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What happened last night?
#1
Question 
What happened last night?
Newish to APAP. Started very late March and had super results. Decreased fatigue and somnolence immediately. Average sleep time down significantly and essentially no naps.  Only issue has been aerophagia once every week or two... until the last few weeks when it seems to be constant. 

About a week ago, I increased minimum pressure to 5.2 vs 4 due to high flow limitations (routinely up to 0.35 a few times a night). Now, I'm experiencing this! Miserable... dang machine won't let me sleep. I've attached screen shots from today. Will follow with a daily from the way it used to be...

Thanks for your assistance.

former "average" night...


Attached Files Thumbnail(s)
               
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#2
RE: What happened last night?
You had quite a bit of flow limitations last night. Could have been a stuffy nose or other congestion, a kinked hose, or other external source.

I expect it is exactly what you do not want to hear, but I think your pressure is too low. I think the following would work much better.

Mode APAP
Min pressure 5
Max pressure 8
EPR 1 full-time
No ramp

You may still need more pressure, but for now that should help.
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#3
RE: What happened last night?
Thanks for your response! I’m still trying to figure APAP out. It has had a positive effect on my life but could be better.

I already have min pressure at 5.2. I will gladly lower the max pressure!

I have had flow limitations in the 0.18-0.36 range since I started using Oscar about a month ago. To the best of my knowledge, there is no mechanical obstruction, no congestion etc. Note, I was started on APAP: min 4.0 max 20.0 based on an at home apnea screen. I lowered the max to 10 on my own about 6-8 weeks ago with much improvement. However, over the last week or two have been difficult. I’ll keep after it! Thanks again.
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#4
RE: What happened last night?
The challenge may prove to be you were getting good therapy in the original 4-9.4 range, then you changed it to 5.2-11 and it went completely off the rails.

Sometimes when you make a change things go wonky and it takes a while for them to get comfortable. Even if you switch to the original settings it may still take some time to readjust. 

I think adding a wee bit of EPR will help smooth out the flow limitations, which should allow a lower pressure than you may otherwise have to use. Worth a try, but if it is not working we have help find another path.
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