[Treatment] New to CPAP, seeking advice after few nights

[breadrug]

Hello everyone!

I was wondering if anyone would be able to help me interpret this data from OSCAR. I bought a used Resmed Airsense 10 Auto after taking a WatchPAT test, where my RDI was 7.7 and AHI 1.3. The results came back "inconclusive" but, considering my symptoms, I decided to experiment with a CPAP machine. 

I've attached screenshots of my last 3 nights. The first two nights (May 1, 2) were quite good- I woke up feeling refreshed. Last night (May 3) felt worse. 

In the middle of the night, I sometimes feel a bit suffocated, as if I couldn't breathe. But I always try and bear with it (I never take the mask off). 

I'm wondering if it's normal for me to have so many Clear Airway events? Especially on the May 3rd report. 

Here are all the details:
- Resmed Airsense 10 Auto 
- Dreamwear Full Face mask
- Humidifer 
- Non-heated generic tube 
- Min. pressure 8, then bumped up to 9 on May 3
- Max. pressure 14
- EPR 3

I'd greatly appreciate if anyone could offer advice for how I can proceed! Thanks!

   
   
   

[staceyburke]

Your main events are clear airway or centrals. You may be able to reduce them by moving the EPR down to 2 or 1 BUT the trade off is larger flow limits and maybe more H events. It becomes a balancing act to see which is best for you. 

I would suggest you go to EPR 2 for a couple of nights and compare how you are feeling to make a decision on the EPR setting. 

Overall you are doing well KEEP IT UP.

[breadrug]

Thank you staceyburke! I will experiment with EPR 2 and see how it goes.

[trenton78]

When did you start your CPAP treatment? Centrals often go down after a couple of months. That's what happened to me.

[breadrug]

Oh, interesting, I’ll give it some more time then. I only started on May 1, so less than a week ago.

[Gideon]

If you are feeling suffocated bump your min pressure up by 1. At this stage comfort is king.

Feel free to try EPR=2 but tell us which settings feel better and why .

If this is Treatment-Emergent Central Apnea like we suspect it occured because your CPAP improved our breathing and you are flushing CO2 out at a higher rate than you did before. This is what is most likely causing your Central Apena.
Reducing EPR will lessen this effect. We don't want to eliminate the central Apnea I. This case, we want a few so your body canadjust and eliminate them without our help

[breadrug]

Thanks for the reply. I tried going down to EPR 2 two nights ago, which did help reduce the Clear Airway events. However, even though the AHI was only 1.7, I felt like my sleep quality was poor:

   

Last night, I bumped it up to EPR 3 again. EPR 3 seems to greatly improve my comfort and makes it easier to breathe. Looks like there are also fewer Clear Airway events compared to a couple nights ago. I also changed to the Medium sized mask, which seems to allow for less leakage while sleeping on my side. I slept very well besides having to wake up often to adjust the mask. I hope this part gets easier with time. 

   

Tonight, I will try bumping the minimum pressure up a little bit.

[breadrug]

Yikes- don't know what happened last night (May 7) but it doesn't look good. What's up with the 2.73% Cheyne-Stokes respiration? I had a lot of mask issues during the night. I ordered a P10 nasal pillow to try out tonight. 

   

The previous night was fantastic: 

   

Weird, because the only thing I changed was the humidity, from 7 to 6.

[Gideon]

First and foremost, that is not CSR, no way, no how!

ResMed calls any and all periodic breathing CSR resulting in scaring many users

That is Periodic Breathing and in this case it is likely caused by positional Apnea resulting from you tucking your chin. The tell is the cluster of obstructive events. For now ignore it. If it presents on a regular basis I'd suggest a soft cervical collar to prevent a chin tuck. This is common enough I've included a link in my signature on collars. You should read it.