managing myself

[stanleyv28]

I started CPAP therapy without a sleep test, and my AHI values look good. I wanted to get your opinion on pressure adjustment as the machine's pressure tends to increase due to flow limitation. I don't want to unnecessarily increase the pressure since my AHI values are low. I'm sharing my 3-day Oscar data with you. Do you think I should increase the pressure, or should I continue with my current settings?"

[SarcasticDave94]

What I'm seeing on OSCAR indicates you'll need to increase pressure, probably focus on Max for now. I would increase max pressure to 12 to see if things get better.

The target areas I'm seeing that indicates edits being required are first flow limits being present fairly frequently. Since you're using EPR 3 already, this leaves only a pressure increase as your answer. Second item is your pressure chart is skimming along the top in a flat line, also an indicator to increase pressure. The CPAP wants more pressure to act, in this case it's circling back to FL. They typically signal to the CPAP to increase, so it's possible to address this by increasing pressure, reducing FL, which may mean overall nightly pressure may be a bit lower. My reasoning for this is instead of attempting to address FL and running its available high pressure of 10.x, it can go up to 12 and resolve, then drop down as events allow.

[Nightynite]

What made you think you needed cpap therapy?

[stanleyv28]

I had all the symptoms of sleep apnea, and I went to the doctor, but there was a long waiting list for the sleep test and it was very expensive

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Thank you for your response. I will try with a pressure of 12

[freakyfrog]

your flow limitations seem quite high. Can you zoom in on your flow rate?

[Sleeprider]

Your flow limitations are extremely high with a 95 percentile of 0.3 to 0.61, however at times, they are not present. This tells us that your flow limits change dramatically and that it is likely related to a sleeping position or poor cervical alignment. Without CPAP this may have resulted in clusters of obstructive apnea, or at the very least in a high degree of respiratory effort related arousals (RERA) which I'm certain is a continuing problem. Anyway, it's pretty clear you needed therapy, and you still need to add something to your therapy to resolve this. Please read the positional apnea wiki article and consider what you can do to protect cervical alignment and avoid chin-tucking or whatever results in this very high airway obstruction. In your case, we don't see clusters of OA events, but we see very strong clusters of flow limitation, and this can be very disruptive to sleep. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[BoxcarPete]

Zoom in on a chunk of those FLs for me please, I want to see what's causing it. I've had wide swaths of that with perfect looking inhales and rounded exhales, which I'm not convinced is anything near as bad as flat-topped inhales.

[stanleyv28]

zoom in fls

[BoxcarPete]

Yep, that's a classic RERA at the end of the second zoom that went without a flag. Once you get to EPR 3 and still see things like this, it becomes a little more difficult to figure out how to resolve. Sleeprider's advice is good, to look into positional contributors that may lead to partial flow obstructions. If none of those work, there is another kind of machine with more control over the settings and pressure differentials that you may want to consider.

[stanleyv28]

Yes, I read the article and realized I was doing the exact opposite of what was written there. I was elevating the head of my bed and using multiple pillows; tonight, I will apply what was mentioned in the article. Thank you all