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New APAP user needing advice
#1
New APAP user needing advice
                Hi apnea community,

I've been using my new APAP for two nights and just trying to get all of the settings/masks/etc. just right. I'm making these adjustments myself so I'm reaching out to the community for any advice you can offer. (I purchased a APAP machine on my own, not through insurance/doctor, because it was going to take months to get me set up otherwise). 

My AHIs are low and my sleep has improved significantly over these past few nights, but I'm getting lots of CAs and wondering if I should be concerned. I'm only making crude adjustments to the pressure and would really appreciate if people could read these charts and help me out! Thank you. 

-Zach
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#2
RE: New APAP user needing advice
Welcome to the board! There are many people who can help with any questions you have.

We don’t know if you had centrals before starting pap therapy. That is important because we don’t know if the centrals are treatment emergents or they have been there all along.

With that being said if there are treatment emergents type of centrals they will go away I 2 to 3 months on their own.

Right now I would suggest a generic setting to see how you do.

Try min7. And EPR4

With those changes it will help your flow limits. A flow limit is apnea just like O and H events. They disrupt sleep and can wake you up

Give the settings a couple nights and post again.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: New APAP user needing advice
I agree with Stacy with respect to increasing the minimum pressure to 7. I suggest being more conservative with respect to EPR and just increasing it to 2 for now to see if it increases your centrals. The max EPR is 3. I think Stacy"s recommendation of 4 was a typo.
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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.

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#4
RE: New APAP user needing advice
Thank you both so much. I will try your recommendations and re-post in a few days. Much appreciated. 

-Zach
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#5
RE: New APAP user needing advice
Yes 2 is a good idea - I don’t know how 4 got up there!(3 is all the highest it vcan go)
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: New APAP user needing advice
Hello again,

I tried your advice (min. pressure 7, EPR 2), and it seemed to help with the CAs a little (decreased from 1.2, to 1.12, to 1.08). But I'm still experiencing 10 CAs over the course of the night, so I'm wondering if there's anything else you can suggest. Thanks again for your input. 

-Zach


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#7
RE: New APAP user needing advice
I don't think I would worry over 1 or 2 CA per hour, if their duration isn't very long and you aren't getting SpO2 desaturations. As mentioned, if these are treatment emergent, they will disappear after a while - StacyB mentioned 1 to 3 months. Youv'e been using CPAP for barely a week, and your body isn't used to all that fresh air just yet Big Grin
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps 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.
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#8
RE: New APAP user needing advice
IMO these CA aren't really enough to be concerned over. I've seen on others OSCAR and created worse CA myself, a lot worse.

I'd suggest shifting focus to the leak rate. The occasional mask blowouts are more likely to derail the therapy. To better control this, attention to mask fit and proper adjusting would be a good idea. I would only get Oscar's data input as the mask fit on the PAP is frustrating in lack of detail, green and red ghouls is all they are.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: New APAP user needing advice
Have you ever held your breath? Maybe just to listen for a faint sound? Everyone has. That can and does cause a Central Apnea. We are on your sider here, if we tell you to worry, then worry, otherwise relax. Keep an eye on it. If we see it getting up there we likely will suggest a change to manage it. Now if you see 30+ per hour definitely call us in to look at it. Even 5 per hour, which is a threshold doctors are supposed to recognize. For now focus on other parts of your therapy.
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#10
RE: New APAP user needing advice
That makes sense. Thanks for your feedback. So far, this APAP has been a life-changer. I feel so much better during the day: more energy, less sleepy, no headache, and more productive. I'll reach back out with more questions as they arise, and a big "thank you" to the community for their help. 

-Zach
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