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+--- Thread: Need some advice- first week of CPAP (/Thread-Need-some-advice-first-week-of-CPAP)
RE: Need some advice- first week of CPAP - pholynyk - 08-01-2017
EPR can have different effects for different people.
In people who are prone to Central (or Clear Airway) events, (you!) the lowered pressure during exhale can increase the number of CA events. So turning it off will improve your AHI.
In people who have a lot of hypopneas, but no CAs, (me!) the increased EPR (lowered pressure during exhale) reduces the hypopneas. When EPR was turned off once, my AHI soared.
RE: Need some advice- first week of CPAP - Chicago - 08-01-2017
But I did have "high" number of hypoapneas on my study. That was the main reason according to my doctor to try CPAP.
RE: Need some advice- first week of CPAP - quiescence at last - 08-02-2017
if this were my data, I would leave it just the way it is, except to put EPR 'on' and set to 1. your machine is responsive and your treatment shows to be effective at reducing the hypopnea.
QAL
RE: Need some advice- first week of CPAP - Chicago - 08-02-2017
(08-02-2017, 08:08 AM)quiescence at last Wrote: if this were my data, I would leave it just the way it is, except to put EPR 'on' and set to 1. your machine is responsive and your treatment shows to be effective at reducing the hypopnea.
QAL
Yes it does seem to treat hypopneas well but what about these CA? and the air leaks. Please take a look at my new results, the AHI went down as well as leaks. I wonder If I should try different mask to get it under control? What do you think guys? Should I change EPR?? or leave it as quiescence at last suggested?
![[Image: wdU9WJu]](http://imgur.com/wdU9WJu)
![[Image: Fv5OZF6]](http://imgur.com/Fv5OZF6)
![[Image: v1RAYjh]](http://imgur.com/v1RAYjh)
http://imgur.com/a/fnPlX
Thank You All!!
RE: Need some advice- first week of CPAP - quiescence at last - 08-02-2017
(08-02-2017, 10:21 AM)Chicago Wrote:(08-02-2017, 08:08 AM)quiescence at last Wrote: if this were my data, I would leave it just the way it is, except to put EPR 'on' and set to 1. your machine is responsive and your treatment shows to be effective at reducing the hypopnea.
QAL
Yes it does seem to treat hypopneas well but what about these CA? and the air leaks. Please take a look at my new results, the AHI went down as well as leaks. I wonder If I should try different mask to get it under control? What do you think guys? Should I change EPR?? or leave it as quiescence at last suggested?
http://imgur.com/wdU9WJu
http://imgur.com/Fv5OZF6
http://imgur.com/v1RAYjh
http://imgur.com/a/fnPlX
Thank You All!!
I would still change the EPR to 'full time'. I was not worried by the CAs, and still not.
(I also think the CAs will reduce further over time)
QAL
RE: Need some advice- first week of CPAP - Gideon - 08-02-2017
(08-01-2017, 05:47 PM)Chicago Wrote: Hey Fred,
I apologize if I sound ignorant but all of this is very new to me and very foreign. I found online how to access the settings and change the pressure. I will do that tonight.
Why wold you suggest EPR OFF? I understand that this should help me to exhale.
Thx Fred
Because you had all the CA events. Frequently with pressure induced CA events going to a single pressure or a narrow range and NO EPR controls it. My thought was to reduce the CA events and then bring back the EPR at a low pressure to start. ROT with CA it's better to be without EPR on a CPAP.
Fred
RE: Need some advice- first week of CPAP - Gideon - 08-02-2017
Looking at your newer data (1 Aug) I would try 7.4 as both min and Max, a fixed pressure but still in Auto mode. Your EPR is Ramp only so we can either turn it OFF or leave it alone. You are not using it for your therapy so for now just turn it off. Your numbers are good, just looking for a happy place to keep your pressure until the CA settles out.
Fred
RE: Need some advice- first week of CPAP - Sleeprider - 08-02-2017
It appears things are on the right track an your CA events are being reduced as you adapt to the therapy. I think it's premature to say you need to be concerned about central apnea, but it is a concern since your sleep study showed CA and H events without obstructive apnea. I agree with Fred a fixed pressure (I'm thinking 7.0) should be less disruptive to your sleep, and may further reduce the central events. Based on what we have seen, you tend to have CA events when pressure rises above 7 or so, and it appears that the machine is raising pressure in response to flow limitation. In your case a single pressure might be better.
This graph provided the best information, so please stick to this format.
![[Image: v1RAYjh.png]](http://i.imgur.com/v1RAYjh.png)
RE: Need some advice- first week of CPAP - Chicago - 08-02-2017
Thank you Friends!
I will definitely try going to 7.0 (or close to it) in next few days but first I think I should give two more days to 6-8.40 and see how I do. Any suggestions for the nasal pillow mask that will hopefully help with the leaks compering to Resmed Airfit P10? I do have a small beard and I feel like that kinda makes it a little bit harder for me to have perfect fit.
I'm between choosing one of these three:
Fisher & Paykel Pilairo Q CPAP Nasal Pillow Mask
Swift FX CPAP Nasal Pillow Mask with Headgear
Swift FX Nano Nasal Mask with Headgear
RE: Need some advice- first week of CPAP - Sleeprider - 08-02-2017
I use the Airfit P10 and have used that and similar nasal pillow masks since 2008. If the problem is the mask being pulled when you move in bed, it will help to suspend the hose from your headboard or wall above your pillow. I use a simple I.D. lanyard to capture the hose and let it move freely from my headboard. There is a Hose Buddy product (Amazon and elsewhere) that is not very expensive and does the same duty. Lightweight and portable it keeps the hose from getting tangled. I also use a fleece hose cover because it makes things more comfortable. Remember that the Airfit P10 is tighter when the straps are together at the crown of your head, and looser the further the straps are spread apart.
If you are having mouth leaks, the problem is a bit more difficult, and you may adapt in time not to have those leaks; otherwise, a full-face mask is not a great solution, but it is out there.