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First Week with APAP
#1
Hi! I just completed my first week using the ResMed Airsense 10 Autoset with AirFit P10 nasal pillows and I was hoping to get some feedback to help me fine tune my settings.

By way of background, I had two clinical sleep studies two years ago. The first diagnosed central apnea and my doctor referred me for a second study. The second clinical sleep study doctor was skeptical of the scoring on the first results and had me stay overnight for a second sleep study. His determination was that I had purely obstructive apnea. He wanted me to come in for a third overnight sleep study and I threw my hands up in frustration about another night with hundreds of wires attached to my head and didn't go back.

Lately my snoring was getting bad (per wife) and blood pressure was getting high (per doctor, 140/90) so I decided to order an APAP and see if that helped.

After a week of using the APAP and checking blood pressure twice a day my blood pressure is down to 119/80, snoring is not bothering the wife and my sleep is better. But, I am noticing on these sleepyhead charts that their are a lot of CA events and leakage.

My pressure is currently set at 5-20 with a 10 minute ramp starting at 4 pressure. I turned EPR off because I was noticing, as I drifted off to sleep, that I'd stop or have "lagged" breathing and it would wake me back up a little.

Any thoughts would be much appreciated! I am still working my way through the wiki and glossaries, lots of helpful information in there.

My initial thoughts are raise my minimum pressure and perhaps try switching from the Medium nasal pillows to the smaller size for a tighter fit (though when I tried the smaller pillows that I felt like I wasn't getting enough air).

I can't embed yet or post clickable links so here are text links to my photo bucket screenshots:

Screenshot 0:
http://i1288.photobucket.com/albums/b490...0b8171.png

Screenshot 1: http://i1288.photobucket.com/albums/b490...c0e1c6.png

Screenshot 2: http://i1288.photobucket.com/albums/b490...f5566f.png

Screenshot 3: http://i1288.photobucket.com/albums/b490...acd4ec.png

And here is a cut and paste of the sidebar stats:

AHIApnea Hypopnea Index 7.95
ResMed AirSense 10
PAP Mode: APAP
Min 5 Max 20 (cmH2O)
Date Sleep Wake Hours
11/29/14 21:56:48 06:58:19 08:56:01
Large Leak 1.79%
Clear Airway 5.71
Obstructive 1.46
Unclassified Apnea 0.11
Hypopnea 0.67

Event Breakdown

Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 8.20 4.08 7.88 11.80 14.68
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 5.81 0.00 5.12 11.12 22.62
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 12.57 0.00 11.60 19.80 50.00
Flow Limit.Graph showing severity of flow limitations (Severity (0-1))
W-Avg: 0.02 0.00 0.00 0.12 0.44
Leak RateRate of detected mask leakage (L/min)
W-Avg: 3.70 0.00 1.20 18.00 49.20
SnoreGraph displaying snore volume (?)
W-Avg: 0.01 0.00 0.00 0.08 0.86
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 2.97 0.22 2.90 4.40 14.74
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 2.17 0.04 2.22 2.94 7.20
Tidal VolumeAmount of air displaced per breath (ml)
W-Avg: 459.51 0.00 440.00 720.00 1240.00

Total time in apnea 00:17:33
Time over leak redline 1.791%
Machine Settings

ModeCPAP Mode APAP
Pressure MinMinimum Therapy Pressure 5 cmH2O
Pressure MaxMaximum Therapy Pressure 20 cmH2O
EPRResMed Exhale Pressure Relief Full Time
EPR LevelExhale Pressure Relief Level 1cmH2O


(Thanks for reading! I appreciate all the help I've found on this forum and I did make sure to donate. Smile )
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#2
(I fixed your links)

That is just one night of stats so going by just that one night...

You are having a lot of CA events but not a scary amount. Concerning, yes. That big cluster of CA and OA events in the last session prior to waking, my bet is you were on your back. That grouping of CA events at about 23:00, those happen during a high period of pressure and *might* be attributed to pressure-induced CA but there are none in the session right before.

Look at your previous nights. Look at the top of the left-hand window, right above the pie chart. Where it breaks down the AHI? Where does your central apnea index fall each night? The shot you provided, it is 5.71. What are the other nights and the overall AHI for that night?
PaulaO2
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www.ApneaBoard.com


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#3
Hi jhb701,
WELCOME! to the forum.!
Don't base things on only one night. You want to look at every night you have been using your machine. In other words, you are looking for trends instead of just one night.
Hang in there for more responses to your post and much success to you with your CPAP therapy.
trish6hundred
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#4
Hi Paula,

I am getting pressure induced CA's and though only a small number, it is clear that as I increase the minimum pressure so the CA's increase.

Purely from an interest point of view, at what stage do CA's become significant and something to be concerned about. Personally I have way to few to be concerned but as you mentioned earlier in thus thread,'You are having a lot of CA events but not a scary amount.', what would a scary amount be?
Failure is NOT an option.
Post Reply Post Reply
#5
(11-30-2014, 02:14 PM)PaulaO2 Wrote: Look at your previous nights. Look at the top of the left-hand window, right above the pie chart. Where it breaks down the AHI? Where does your central apnea index fall each night? The shot you provided, it is 5.71. What are the other nights and the overall AHI for that night?

Thanks for the comments and for fixing the links! Your advice about looking for trends sounds good, I need to work on getting a full nights' sleep with the mask on the whole time. This first week I had a lot of partial nights, mask slipped off, fell asleep without it and woke up and put it on later, etc.

FWIW, my CAs for prior nights were:

CA 14.8 / AHI 17.49 (3:43 hours)
CA 3.55 / AHI 3.82 (7:36 hours)
CA 15.83 / AHI 18.33 (2:24 hours)
CA 9.01 / AHI 10.73 (8:06 hours)
CA 9.28 / AHI 10.64 (4:25 hours)
CA 2.71 / AHI 3.61 (2:13 hours)
CA 2.94 / AHI 3.24 (3:24 hours)
CA 5.71 / AHI 7.95 (8:56 hours, the one from the screenshots)

I'll keep working on better time and data. And I need to try to sleep on my side with the mask intact/in place. Thanks again!




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