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Improvement, but what else should I change?
#1
Improvement, but what else should I change?
Hey all, I'm still new but thanks to some very helpful people here on this forum, I've made some adjustments to my settings and it's helped last night. 
I made some changes to the settings last night and I've attached the graphs for comparison.

I cranked up my min from 4 to 6.4. Lowered my max from 15 to 9.4 (I was tryna make a narrower window but i think I lowered the max too much from what I see on my graph). EPR down from 3 to 0 (was gonna do 1 but I decided to go all out). 

I've noticed a pattern that I wake up at around 6-7 in the morning ever since starting CPAP 4 nights ago. Also, a Cheyne Stokes pattern appears at that time as well (although I've been told the pattern itself is misleading). I know the sample size is small but do these patterns mean anything???

I believe I may be experiencing treatment-emergent central sleep apnea. From what I know about it:
- changes in nasal resistance could be a factor in the mechanism - I do have sinus issues, which I've recently started treating properly so hopefully that may help. 
- I also have mild asthma but this has been under control so not sure if its contributing.
- I've been told lowering the EPR can help, which I believe it has comparing last night's new settings to the night before. 
- Also, I believe treatment-emergent CSA may improve/disappear over time with use. 

Studies are still being done so I guess no one knows for sure. I'm gonna stick with CPAP and hope that it resolves itself. Do you guys have any further tips?

Thanks!


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#2
RE: Improvement, but what else should I change?
First I would just try to keep one treatment thread.  It helps with history and continuity.

When you do Screen shots got to View > Take screen shot OR F12.  It gives the best look for us.  So maybe post new ones 
Info:
OSCAR Chart Organization and preparing for Screen Shot
For a brief tutorial on the best way to arrange your OSCAR charts for review, follow this link: For advice on attaching charts and images to Apnea Board forums, follow this link:
Here is what I see.

You do have a lot of CA events.  Where you told you have Central Apnea?  if not it could be treatment emergent.  How long have you been on CPAP?

You are hitting your max pressure.  So you need to make that Max 14 

I would use EPR at 1 or 2 to do that you need to up your min pressure to 7.  off is not good for you.

The goal is no ramp so I would turn that off.

Do you have copies of you sleep study if so post redacted versions.

Setting recap
Min Pressure 7
Max Pressure 14
EPR 2 or 1. (your choice we can always change it back)
Ramp Off
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

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#3
RE: Improvement, but what else should I change?
I'd definitely like to see your initial sleep study, to see whether you had any central events during that.

It's almost certainly not CS respiration, and honestly, in the absence of serious heart issues, I would assume it's just periodic breathing. It's definitely possible that you can have some treatment-emergent centrals, and you're right that they should (hopefully) reduce in time if you're a very new user.

Definitely increase your max if you're topping out frequently. How were your centrals with EPR of 3? Though centrals are nothing if not inconsistent, so you'd need a few more days of data to really see if a change has made a difference or if it's just a particularly good/bad day.


See my comparison of Viatom/Wellue and CMS50F oximeters here.

Not a doctor, definitely not your doctor, all advice is given as-is and represents simply my own understanding as a fellow patient and OSCAR user.
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