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Caro2020 - Therapy Thread - Caro2020 - 02-06-2023
Hi, I am new to the forum, but have learned alot already, but still alot to learn. I have been using my AirSense 10 with a nasal mask for about 6 months, with pretty good success. I was diagnosed with Severe Sleep Apnea with both OA and CSA. The OA's are pretty non existent but the Centrals are still there some nights under 20 and others over 30. My pulmonologist during my last appontment a few months ago was happy with results, but I have noticed over the last few weeks, the CSAs are more on the higher end and not so many low nights. I have noticed though that about 50% or more are within the last several hours of my time in CPAP. I do toss alot still, maybe RLS, but I am confused as to why the majority are during that time. Does anyone have that same issue or know what would cause more in the am ?
RE: Most Clear Airway episodes in the AM ? - Gideon - 02-06-2023
Please post Daily Detailed charts so we can see the data. OSCAR charts are what we like to see.
RE: Most Clear Airway episodes in the AM ? - Caro2020 - 02-06-2023
[attachment=47744][attachment=47741]
RE: Most Clear Airway episodes in the AM ? - Caro2020 - 02-06-2023
Uploaded 2, thank you
RE: Most Clear Airway episodes in the AM ? - Gideon - 02-06-2023
First thing is that with EPR=3 your min pressure should not be lower than 7, it is 5 now. This causes a lot of fluctuation of a very useful EPR.
Your 95% FL is 0.09, we like to see it Less than 0.1 but preferably in the 0.02-0.03 range.
Your CA events are not dangerous but are a bit higher than we like to see them. Step 1 is to reduce EPR, we will do that but also suggest an increase in min pressure to allow the full functionality. So multiple changes which are likely to decrease CA events but also increase obstructive events, especially flow limitations.
Set Min Pressure=7
Set EPR=2
Then repost and also let us know how you feel.
RE: Most Clear Airway episodes in the AM ? - Caro2020 - 02-06-2023
ok, thank you. Is that what is causing the flow limit to be that high, I just read a few things on flow limit, but don't really understand, will do more research. I will adjust for tonight. So that may cause lower ca but higher oa ?
RE: Most Clear Airway episodes in the AM ? - Gideon - 02-06-2023
You are using a machine that is, by design, doing absolutely nothing for Central Apneas. It is designed only to treat Obstructive apneas.
So for the CA events we try to avoid what causes them.
Basically what improves Obstructive Apneas makes central apneas worse. And vice versa. It is a balancing act and the search is for a happy middle ground.
Think of flow limits as mini obstructive events that are not timed like apneas and hypopneas are.
RE: Most Clear Airway episodes in the AM ? - Caro2020 - 02-06-2023
Thank you, shoud I leave the maximum at 20 or reduce that lower, I never seem to go over 9 much
RE: Most Clear Airway episodes in the AM ? - Gideon - 02-06-2023
The only time we need to be concerned about the Max Pressure is if we need to artificially limit the max pressure. I run mine on the machines max and it NEVER gets even close.
RE: Most Clear Airway episodes in the AM ? - Caro2020 - 02-07-2023
Last night my AHI was higher and CA's were 70 for the night. Never had that high. I did notice today I only increased the min press to 6 not 7, I did reduce EPR to 2. The FL is about the same. But it was a long night and I used the CPAP for almost 12 hours, got up a lot, but I am a tosser and last night was a lot. Having issues with my mask not feeling comfortable, and the large leak last night was 41 events, had about 40 a few nights ago as well. Never been like that. I will try the 7 tonight, just not sure why the CA's were that much more. Also very dry mouth several times woke me up. Have had before but not consistently. I was going along so well up to about two weeks ago, not sure, ugh what happened.