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[Treatment] New User - Advice on settings and charts
#1
New User - Advice on settings and charts
Hi,

I'm very new to the CPAP community and I have just started treatment. My initial prescription was from 6cmH20 to 16cmH20 and was bumped up to 7-16cmH20. I adjusted to 10cmH20 seeing as it was the median for many of the nights but in this chart it seems to have gone to 12cmH20. Overall, I've had varying AHI number for the first two weeks and the disparity can be quite drastic but a rough average over the last 2 weeks would be 8 AHI. So I'll give you my chart and I'd really appreciate any advice you might have. Thank you for your time and guidance! 

dews


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#2
RE: New User - Advice on settings and charts
Welcome, you will receive great help here. 
Is this a typical night? How are you feeling in the mornings?
Can you post your sleep study with your personal info redacted? Did you have central apneas on it?
Please hide the calendar, more settings will show. Pressing F12 will prompt you to save a screen capture.
What mask are you using? Do you use a cervical collar or mouth tape or a chin strap?
Finally do you have any underlying condition or are you on any medications that would effect your breathing?
Good luck on this journey!
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#3
RE: New User - Advice on settings and charts
Thanks jdougc,

Yes this is a pretty typical night.

I feel decent after this night's sleep.

Thanks for the F12 trick. I'm on a Mac and you have to press fn+F12 (for any Mac users out there).

I use the ResMed P30i.

No cervical collar, mouth tape or chin strap. I am usually a nasal breather.

Underlying condition would just be overweight.

Sleep Study below:


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#4
RE: New User - Advice on settings and charts
Can you pot the new night of data and how you feel?
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#5
RE: New User - Advice on settings and charts
I don't know if this will work for you, but if you could get your medical team to switch you to a ResMed AirCurve VAuto bilevel, for comfort purpose, you'll be better for it. Though the lesser issue, you get to try trigger High to avoid more CA, which you had some, 22 shown on the test.

Also with the somewhat higher pressures you're already on, bilevel will be more comfortable.

PS on bilevel will help with the flow limits, which can be set higher than EPR 3 on your AutoSet.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: New User - Advice on settings and charts
Like Dave, I think you should give EPR of 3 a try, partly for comfort and partly to see whether reducing flow limitations helps you sleep better. To compensate, I'd recommend that you raise your minimum to 11.

Your home sleep test would not have been able to tell whether those central apneas were post-arousal or not. One advantage of an in-lab test is that when the results are scored, CAs that occur when you're awake aren't counted.

You can zoom in on your CAs to see whether they follow arousal breathing, which tends to be deeper and more irregular than asleep breathing. If that's mostly what you see, then the CAs aren't the real problem, the arousals are. With luck, you'll have fewer arousals as you get more and more used to the machine.

Your sleep study noted that you had more OAs while sleeping on your back than in other sleep positions. Do you think you still spend a fair amount of the night on your back? If so, can you consider using a pillow or two to try to sleep more on your sides?

I have to say your leak rate is amazingly good, especially with no collar, tape, etc!
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#7
RE: New User - Advice on settings and charts
jdougc:

I've attached last night's data - thank you!


SarcasticDave94:

Thank you for your reply and advice. As I've seen some comments and delved a little deeper into the world of CPAP the ResMed AirCurve VAuto has come up quite often. As of right now, I've paid out of pocket for my current machine and I'd like to give it a try before switching to a different machine. But if the AirCurve will be best for my therapy I will definitely consider it in the future. I really appreciate your thoughts.


Dormeo:

Thanks for having a look and your recommendations. I will try setting min pressure to 11 with EPR on 3. If I keep having issues I will ask for a in-lab sleep study. The at-home was all my physician offered. In regards of sleeping on my back, I know I fall asleep on my side but then I must lay on my back. I have no partner to tell me otherwise so I'd have to get an overnight camera to really know. And I can always consider a back pillow or just pillows to avoid turning on my back. I've taken a picture of a few CAs and an OA then zoomed in to show my breathing pattern during CAs and an OA. If you have any thoughts or advice on those I'd really appreciate it. Thanks again for your reply and advice.


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