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New to cpap - struggling to have good results
#1
New to cpap - struggling to have good results
Hello all,
I'm 30 and I suffer from severe sleep apnea with an AHI of 32. 
Last month I was finally able to get my prescription in hospital and I got my therapy setup with 11 cmH2O. The final result for the compliance was a "score" of 3 AHI. In hospital I used a Phillips dreamstation without humidifier and a nasal mask from epson. 
The doctor prescribed the same mask and a Resmed airsense 10 elite, that I got from a supplier, who advised for a Resmed N20 nasal mask for more comfort compared to the epson. 

In this last 2 weeks I have started the therapy but I never got a AHI lower then 5. Tried with different EPR settings, I also reduced a little bit the pressure but no big improvements. I'll get back to the doctor after the summer holidays, in the meanwhile I'm seeking some advice about the situation. 
Is it something normal to have these results at the start of the therapy? Is something wrong with the mask I'm using? I tried a lot of different fittings.
Most of the AHI is due to CA, should I be worried that i got the wrong machine? I wonder I a got a AHI 3 in hospital...

I'm attaching the last 3 days. hope to get some help

Thank you in advance


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#2
RE: New to cpap - struggling to have good results
The experts will show up soon, but I know there is a thing called treatment-emergent central apnea. Apparently, some people get this when they just start out. If it's really treatment-emergent, it will go away by itself. The experts will be able to tell you more from reading your OSCAR report. Don't worry, you will get good advice here.
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#3
RE: New to cpap - struggling to have good results
You have 3 problems that sho up. 1st the centrals. You setting of fixed (Cpap) is probably a good choice to start. IF these are treatment emergents centrals it will decrease in a couple weeks at the most.

2nd you do have large leaks - when you have large leaks your machine can not treat the event You need to work on it and try to get them down as much as possible. It is sometimes we all need to do. It may take a new mask or just adjustments. Many times it is because it is OVER tightening.

3rd and import for you - you have a lot of positional apnea. You can see them in the O and H roe where there are clusters. You can easily see these

Positional apnea is when you cut your own airway off like kinking a water hose - nothing can get through.
NOTHING you can do with your machine , pressures will not help.

You must find a way not to get into a position where your chin drops to your Sternum. It’s called chin tucking. Sleeping on your side only could help or changing to lower pillows. If those easy fixes don’t work you WILL NEED a collar. Please read the link I have in my signature on COLLARS.
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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#4
RE: New to cpap - struggling to have good results
(07-26-2021, 03:55 PM)staceyburke Wrote: You have 3 problems that sho up. 1st the centrals. You setting of fixed (Cpap) is probably a good choice to start. IF these are treatment emergents centrals it will decrease in a couple weeks at the most.

2nd you do have large leaks - when you have large leaks your machine can not treat the event   You need to work on it and try to get them down as much as possible. It is sometimes we all need to do. It may take a new mask or just adjustments. Many times it is because it is OVER tightening.

3rd and import for you - you have a lot of positional apnea. You can see them in the O and H roe where there are clusters. You can easily see these

Positional apnea is when you cut your own airway off like kinking a water hose - nothing can get through.
NOTHING you can do with your machine , pressures will not help.

You must find a way not to get into a position where your chin drops to your Sternum. It’s called chin tucking. Sleeping on your side only could help or changing to lower pillows. If those easy fixes don’t work you WILL NEED a collar. Please read the link I have in my signature on COLLARS.

Thank you very much for the quick reply. I'll work with the 3 items in the next weeks and I'll update the post. 

For point 3, I'm experiencing a swelling in my throat since using the CPAP. Don't really know if directly related, as I've been exposed to aircon and really high heat in this period, so not sure. I guess this might just make things worse. 

Really appreciate the help!  like
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