Back to CPAP after 15 yrs, struggling this time

[kkvdogmom]

            I was previously on CPAP therapy for about 4 yrs and lost a lot of weight, had another sleep study and was deemed not to need it anymore. I haven't gained the weight back but about a year ago my husband said I was "heavy breathing"...I'm pretty sure snoring lol. I also was not sleeping well, waking frequently through the night. 

So, I had a sleep study in November and it should mild OSA, actually mostly hypoapneas and desats to 83%. So I opted to restart CPAP since I never had an issue the first time. This time I struggled with finding a mask that was comfortable and I didn't have leaks. I finally found the Evora and I'm happy. 

But I'm still not sleeping well! First, I had a lot of sore throat/dry mouth issues despite the humidifier set at 5. I read online that my pressure might be too high (it was 5-15) so I changed it to 7-12 (I was usually 9-10 in the past). The sore throat/dry mouth is gone so that's good! So I got a SD card and down loaded OSCAR. 

I think looking at the data that I'm having respiratory arousals and wanted to know what you think and I'm open to any advice on setting changes. I included a zoomed in shot of what I think is the respiratory arousal (one of 4) and my typical wave form most of the night.

[Deborah K.]

I see a couple of changes that should help.  It would be good to change your pressure range.  Because your median pressure is over 10, 10 would be your best starting pressure.  I would also raise the high pressure to 12.  

I don't know if you are using EPR, but I suggest you set your EPR full-time to 3. That should make your breathing more comfortable, and, more importantly, it will cause your flow limits to drop. Flow limits are short apneas that are not reported, but it is best to get them as low as you can.

You are also having some Positional Apnea. These show on your chart where you have clusters of OAs and/or Hs.  No setting can help with these.They are caused when your chin drops toward your chest, limiting your airflow, much like a kink in a hose reduces water flow.  During the one night you show, they were not too bad, but other nights will show if they are sometimes worse.  You may be able to control them by sleeping on a much flatter pillow but most end up wearing a soft cervical collar.  Amazon sells lots of them and most drug stores offer a few. I liked the Caldera Releaf Collar the best, as it was quite comfortable and worked as well as the others I tried.

Again, welcome, and good luck with finding your best therapy and comfort!  

[kkvdogmom]

Debora K-
I’ll change my minimum to 9, I’m already at max 12 so I made it 12.2. My EPR was 3 full time so I kept that. I’ll look for a flatter pillow as well.

[SeePak]

@kk

You have a lot of obstructive events.

Which setting are you using, Auto for her?

Not really sure if they are positional or not?

If not, i am thinking you need more pressure both min and max.

The EPR3 , i believe, is taking your EPAP below your point of obstruction, whatever that is in your airway.

And you have high flow limits in spite of using max EPR.

That's how it looks to me.

Will see what others think?