Would like suggestions after two weeks of APAP

[BlueDragon75]

I've now been on CPAP therapy for two weeks and would appreciate suggestions on how to adjust my settings.

The lab study recommended 13 cm H20 and C-Flex 3.  My doctor changed the order to an APAP machine (which is what I wanted) and I got an Autoset for Her, which was set at 4-20 and EPR 3.

   

I changed the pressure range to 6-15 and then started increasing pressure 1 cm at a time.  At 10 cm, the APAP was no longer increasing the pressure above the minimum all  the time.  The chart below is from last night at 11 cm H2O.  I turn over several times during the night, and the peak pressure is when I am on my back (confirmed with an overnight video).  There are always a lot of flow limits.  I am using EPR 3 (which I know is very different than C-Flex).

I'd appreciate suggestions on further changes I should make.

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[Walla Walla]

I don't think you need to make any changes. It looks like you nailed it. Good Job!

[OpalRose]

Looks good to me.

You could change the EPR setting from 3 to 2. You’ll still receive relief when exhaling, and it may help with the few Clear Airway events. This isn’t major, so it’s up to you.

[BlueDragon75]

Thanks!

Should I be at all concerned about the Flow Limits?

[Walla Walla]

It would probably help to keep the EPR at 3cm to keep the flow limitations down. You've already capped the maximum pressure so that's about all you can do with a CPAP machine.

[BlueDragon75]

It would probably help to keep the EPR at 3cm to keep the flow limitations down. You've already capped the maximum pressure so that's about all you can do with a CPAP machine.

Thanks.

Flow limit statistics have been about the same since min pressure was 7 cm.  Typically flow limit 95% is 0.09, med is 0.00, and max from .36 to .46.

Why is it that the flow limit measures would be relatively unchanged with pressure changes?  And what flow limit values would be a concern?

[OpalRose]

BlueDragon75,
Your AHI is great, and your Flow Limitation numbers really aren't bad.  For 95% of the night and below, you FL was .09.  There were a couple spikes in FL which can raise pressure and cause sleep disruption, but as long as you feel rested, I wouldn't worry too much about it.  If you had FL numbers reaching past .50 and up on the statistics, and it disrupted sleep, it could be something to look at. But for some, raising the minimum pressure and all the tweaking of numbers don't make much of a difference in Flow Limitations.

It seems to me you have a pretty good handle on adjusting your pressures.