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Help Adjusting cpap to stop clear airway events
#1
Help Adjusting cpap to stop clear airway events
Hello,

I did an at home sleep study and had a mild AHI of 5.6, but a high RDI at 19.  So mostly hypopnea's and rera's and less OSA.  Study did not show and clear airway events.  I have been on cpap therapy for about 3 weeks, and been playing around with the pressures and settings to find the most comfort.  Last night was the first night that i didn't rip the mask off in my sleep so thats progress, but I still had 2 wake up periods, and I would say I got maybe 5 hours of sleep.  I do feel better than i have in quite a while though.  The cpap does seem to do a really good job for me in preventing OA, and H events some nights those being zero even, while others they are super low.  My AHI has always been below 5 while using cpap.

So my questions are how can i fine tune the machine a bit more to stop the CA events because those seem to be 90-100% of my AHI most nights(pretty sure these are cpap induced), and how can i prevent the wakeups to get that much sought after 7+ hours of straight sleep with cpap on.

I have attached 2 screenshots from OSCAR from last night.  Let me know if you want me to provide anything further.


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#2
RE: Help Adjusting cpap to stop clear airway events
Your CA index is relatively low and may decrease in a month or two. It is not unusual for new users to experience treatment emergent CA which decrease as they adjust to the therapy. EPR may also induce CA events but it is the best treatment for flow limitations, RERA, and hypopnea. You may want to turn off EPR and see what happens. If it results in RERA and hypopna  you can turn it on again. An AHI of 1.5 is pretty good. Not everyone can get it below 1.
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#3
RE: Help Adjusting cpap to stop clear airway events
Oh boy Dont worry about those Numbers? They are great, I wish had your Numbers ?, More so how is actual sleep ? or wakings' during Night? How feel, during day? Should Add your SLEEP-STUDY, Diagnosed boarder line criteria for Apnea treatment?
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#4
RE: Help Adjusting cpap to stop clear airway events
My sleep historically was awful, and I was falling asleep while driving which is why treatment with cpap was the route they decided to take first even though the AHI was only mild.  With the cpap so far I have consistently woken up twice each night, and havn't gotten a consistent sleep over 5 hours yet.  My sleep for sure feels like its more restful than before, but I am still tired, likely because I am not getting enough.  Are you saying I should not have been prescribed a cpap?  I am to follow up after a month or so and to look into possible other options, but due to the severity of the symptoms i was having they wanted me to start cpap.  Your implication that I shouljdn't be on cpap leaves me a little disheartened.  I have been dealing with years of restless sleep with no answers, and this gave me my first sign of hope in a long time, but now i feel like its gonna be a waste.  I have attached my sleep report.


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#5
RE: Help Adjusting cpap to stop clear airway events
Depending on your insurance, they may require you start with CPAP, and then when you find it is not working out (assuming so) then they will try the next level machine -- then the next level. I had to go through 4 sleep studies and 4 machines before they got me on an ASV machine, which is what generally is needed for my Central Apnea. It's part of the hoops you have to jump through.

Also, I have had a number of nights with 0.00 as my score, and I still felt terrible the next day. The score is not everything. Also to figure in is "how do you feel". I am getting plenty of good sleep these days, but I still wake up a couple of times during the night. BUT I have had prostate cancer and radiation treatment and that could be a big part of my problem.

If you're ripping your mask off, ask yourself why. Are you getting too much air, or are you starving for air -- or are you having trouble getting used to the mask and machine blowing air into your head.
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#6
RE: Help Adjusting cpap to stop clear airway events
Been reviewing my OSCAR charts more, and i'm noticing a trend of when i rip off my mask in my sleep.  I would expect that it would happen when my pressure reaches a max level i get uncomfortable with, but it seems to consistently happen after that peak pressure and maybe 20 minutes later after the pressure has gradually gone down some.  Why do i seem to pull it off as the pressure comes down?  The level the pressure is at is still above the early phase of my sleep where i have no issue leaving it on so not sure how to stop this.

Attached a few SS of the areas im referring to.  I can zoom in on any of these areas if needed.  The cpap seems effective for me when its on, but i can't stop removing it, and i always struggle to fall back asleep after if i even can.  So this leaves me completely un-rested and feeling like garbage.  If i can figure out how to stop removing the mask hopefuly i can get a full sleep with it on.


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