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+--- Thread: [Pressure] Need help finding the right pressure. (/Thread-Pressure-Need-help-finding-the-right-pressure)
Need help finding the right pressure. - kidchameleon - 01-28-2023
A year ago I had a study confirming I have sleep apnea. I decided instead of a titration study to buy a Resmed Autoset 10 and do it myself. After a year, I gave up after not seeing any results, even with help from online, and decided to schedule an appointment. By results I mean I wanted to feel fully rested and feel normal.
My titration study results say my prescription should be 8cm CPAP, but I feel like it's not making much of a difference, especially with my AHI being around 3-4. I know it hasn't been long since I've been on 8cm, but I've been using APAP for over a year (with different pressures all over the place) so I'm definitely used to sleeping with it.
I also don't feel like I slept enough at my sleep study, it was very difficult. I did sleep enough according to the nurse, but I'm still not sure. And I wake up a lot during the night too and I move around too much. I don't wake up coughing or choking or needing the restroom
I just open my eyes, change position and fall back asleep.
And lastly, my AHI for the first few hours is usually pretty low but after that it increases. That's been happening with the different pressures I've used throughout the year.
I do have OSCAR in case that's needed, but I only have a few days of being on 8cm and I'm not good at reading the charts.
Would it be better to switch to APAP instead, something close to my prescription?
I can't post any links yet, but on one of my nights on 8cm, I had
Large Leak - 0.62%
Clear Airway - 0.14
Obstructive Apnea - 3.42
Unclassified Apnea - 0.00
Hypopnea - 0.14
RERA - 0.00
I'm 29, 5'7, about 160lbs and I use a Resmed Autoset 10 and I wear a full face mask.
RE: Need help finding the right pressure. - Crimson Nape - 01-28-2023
Hi kidchameleon! -
You can't post links, but you can post images of OSCAR's Daily screen. While in OSCAR, use the F12 or Fn+F12 for a Mac to take the screenshot. This will eliminate the calendar and right side menu if you have either open. My signature has information on how to post an image here. Just remember that you will need to use the full editor and not the Quick Reply in order to post images.
- Red
RE: Need help finding the right pressure. - kidchameleon - 01-28-2023
Alright, thanks! I'll see if I can do this...
I tried on my phone earlier but maybe it'll work on my desktop.
I'm posting 2 nights where I had at least 7 hours of sleep with 8cm fixed.
RE: Need help finding the right pressure. - Melman - 01-28-2023
It will be helpful if your chart includes flow limits and the entire leak rate chart. You can make them fit by adjusting the height of the graphs by using your mouse to move the line under each upward. The clustering of OS events on the 24th are indicative of positional apnea. See this link for an explanation. http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea
I suspect you may get better results using APAP mode and EPR but would like to see the flow limitation data first. Please post again and consider dealing with the positional apnea since no pressure will fix that. You may need a different pillow or soft cervical collar (see the link below).
RE: Need help finding the right pressure. - kidchameleon - 01-28-2023
Oh right, will this do?
RE: Need help finding the right pressure. - Melman - 01-28-2023
Perfect
As I suspected your flow limitations are contributing to your obstructive events. They can be reduced by use of EPR (expiratory pressure relief). I recommend full time EPR at 3. I think you may also benefit from using APAP mode starting with a range of 7-15. Keep in mind that no settings adjustments will overcome the positional apnea. You will need to deal with that. Please make what changes you feel comfortable with and post more data.
RE: Need help finding the right pressure. - kidchameleon - 01-28-2023
Okay, sounds good! I do have a soft cervical collar that I use sometimes. The charts I posted didn't have me wearing one though, but I'll wear one tonight and post my results tomorrow with the settings I was recommended, thanks!
RE: Need help finding the right pressure. - kidchameleon - 01-30-2023
I said I was going to post my results from the night before, but I accidentally fell asleep without wearing my cpap for most of the night, so I waited for last night's results instead.
My AHI is higher than I usually get, most likely because of EPR. I get lower results when I turn it completely off. I also wore a cervical collar. Should I then try again without EPR but the same settings?
RE: Need help finding the right pressure. - Melman - 01-30-2023
Your OAs are clustered indicating you are stillexperiencing positional apnea. I doubt EPR is the issue. Does your cervical collar actually prevent you from tucking your chin. If it's too loose your chin may be tucking behind it. Or perhaps it's not high enough ot too soft.
RE: Need help finding the right pressure. - kidchameleon - 01-30-2023
Hm, it's definitely not loose or low, but I do suspect it might be too soft. I use this exact one here
https://a.co/d/7v2yBQC
I tried looking for others I could buy but I'm not sure which one would be ideal for me.