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6 month status update - suggestions
#1
6 month status update - suggestions
Hello all, I started CPAP about 6 months ago, and tested multiple machines and masks before purchasing my current setup. It's a resmed airsense 10 autoset, paired with a Fisher & Paykel full face mask, which I've been using regularly for the past 3 or 4 months.
My AHI's have been below 5, but I saw somewhere that with good therapy, they can consistently be below 1.  I have definitely not gotten that low.  So I thought I would ask the experts if they see anything in my numbers that could be improved on or worked on.  I am feeling fairly well rested, but sometimes think I could feel better.  I've attached my Oscar results for the past 2 days, as well as a couple weeks from the overview page.  All suggestions are welcome!
Thanks, Brian
   
   
   
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#2
RE: 6 month status update - suggestions
You seem to be topping out at 11.  Take it up to 12.  The Min is at 7 but it should be about 8.5. And your EPR is at 1 I would put it to 0.  I think those numbers are better for you but the Centrals are the highest number and those will not change with the settings on this machine.  Give the numbers a try you can always go back to your original ones.  Notice that all of your top pressure readings are with you Hypopnea.  If these settings cause more centrals back off the upper number again.

The lower number will help your Flow Limits of which are not big but numerous.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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#3
RE: 6 month status update - suggestions
(08-28-2020, 01:11 PM)staceyburke Wrote: You seem to be topping out at 11.  Take it up to 12.  The Min is at 7 but it should be about 8.5. And your EPR is at 1 I would put it to 0.  I think those numbers are better for you but the Centrals are the highest number and those will not change with the settings on this machine.  Give the numbers a try you can always go back to your original ones.  Notice that all of your top pressure readings are with you Hypopnea.  If these settings cause more centrals back off the upper number again.

The lower number will help your Flow Limits of which are not big but numerous.

Thanks!  I can give those suggestions a try for a few nights.  Brian
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#4
RE: 6 month status update - suggestions
Brian, your machine is set at 7.0 to 11.0 with EPR 1. Your pressure is increasing mostly in response to flow limitations, and your events are mostly CA and H. This is a pretty difficult combination, and I don't agree the best approach is a pressure increase. Before we get into changed settings, I'd like to ask you if you have ever tried higher EPR settings, and if so, did it increase your CA events? More EPR would reduce the flow limitations and significantly reduce the pressure increases we are seeing here. The risk with EPR is that the increased ventilation may increase CA.

Contrary to the advise above, I see two very different options. One is to use fixed pressure at 8.0 and keep your EPR 1, and the other is to increase EPR to 3 and just see what happens. The first option is based on the fact your flow limitation and events are positively correlated with increased pressure. in other words, you appear to have more events with higher pressure, and that seems like something we should avoid, especially since CA is not treated by using higher pressure. Limiting pressure to a fixed value should help reduce events. The second option is based on treating the cause of the pressure fluctuations, which may or may not reduce or increase the CA events.
Sleeprider
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#5
RE: 6 month status update - suggestions
(08-28-2020, 07:58 PM)Sleeprider Wrote: Brian, your machine is set at 7.0 to 11.0 with EPR 1. Your pressure is increasing mostly in response to flow limitations, and your events are mostly CA and H.  This is a pretty difficult combination, and I don't agree the best approach is a pressure increase. Before we get into changed settings, I'd like to ask you if you have ever tried higher EPR settings, and if so, did it increase your CA events?  More EPR would reduce the flow limitations and significantly reduce the pressure increases we are seeing here.  The risk with EPR is that the increased ventilation may increase CA.  

Contrary to the advise above, I see two very different options.  One is to use fixed pressure at 8.0 and keep your EPR 1, and the other is to increase EPR to 3 and just see what happens.  The first option is based on the fact your flow limitation and events are positively correlated with increased pressure. in other words, you appear to have more events with higher pressure, and that seems like something we should avoid, especially since CA is not treated by using higher pressure.  Limiting pressure to a fixed value should help reduce events.  The second option is based on treating the cause of the pressure fluctuations, which may or may not reduce or increase the CA events.

Thanks for the expertise and advice @sleeprider.  I didn't bother going through all of my past settings, but a higher EPR (2) and a higher max (16 auto) have both been tried for 24 days early in my trials - albeit with masks that were leaking enough to impact the outcome at the time.  During that time, the CA events seem to be the most prevalent events.  Based on that, I am thinking that I'll try a fixed pressure at 8 and EPR at 1 for the next few nights, and check in in a few days.  Thanks!  Brian
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