Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Need help with fine tuning pressure!
#1
Need help with fine tuning pressure!
I was diagnosed with mild sleep apnea (AHI 5) and have been using my cpap for about 6 weeks. I'm still very sleepy during the day and not waking up refreshed at all. I mostly have CA's each night and it seems like a lot of them are SWJ. I have tried different pressures and using EPR but nothing seems to help the CA's go away. Any help will be very appreciated! The attached SleepyHead data is from last night and is a pretty typical night for me.


Attached Files Thumbnail(s)
   
Post Reply Post Reply



Donate to Apnea Board  
#2
RE: Need help with fine tuning pressure!
You have a few hypopnea and considerable flow limitation. It is the FL which is causing your pressure to rise. We don't know the cause of your CA events yet, but could be sleep disturbance or mild complex apnea. We're going to find out...

Your pattern is typical of Upper Airway Resistance Syndrome (UARS), and I would bet your sleep study was all or mostly hypopnea. I think you would benefit from using the exhale pressure relief EPR feature on your machine. This will specifically target FL and H events, and should increase comfort. There is a slight risk it will increase the incidence of CA, but it's worth a try. This article explains why using EPR to achieve bilevel pressure may be beneficial. http://www.apneaboard.com/wiki/index.php..._and_BiPAP

The only changes needed is to go into settings, and under Comfort, turn EPR to ON, Full Time, and set it at 2 or 3. A higher setting is more pressure relief on exhale. Give it a try, and please check back. Let us know if you need help accessing the settings. A clinical manual is available free from the forum https://www.apneaboard.com/adjust-cpap-p...tup-manual
Post Reply Post Reply
#3
RE: Need help with fine tuning pressure!
Thank you for your reply! I have wondered if I might have UARS as well. I have tried using EPR. I have attached two nights using EPR. It definitely helps lower my FL but the CA's are still there.


Attached Files Thumbnail(s)
       
Post Reply Post Reply
#4
RE: Need help with fine tuning pressure!
H and FL are lower with EPR, and it appears your minimum pressure was set to 12 at that time. I think you might use EPR but try a pressure range of 9.0-14.0 and see if that helps with CA. If you are concerned about the CA events, you might be able to reduce or eliminate them using Enhanced Expiratory Rebreathing Space (EERS), http://www.apneaboard.com/wiki/index.php...ace_(EERS) This is somewhat experimental, but has worked as discussed in this thread. http://www.apneaboard.com/forums/Thread-...a-attached
Post Reply Post Reply



Donate to Apnea Board  
#5
RE: Need help with fine tuning pressure!
Nice chart, now all we have to do is reduce the CA.  This is done on a CPAP by either reducing EPR which we are NOT going to do now and or by reducing pressure.

I would drop your min pressure by 1 cmw with no other changes, then repeat in a day or 2 until the charts show a negative change, either an increase in CA or an increase in other Apneas.  Also of note with this chart is that it shows a nearly constant pressure.  Before all is said and done you could be at a constant pressure say Min 9 and Max 9 with an EPR of 3.  Constant pressure is a method of dealing with CA on a CPAP, not all the time but frequently.  


 Time and trials will tell.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#6
RE: Need help with fine tuning pressure!
To clarify I made my post then was interrupted so I didn't see SR's post until after I posted mine.  

I'm targetting the same place SR is sending you, but I usually choose a slower approach.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#7
RE: Need help with fine tuning pressure!
Last night I tried 9-14 with an EPR of 3. I got about the same results. My chart looks a little different because I tried taking a nap earlier in the day and didn't fall asleep. I zoomed in on just my sleep for the night. Also I woke up briefly because my son woke me up. Should I stick with this range for a few nights and see how I do?


Attached Files Thumbnail(s)
   
Post Reply Post Reply



Donate to Apnea Board  
#8
RE: Need help with fine tuning pressure!
I kind of like Bonjour's idea of using a fixed pressure of 9cm. But I would turn off the EPR. I think it would answer the question of can the CA events be controlled by machine settings.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help 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.



Post Reply Post Reply
#9
RE: Need help with fine tuning pressure!
Based on a few things, first EPR initially controlled your Flow Limitations and while I would be likely to change it later lets only change one thing at a time.  
I would like to remove the variation caused by the auto algorithm doing what it is supposed to be doing for now. I would like you to set both your Min and Max pressures to 10 cmw.  Pressure fluctuation commonly induces CA events in some patients, it seems likely that you are one of those lucky ones.  This may be followed up with either a pressure reduction (I do like to take it slow) or a reduction in EPR depending on results..Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#10
RE: Need help with fine tuning pressure!
Here is last night's data. I used a steady pressure of 10 with an EPR of 3. I had more CA's than I usually do. Any suggestions?


Attached Files Thumbnail(s)
   
Post Reply Post Reply



Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [Treatment] Fine Tuning my Resmed ASV Machine with Incremental Wins RayBee 7 225 03-16-2019, 11:15 AM
Last Post: RayBee
  All was fine last night and then after 2 hrs everything went crazy! Haley 11 441 02-19-2019, 09:44 AM
Last Post: Haley
  Fine tuning my new(-ish) machine heropass 2 226 01-15-2019, 04:42 PM
Last Post: jaswilliams
Question 90% Pressure meaning & Setting Correct Pressure for Auto-CPAP dk2011 2 482 12-28-2018, 05:37 PM
Last Post: bonjour
  Pressure vs Mask Pressure paulag1955 8 1,301 08-21-2018, 09:31 AM
Last Post: Sleeprider
  AHI is fine.... mental fatigue is not MoApnea 16 1,026 04-19-2018, 02:27 PM
Last Post: Sleep2Snore
  Help me fine tune my BIPAP settings, please! Nito 27 1,327 04-18-2018, 02:25 PM
Last Post: Sleeprider


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.