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[CPAP] Should I adjust my CPAP settings?
#1
Should I adjust my CPAP settings?
Hello!

So I've been on a CPAP for four years now, and while I definitely see improvement in terms of daytime alertness, my sleep quality is still blah. Notably, I don't wake up refreshed, and I still get a lot of nightmares and wake up a lot at night, which leads me to sleep longer than I feel I should be. My CPAP and mask have been ok in terms of fit and comfort.

I've attached my OSCAR data, could a more knowledgeable person on here please review it and let me know if there's anything I should be adjusting?

Any help is much appreciated Smile


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#2
RE: Should I adjust my CPAP settings?
Welcome to the board. Your AHI is great but you have a lot of flow limits. They are also apnea but are not included in the AHI.

We treat flow limits with EPR. You just need to turn it on and set it at 3. You should get a better night sleep.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Should I adjust my CPAP settings?
Further to SB's comments on flow limitations, you can see that your pressure is bumped up whenever your have lots of flow limitation lines poking up. These increases may be disturbing your sleep without waking you up. As mentioned, flow limitations are usually reduced by using Exhalation Pressure Relief, which can be thought of as inhalation Pressure Boost - (in a bi-level machine we call it Pressure Support). It helps overcome the resistance to air flowing in.

At the same time, it reduces the air pressures holding the throat open, so we have to watch out for increased obstructive events; if that happens we must increase the Pressure so that the exhale pressure remains high enough to prevent the obstructive events. You don't have very many obstructive events, but they seem to occur when your pressure is falling to around 10.

My recommendation would be to raise your pressure to 11 cm H2O and add in 2 cm H2O of EPR full time.  In addition, I would raise the Ramp Start pressure to 7 or perhaps 8, and leave the time set to Auto. My reasoning here is that the flow graph during the start shows increased flow, which, for me, means I am trying to suck air rather than being comfortable with the amount supplied. You can see that the flow slowly reduces as you get closer to sleep, when the pressure rises to your set minimum.

There's a lot there. The real point is to make relatively small changes and see how things go after several days, rather that changing things every day. You can always come back here and raise any questions that occur to you.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#4
RE: Should I adjust my CPAP settings?
Awesome, thanks for the detailed instructions. So minimum set to 11, max kept at 20, EPR set to 2, and Ramp Pressure at 7 or 8.

I'll try that for a week or two and report back Smile
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#5
RE: Should I adjust my CPAP settings?
I was also having problems getting a good nights sleep, and after watching a couple of youtube videos went in the clinician settings and started playing around with my EPR (changed it from 2 to 3), and through trial and error changed from 8-16 to 9-15 and reduced my Events Per Hour from 1+ to anywhere from 0.0 to 0.5

I had no idea I could take charge of what had been prescribed in 2010. Certainly helped

Next step as a 26 year CPAP veteran and 61yo senior citizen, is to dabble in this Oscar stuff and see what's going on behind the smiley myAir emojis
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