Help with 9.52 AHI from CA events

[YouTakeMyBreathAway]

Just started therapy yesterday and I am getting a good amount of CA ("Clear Airways") events in OSCAR:

   

Should I try increasing the pressure?

[pholynyk]

If you look at the pressure graph and the CA flags in the flow graph above it, you can see that the CAs come after the pressure is higher.

I would suggest turning off EPR, or at least reducing it for a while. If your sleep study did not mention CAs, these are probably treatment emergent CAs, which requires your body to get used to the better ventilation. It may take a month or so to for them to subside.

Keep posting, a couple of times a week, so we can track how things are going. I would want to keep track of flow limitations, as well as your CA.

[YouTakeMyBreathAway]

Thank you for your advice. 

I think I'm going to see if my body adjusts to the EPR setting for at least a week and if the issue persists, I'll take your advice and turn off EPR. I am also considering turning off the APAP mode, since it seems like, to your point, events are more likely at higher pressures.

Night #2:
- AHI 9.88
- Similar amount of CA events
- Changed pressure to 8-14 (vs 6-14)
- Wore oximeter for first part of the night - confirmed desats.

[attachment=43121]

Night #3:
- AHI 6.92
- Slightly fewer CA events.
- Changed pressure back to 6-14
- Wore oximeter for full night - multiple desats to the high 80s.
- Some areas of Cheyne-Stokes breathing pattern (image 2)

   
   

[YouTakeMyBreathAway]

Here's the first attachment that doesn't render above and the second day w/ flow limit showing.

Are these flow limit numbers concerning or normal?

       

[YouTakeMyBreathAway]

Same general story today:

- AHI: 7.25
- Similar amount of CA events.
- Multiple desats to the high 80s.
- Some areas of Cheyne-Stokes breathing pattern mixed w/ CAs

I feel a little less tired than when I woke up yesterday (but still tired).

   

[OpalRose]

Have you tried to turn down the EPR? I'm not saying to turn it off all at once.
Try EPR 2 for a couple days. If you see and feel a positive result, take it down to EPR 1.
Eventually set to OFF.

[YouTakeMyBreathAway]

I'm not saying to turn it off all at once.
Try EPR 2 for a couple days.  If you see and feel a positive result, take it down to EPR 1.
Eventually set to OFF.

Any disadvantage in just going all in and turning it off all the way? Would you also recommend setting the machine to CPAP instead of APAP?

[YouTakeMyBreathAway]

And here is my night w/ EPR turned down to 2 (previously 3):

- Lower AHI
- Fewer oxygen desat events
- Took mask off a couple of times (b/c it felt uncomforatble?)

   

[YouTakeMyBreathAway]

And here's my second night at EPR 2.

- AHI stayed lower
- Oxygen continued to have fewer desat events
- Continued to take mask off a few times in the night (looks like 5 times)

I'm still feeling tired in the morning - seems like something isn't dialed in fully yet.

   

[OpalRose]

Any disadvantage in just going all in and turning it off all the way? Would you also recommend setting the machine to CPAP instead of APAP?

I was thinking along those lines. If you want to try Cpap mode, set it to "Auto mode" with minimum 7 and maximum 7. Keep EPR set at 2 and see how it goes.
If you sleep better, then we can turn down the EPR further.

I'm suggesting Auto mode 7-7 instead of Cpap mode 7 (same thing) because then it will still show flow limitations.
The A10 didn't show FL in Cpap mode, but I'm not sure if the A11 shows FL in Cpap mode.

BTW, did you have a sleep study and did it flag CA's?