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[attachment=68576][attachment=68576][attachment=68577][attachment=68576][attachment=68577][attachment=68576][attachment=68577]Hi
I have been using cpap for about two months. I am on my third mask and have tried several different settings. My doctors office seems to want me to be on a range of 7-15 on my Airsense 11. I have been changing this to cpap mode at level 7, then 8 then 9,now back to 7 with various epr settings. Still can't seem to get a restful sleep. I was using the n30i, then went to then tried the p10 (did not like nasal pillows) then went to N30 and now F40. The reason i went to the f40 was to get away from mout taping, which is OK, but to try somethng different. Still not any change to sleep quality. Most of my AHI seems to be central sleep apnea, but the doctor did not think it was that bad. Either way, i beleive i slept better before cpcap. I also just started to wear a soft cervical collar to see if that could help. It was not comfortable when combined with a full face mask so I prefer to skip that unless it could help me. Attached is an image from last night as well as an image of my trends. Any suggestions would be greatly appreciated.
The CA’s are quite possibly still treatment emergent given the number of changes you have made so far. The hypopnoea’s tell us you need more pressure.
I suggest for now using APAP mode to help dial-in the correct settings. You have enough flow limitations to justify some EPR, so give this a try for a few nights.
Mode APAP
Min pressure 7
Max pressure 15
EPR 2 full-time
No ramp
That should tell us quite a bit. Once you have a few nights post some charts.
Regarding the mask, it is a personal choice. The pillows seem to be working well for you so I suggest sticking with that for now. Whether or not you use a soft cervical collar with them is your choice, but given no leaks it is not necessary at the moment.
i had been using APAP a few times over the last two months. On 8/7 i tried min 7 high 15 after my one and only appontment with the sleep clinic. They suggested this. I went back to cpap because i had a rough night. Attached is that screenshot showing the data. I had this approximate setting early on as my machine came with these default settings. I was not using Oscar at the time, but in reviewing my events per hour history on my air I was running between 9 and 12 events per hour. I hate to try APAP again as it usually leads to a difficult night. Can you glean anything from this?
Thanks
Leaks with the new settings are out of control. Also, your AHI is greatly affected by a cluster of positional apnea at the beginning of therapy. I don't see this as disqualifying of the new settings, so much as I see it as a need to get leaks under control and consider if positional apnea is playing a role. https://www.apneaboard.com/wiki/index.ph...onal_Apnea
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
It is difficult to compare early days of using CPAP to latter ones. The first few months are an adjustment period of getting comfortable with the machine and mask, finding the right settings, and learning to relax with the new way of sleeping. No wonder we all get frustrated and cranky during the adjustment period.
The last chart you posted is similar in many ways to the first one. Same patterns of centrals and hypopnoeas. If I was going to use the first chart as a baseline for a fixed pressure, I would suggest starting with pressure=11. It may have to go quite a bit higher, but until you have a few days to review it is merely an educated guess.
I think sticking with my previously recommended settings is worth a go. Once you have a night or two on it folks can help tweak from there.
Also read up on sleep hygiene (link is in my sig) to see if anything resonates with you.
08-21-2024, 07:16 PM (This post was last modified: 08-21-2024, 07:19 PM by rockyarbor.)
RE: not sleepting well, need help
Ok, I will try the settings for two nights and post the results. Thank-you for taking time to review.
Thanks, I will follow the setting recommendations from peaceloveandpizza and post the results in a couple of days. Hopefully that will shed some light on things.
OK, I completed two nights at recommended changes of min pressure 7 and maximum 15 with epr of 2. Attached are the results.The first night on 8/21 I slept surprisingly well. Last night, 8/22, I went back to my usual diruptive sleep. I did notice leaking which worke me up when pressure was changing. Had to tighten the mask. The resmed f40 is silicone which makes it more comfortable but feels like it could leek more at a high pressure. Any help with settings would be greatly appreciated.
As a side note I generally sleep on my sides, but flip around throught the night including some time on my back. I did not use a cervical collar as I find it uncomfortable. I am not overweight (5'9" 153lbs) age 66.
08-23-2024, 09:36 PM (This post was last modified: 08-23-2024, 09:36 PM by PeaceLoveAndPizza.)
RE: not sleepting well, need help
Overall it looks to be headed in the proper direction. How do you feel falling asleep? After waking up? Any noticeable issues or improvements? In the 8/21/2024 chart there looks to be some good quality deeper sleep, so hopefully it feels that way.
Looking closely you can see how at fixed 7 (8/20/2024) you had a certain “puffiness” to the flow rate from irregular breathing. With APAP 7-15, you have settled in nicely around the 7.5/5.5 pressure, but with occasional pressure spikes up to the 99.5% of 13 and 95% of 11. This tells me that 7 is too low for handling the H/OA events. Note I am putting CA’s aside for the moment as there are enough other events to focus on first.
I think upping the min pressure and dropping the max pressure, along with a bit more EPR, are the next things to try.
Mode APAP
Min pressure 8
Max pressure 12
EPR 3 full-time
No ramp
What I want to see is how you handle EPR=3 and whether it will create a CA problem. The extra pressure should help with the H/OA events, but depending on how you do with EPR=3 there may be more finer tuning required. We will know more in a few days when you post some charts.
