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Could be better
#1
Could be better
I've been on CPAP for a little over 4 months and it's good but not great.  AHI numbers aren't bad but most nights I fully wake up at least once during the night and usually wake up tired in the morning and can have trouble staying awake during the day.  I wear a Wellue O2 ring and it shows that CPAP keeps the O2 saturation fairly high.  Without CPAP my O2 saturation falls into the 80's for most of the night.  With CPAP my O2 stays in the 90's and usually +95%. However I experience frequent spikes in heart rate throughout the night

Static pressure works better for me than auto pressure in terms of making it through the night and feeling more awake the next day.

I'm looking for suggestions/ideas on where to go for improvement.  When I increase pressure above 13 cmH2O sleep seems to get worse in terms of how I feel in the morning.  But sometimes the trends look better at 14 cmH2O than at lower pressures.

Here's a recent night at about 12.6 cmH2O.  Snore is always zero so it's omitted in the trends below.  The second screen capture is a 3-ish minute zoom.  The wave forms don't have the nice rounded tops that I'm hoping to achieve.  

The third graph shows the frequent spikes in heart rate which I'm assuming are micro arousals of some type.

The big gap in the middle of the night is when I was awake and couldn't sleep.  I eventually got tired, put the mask back on and went back to sleep.  This is a fairly typical night.

1) Zoomed out:
   

2) Zoomed in: 3-minutes
   

3) Heart rate spikes
   


I previously had a Beyond model of CPAP and it wasn't great.  Moving to the ResMed AirSense was a definite improvement 4+ months ago.
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#2
RE: Could be better
Your problem looks like high flow limits.  Fl are apnea just like O and H events they are smaller in duration and do not count in your AHI so many people don't look at them but they stop you from getting into deep sleep and can wake you up.  We help FL buy using EPR full time.  The only thing I would change is...


EPR full time
EPR 3

post after a day or two with this setting changed and let us know how you feel.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Could be better
Thanks for the tip. I’ll give EPR a try.
ResMed AirSense 10
Static Pressure ~12 cmH2O
EPR = 0
Humidity = Auto
Climate Line Air Tube
Wellue O2 ring
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