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New CPAP user night reports - Please advise
#11
RE: New CPAP user night reports - Please advise
I'm adding 3 more charts. Those seem to be the precursors to a set of SpO2 drops. 
0:20am
4:31am
4:58am

There's some strange breathing, followed by pulse rate increase then slight movements later and CA.

Overall feeling today is that even though I got much more sleep than during the last 3 nights, I don't feel as crisp and rested.

(08-18-2020, 01:06 PM)bonjour Wrote: Your breathing went shallow, thus your O2 stats dropped.

Excellent! Thank you for reviewing the charts. 

I also had that impression that in the pre-CPAP nights, I felt I was breathing shallow right before my O2 ring would alarm for dropping below 88%. 

What could be causing a tendency to breathe shallow and is CPAP the right treatment?


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#12
RE: New CPAP user night reports - Please advise
Cubus, you need to raise minimum pressure. You are using EPR which has the potential to help you increase tidal volume, but when your pressure is stuck at 4.0 cm, you don't get any EPR. We use a rule of thumb that the minimum pressure should be 4.0 plus the EPR setting. In your case that would be 7.0 for a minimum pressure with EPR at 3. I actually think give the central events here, you should set minimum pressure at 6.0 and EPR at 2. If that interferes with your respiratory drive or triggers more centrals, then we will recommend switching EPR off.
Sleeprider
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#13
RE: New CPAP user night reports - Please advise
Thank you Sleeprider for your feedback. You guys have been so much help, it's totally awesome, I highly appreciate it.

I'm "walking" my pressure up. I set the min at 7 three nights ago but I couldn't fall asleep. Too foreign of a feeling I guess (I always had issues falling asleep and have been a very sensitive sleeper). So, my plan was to reset, try to get some sleep and increase min pressure steadily.

I've run a min pressure last night at 5.5. Attached is a chart. There doesn't appear to be that many events recorded, but I'm not sure what that effectively means in terms of apnea or treatment, especially that I still have quite some SpO2 drop offs. Not as bad as before CPAP treatments where I'd drop off to 78% SpO2 but still nonetheless. 

It seems to me that my daytime fatigue is closely related to how bad by SpO2 was at night. So my goal is also to try to eliminate the SpO2 drop offs.

Would you suggest that I should try min at 6 and EPR of 2 tonight?

Thank you so much for your feedback!


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.pdf   Aug_18_O2Ring_20200818221324_OXIRecord.pdf (Size: 295.25 KB / Downloads: 2)
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#14
RE: New CPAP user night reports - Please advise
I want you to get a practical demonstration of CPAP pressures. Get a tall glass of water and a straw. A full large drink from McDonalds works. Now the hard part, blow bubbles. Yes make like a kid and blow bubbles. Here's the physics of what you just did. With the straw near the bottom, 8 inches below the surface you exerted a force equal to the max pressure your CPAP can exert., 20 cmw. Or 0.28 psi. 7 cmw is about 1/3 of that.
I'm not saying you are not having issues with pressure, just wanted you to have a practical experience with the pressures involved.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#15
RE: New CPAP user night reports - Please advise
I really think you need to turn EPR down from 3 to 1 or 2. It could be that your perception of the pressure is actually coming from the contrast between inhale and exhale. As bonjour suggests, your pressure is very low. The good thing is the leaks are also very low so there is a good chance you will have quiet and comfortable therapy, I just can't imagine any adult feeling ventilated at 4 cm.
Sleeprider
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____________________________________________
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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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#16
RE: New CPAP user night reports - Please advise
(08-19-2020, 09:39 AM)Sleeprider Wrote: I really think you need to turn EPR down from 3 to 1 or 2.  It could be that your perception of the pressure is actually coming from the contrast between inhale and exhale.  As bonjour suggests, your pressure is very low.  The good thing is the leaks are also very low so there is a good chance you will have quiet and comfortable therapy, I just can't imagine any adult feeling ventilated at 4 cm.

Hmm, I will try that and it is a very interesting point. 

I think the most awkward feeling to me was that my full mask felt like it was constantly moving (almost like pumping) on top of my face. With every inhale and exhale it felt like it was a bit inflating and deflating on top of my face. 

Thank you Bonjour as well. I will do the experiment, it sounds like a fun thing to do with my kids too as they're curious about the hole thing anyway :-)
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#17
RE: New CPAP user night reports - Please advise
I teased my toddler grandkids by blowing air on them as a game when they started to sho some fear.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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