

            hi, i've been on CPAP with the resmed airsense 10 for 2 weeks and it hasn't been making my symptoms better. i've been using a constant pressure of 7. My charts look good to me but im not sure. I use a small size N30i. Any recommendations on what i should change? i haven't been getting a full 8 hours, but i also almost never get a full 8 hours. the first week i usually woke up after ~4 hours and took off the mask, but recently i've been able to go 6+ hours without taking it off, yet still don't feel better.

Any suggestions?



my sleep study that got me diagnosed was 5.3 AHI per hour (all hypopneas) and 4.1 RERAs per hour.

[staceyburke]

Welcome! Almost all your events are centrals. No pressure changes will make any difference. Cpap machines are used to clear obstructions - centrals are also called clear airway apnea. Which means there is no obstruction to clear.

A central is when you quit breathing for more than 10 seconds. Sometimes it might be holding your breath when you turn over or pull up bedding. But you have more than that. What you have is because your machine is working well and removing more CO2. This causes us to pause our breathing. And the GOOD thing is that most of them will go away in a month or two as your body gets use to the therapy.

One thing we can do to make it less is to remove the EPR (exhale pressure relief). What that would do is make the inhale and exhale the same. And that will help eliminate some of the centrals.

You will feel more pressure on exhale because EPR moves the pressure of exhale down to help make it easier to exhale. If it seems to hard to breath out move back to EPR=1. But if it feels ok leave it at 0

[NomCarver]

Thank you so much!

okay my EPR is currently 3 so maybe ill try to drop to 2 or 1. Other than that is the plan just to keep using it for a month and see if clear airway events drop?

What is a "normal" amount of clear airway that wouldn't impact sleep quality/is just due to turning over?

[staceyburke]

Centrals happen to everyone some people have many many more than you do. When there are dozen and dozens during a night a special type of pap machine is needed to help a person breath when they don’t on their own. THIS IS NOT your case. Yours will go away for the most part but all of us have a few centrals. 

They are vey inconsistent- one night you may have a lot the next night virtually none. So again we try to stop them from happening. And for you I think you will do better without EPR. after a few weeks I would go to EPR of and the in a few more weeks go to 2 and then to 3. 

EPR will HELP with several things:
1. Make it easier to exhale
2. Help with H events
3. Help with Flow limits

All of those are good things and as you get use to the pap therapy add the EPR back.

[NomCarver]

Update: I'm realizing that my waveform flow doens't look normal. Any idea what's going on here?

[clownbell]

I notice you are using CPAP mode instead of AutoSet mode. Is there a reason for that?