Wjg's Therapy Thread

[wjg1]

Hello. I am about 3 weeks into using my CPAP machine. I used it set as the doctor recommended with a steady pressure of 9, not EPR and no Ramp for several nights so I could show them that I had it set there way. I made a change at the advise of another member here to switch to APAP mode with min set to 9 and max to 12, and EPR set full time to 3. So far that change is much better with most of my nights below 5 AHI. So if anyone will look over my charts and give me your thoughts I would greatly appreciate it.

[gainerfull]

It looks like whichever position you start off sleep in is kinking your airway and causing a lot of turbulence. Do you start sleep with your chin tucked?

Also, I'd probably raise the maximum by 2 cmH20 to give yourself some more headroom. Lastly, do you wash your face and mask every night? Although your overall leak data looks good I'd shoot for 0.00 leak for 95% to avoid sleep disruption / arousals caused by sudden leaks.

[wjg1]

Thanks for the advise. I will raise the max to 14 and I do wipe the mask with wipes but I do not wash my face. So I will also do that. I appreciate your help.

[wjg1]

One thing I forgot to mention is I see my family doctor next week for my follow up and normal 6 month check. I am trying to decide if I need to ask my doctor to prescribe a different machine. Bipap or something else to get rid of the central apneas that I always have. If anyone has any thought on this I would appreciate it.

[Deborah K.]

I don't think you have positional apnea because the clusters are CAs, which have nothing to do with position.  I would not worry about the leaks either.  They are nice and low.  As to the CAs, as you are quite new to pap therapy they may be treatment-emergent.  In that case, they will diminish on their own as time passes.  Did you have a lot of CAs in your sleep study?  If so, it would be good if you could post a copy.

[wjg1]

Thanks for the replies. I had a lot of Central Apneas during the sleep study. I am attaching the paragraph that explains the apneas from my sleep study and last nights Oscar chart. Washing my face did help with the leaks some.

[wjg1]

Attached is last nights Oscar report. I had a little mask issue but I am working on that. Any other thoughts. As I mentioned I am trying to determine if I need to request a BiLevel machine.

Thanks

[wjg1]

Attached is last nights Oscar report. I noticed I am bumping up against the max pressure when I first go to bed. Is that enough to warrant raising the max pressure more? The rest of the night I guess the pressure is good. Any other thoughts would be very much appreciated.

[Sleeprider]

Wjg1, you have done better with CPAP than I would have expected for someone with complex sleep apnea (mixed obstructive and central). Given how serious your ODI was in that study, you are a prime candidate to use a recording oximeter to ensure your therapy is also preventing the significant oxygen desaturation that was observed. I'm sure your doctor was prepared to see you fail CPAP and end up with ASV, but so far you're hanging in there with borderline acceptable therapy. My guess is, your sleep quality has not recovered, and that is something to focus on with any follow-up with your doctor. ASV would make all these events go away.

[jcp519]

Your flow rate graph does look quite chaotic as well. ASV tends to help even that out and keep you at a good stable breathing level.