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New Member- CPAP Settings
#1
New Member- CPAP Settings
Hi all,

First and foremost, thanks to all the people who have contributed to various posts and wiki pages through the years. There is a lot of great information on this site and I have learned a ton from reading the articles and the responses to other member charts. 

My story... I have had issues falling and staying asleep since I was ~12 but this has only significantly impacted me over the last 2 years - I just turned 30 this month. After failing to see any improvements with CBTi for a 3rd or 4th time, I was able to convince my doctor to order a sleep study. The home sleep study showed no CA events, but enough OA and hypopneas to give a mild, possibly moderate, OSA diagnosis. 

I received my Dreamstation in middle/late April. The doctor left the default settings on the machine - 5min, 20max, APAP, A-Flex 2. So far, I have had all the same issues while using the machine that I had prior to it. I wondered if the issues were with comfort of the mask but i have now tried 3 different masks (dreamwear FFM, F30, and N30i) and while the F30 seems the best for me, I am still struggling to sleep through the night and never feel rested when I wake.

My doctor thought that we should use sedatives to establish a consistent sleep schedule and that should be the end of my problems - plus they feared I wouldn't meet compliance for insurance if we didn't try something different. I was on 2 different dosages of lorezapem for 2 weeks each then was on zolpidem extended release for another 2 weeks to establish that sleep schedule. Zolpidem XR was the most effective but I was still waking up multiple times in the night and felt no improvements in restfulness the following day. 

I wondered if the reason i was waking up could be because the machine settings weren't tailored to my needs. I saw that my 95% pressure number was ~14 and decided to move the min pressure from 5 to 8. This helped AHI numbers and slightly reduced the number of times I woke (still on Zolpidem) but didn't significantly improve how i felt the following days. 

I haven't taken any medications for a week now and am waking up more frequently. I  was seeing high OA numbers at min pressure 8 which caused me to play with settings again. My AH events seem to worsen as the night goes on but I have a much easier time falling asleep w/out the machine so I generally just abandon the machine if i wake up numerous times and have hit my 4 hours for compliance.

With min pressure 10, my OA events dropped slightly but my CA events increased. Since I didn't have a problem with CA on my sleep study, i thought this could be machine induced and read that flex settings may help reduce CA. I struggled to get to 3 hours of sleep without flex (though i want to try it again) but my OA number went up slightly with C-Flex. I increased the pressure from min 10 to min 12 on C-Flex to try to combat the increase in OA but woke up twice and felt awful so abandoned the machine for the rest of the night.

   

Knowing my OA numbers were less with A-Flex, I decided to drop the pressure to min 10 and try A-Flex 2. That seemed to improve OA numbers but increased CA numbers. 

   

I am not a big fan of the doctor that I am seeing and I am in the process of finding another doctor but most specialists I called have wait lists of 6-10 weeks to get an appointment. I know that I haven't used some settings for long enough to have any statistical significance but I am growing impatient and simply hoping that something will work. 

Does anyone see anything in the charts or have any suggestions that may improve my sleep quality? 

Thanks,

Trevor
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#2
RE: New Member- CPAP Settings
Flex settings won’t help CA’s, and may actually increase them. I would turn Flex down to 1, possibly off.
Also, try raising the minimum pressure by .5 at a time and watch to see if there is a difference.

Also take into consideration that the meds you are on might cause the CA’s.

I can’t say by looking at your graphs why you are waking up, but it could be your mask or you are sensitive to higher pressures.

When you wake up, try to note the time. One way to do this is to briefly turn the machine off, then back on. When you look at your chart, you will see the break. Then note what is going on right before you turned the machine off...like leaks, mask issues, apnea’s, what pressure the machine was at.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com
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#3
RE: New Member- CPAP Settings
I'm not sure if the following applies to non-resmed machines. mentioning for general reference.

note that if using oscar, you'll have to turn off the machine for more than a minute. otherwise oscar will combine the sessions and it won't be as easy to find the break.

another way is to spike a quick big leak. or use a voice recorder, like on a phone, to note the time.
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#4
RE: New Member- CPAP Settings
Thanks for the advice OpalRose and Sheepless!

I have been off all meds for a week, so I suspect the medicine may not play as much of a role any more.

I will try turning off the flex setting and seeing if that helps after an extended period of time. I will also try track the wake ups by turning the machine off- while considering sheepless' advice that it may need to be off for longer than a minute.

Thanks again,
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