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+--- Thread: New to CPAP - have 3 instances of Cheyne-Stokes (/Thread-New-to-CPAP-have-3-instances-of-Cheyne-Stokes)
New to CPAP - have 3 instances of Cheyne-Stokes - aussienana - 07-03-2024
Hi - I had a home sleep study done on 1 June and was diagnosed with severe obstructive sleep apnea-hypopnoea. Sleep study attached.
I have had my cpap machine at home since 11 June, and after trialling several masks, seem to be on the right track with either the F30 or F30i ( although am waiting for the F40 to become available in Australia). My figures have been going down until last week when it was recorded I had 3 Cheyne-Stokes episodes on 26/06, 29/06 and 2/07.
After reading several threads on here realised to be accurate I needed to have OSCAR downloaded and an SD card. Have purchased a computer and SD card today and will download Oscar later.
Do I have to format my SD card or can I just insert it into my cpap machine?
RE: New to CPAP - have 3 instances of Cheyne-Stokes - aussienana - 07-03-2024
Oops - trying again with the attachment
RE: New to CPAP - have 3 instances of Cheyne-Stokes - aussienana - 07-04-2024
[attachment=66577][attachment=66576][attachment=66575]
Hi - I managed to load last nights data into Oscar and have attached 3 thumbnails to this post. Could someone please check this data to see if I had any Cheyne-Stokes incidents last night? Also whether my settings could be improved? I had trouble falling asleep last night (still awake at 23.39) and had a lot of snoring events. I think the most I've had since starting CPAP.
For information I also wear a chinstrap
RE: New to CPAP - have 3 instances of Cheyne-Stokes - PeaceLoveAndPizza - 07-04-2024
A few questions first.
Do you have a history of heart conditions?
Any family history of heart conditions?
Are you taking any medications?
Did any CSR show up during your sleep test?
Onto the charts. You have a lot of positional apnoea going on. Positional as in chin-tucking. The clusters of obstructive (OA) and hypopnoea (H) events suggest you are tucking your chin towards your chest and cutting off your airway. A flatter pillow may help, but most showing this use a soft cervical collar. I have attached a chart you can use to measure your chin-to-sternum distance and you will also measure the circumference of your neck. That should help find one that will meet your needs. I personally use a Caldera Releaf and have for years. Any that meet your measurement requirements will help. Read the following link for more details on positional apnoea.
https://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy#Positional_Apnea
Before getting to deeply into the CSR issue, I suggest first dealing with the positional problem. It will give a better idea of what you are dealing with in your therapy.
I also suggest increasing your minimum pressure a bit, which should help with some of the flow limitations. Try the following:
Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
no ramp
Use that for a few nights with the soft cervical collar and post some charts.
RE: New to CPAP - have 3 instances of Cheyne-Stokes - aussienana - 07-04-2024
Hi - thanks for the quick reply.
No CSR’s recorded on my sleep study and these 3 CSR’s recorded above were after being on CPAP for 15 nights with no incidents.
I had an EEG in Feb prior to a hip replacement and no abnormalities were recorded. I am taking tablets for high blood pressure and high cholesterol and have been taking these for years.
I have ordered a cervical collar but it won’t be here until mid July. I’ll use a flatter pillow till it arrives and I’ll adjust the settings for tonight.
RE: New to CPAP - have 3 instances of Cheyne-Stokes - aussienana - 07-05-2024
Went into the clinician’s menu and selected the following
Mode: CPAP (other choices were Autoset or Autoset for her)
Pressure: set it to 8 (couldn’t see anyway to set max pressure)
EPR: was already set to 3 full time
Ramp time: was already set to off
RE: New to CPAP - have 3 instances of Cheyne-Stokes - PeaceLoveAndPizza - 07-05-2024
You need to be in APAP mode, not fixed pressure CPAP mode.
Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
No ramp
RE: New to CPAP - have 3 instances of Cheyne-Stokes - aussienana - 07-05-2024
Had another look at settings before I went to bed and put them on
Mode: Autosense for her (APAP)
Min: 8
Max: 15 (figured out how to do it
)EPR: 3 full time
Ramp: off
Will post data after a few nights sleep with these settings
RE: New to CPAP - have 3 instances of Cheyne-Stokes - aussienana - 07-07-2024
[attachment=66682][attachment=66683]
Have two nights sleep data with the new settings. Could someone check my data and see how I'm going, whether I need to change anything etc. MyAir informed me that I had large leaks over the last two nights although I used a thinner/flatter pillow. Not sure what to do next
Friday nights data:
[attachment=66684][attachment=66685]
Saturday nights data:
RE: New to CPAP - have 3 instances of Cheyne-Stokes - Jay51 - 07-07-2024
You have several problems going on.
1st: leaks. Way to many IMO. Here are some tips: Mask Primer
2nd: You have positional apnea. Here are some tips:
3. Also, your pressure may be too low. I would suggest increasing your max pressure slowly. Do you have EPR turned on? EPR can help your flow limitations (0.38 at 95% is way too high). You can start with EPR 1. Then try EPR 2. Then EPR 3.
These should be plenty of things to do to start with.