Recommendations to optimize settings - Printable Version +- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums) +-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area) +--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum) +--- Thread: Recommendations to optimize settings (/Thread-Recommendations-to-optimize-settings)

Recommendations to optimize settings - roost - 12-30-2023 Hi there.  This is my first post here.  From what I've read so far, this is an awesome community. I've been using CPAP for months without much success.  The AHI numbers are "great", but I anticipated feeling better than I do.  I feel fine, but I also felt fine before CPAP. I've tried playing with the pressure settings.  I've tried constant pressures, APAP without EPR, and APAP with EPR.  I get similar AHIs with everything I try, but it seems that APAP with EPR gives me the best flow limitations and inspiration curves. One other thing I noticed: My inspiration time is always greater than expiration time.  Not sure if that makes a difference for settings recommendations.  Hoping someone can offer tips to optimize the settings. I've posted the past 3 nights.  The first two have a pressure range between 6-11 while the third has a range between 7-11.  Thanks! RE: Recommendations to optimize settings - Old Steve - 12-30-2023 Welcome to the forum! Your settings appear to be about right, I would stay at 7 min for now. I would not to use the ramp if possible and set your machine Response to Normal. RE: Recommendations to optimize settings - Sleeprider - 12-30-2023 100% agree with Old Steve. You tend to have flow limits build up until the machine delivers above 7.0 cm pressure then they abate. Rinse and repeat over and over. You need a minimum pressure of 7.0. RE: Recommendations to optimize settings - roost - 12-30-2023 Thank you both for the advice.  I'll keep min pressure at 7.0 and change the response to normal. I'll post the results after a few nights of sleep. RE: Recommendations to optimize settings - roost - 01-10-2024 Hi again. I have been using the settings discussed above and I'm still seeing flow limitations.  I also feel the same during the day as before. I have attached screen grabs of the past two nights sleep. I have also attached a 3-minute flow rate screen grab. The inhalation curves are not smooth, which from my readings on the site indicate flow limitation.  Yet the flow limit chart shows 0.  Is it possible flow limit is occurring even though the flow limit chart shows 0? Any other optimization suggestions are appreciated.  Thanks! RE: Recommendations to optimize settings - Old Steve - 01-10-2024 You might try setting your minimum pressure to 8cm and see if that helps some. RE: Recommendations to optimize settings - roost - 03-06-2024 Hi there, I've changed the min pressure to 8 and slept with it for many nights.  It hasn't really helped.  I have attached charts from the past 2 nights plus a zoomed in flow rate chart. I've been reading a lot of posts trying to learn from the amazing community.  Below are some things I noticed.  I don't know exactly what they imply or if/how to address them.   The zoomed in flow rate shows many class 2, 4, and 7 inspiratory flow shapes.  At the same time, the flow limit chart shows 0. Inspiration time is always greater than expiration time Tidal volume (seems) low. My IBW is 91, but the median tidal volume is consistently below 500. I'm hoping someone can offer more tweaks to help my treatment.  And, if possible, explain the impact of my observations (for my education). As a side note, I've tried sleeping several nights without CPAP.  I generally feel the same when I wake up, but I get tired later in the evening.  So far, it doesn't look like CPAP is benefiting me at all. Thanks! RE: Recommendations to optimize settings - Sleeprider - 03-06-2024 Your zoomed chart shows a lot of abnormal artifacts. I think your I:E times are incorrect and the machine is being fooled by a relatively fast return to zero flow ahead of inspiration trigger, but there are a couple cardiogenic oscillations that make the machine think inspiration has started https://www.apneaboard.com/wiki/index.php?title=Cardiogenic_Oscillations so it counts a long inspiration time. I think it would be interesting to see the mask pressure under the flow rate graph to see how your CPAP is responding to these. In this case mask pressure is much more useful than pressure. You are correct the inspiration peaks have varying types of obstruction / flow limitation and that is messing with your sleep a lot more than your flow limitation or AHI statistic might suggest. Tidal volume, respiration rate and minute vent seem to be in a normal range for what we see in Oscar results, but I suspect you're around 6-feet tall similar to myself, and my Vt is in the 600s and Vm is 9 to 10 L/min. Your challenge in Canada is going to be getting your hands on a bilevel like the Aircurve 10 Vauto to do something about it. RE: Recommendations to optimize settings - roost - 03-06-2024 I have attached a new chart that shows mask pressure from last night. I'm approx 6.5 feet tall.   Based on your numbers then, my tidal volume and minute ventilation are very low.  Aside from bilevel, can you recommend any setting changes to try? Thanks for helping.