[Pressure] Just started, can someone help with poor results?

[SleepGuy86]

Hello all.  I'm two weeks into cPAP with my Airsense 11 Vauto.  Originally diagnosed with mild OSA, 5.4 AHI after a one night take home test.  Finally got my machine after 3 months, during which time I've used a Wellvue o2 ring nightly.  After the first week of prescribed pressure 5-20 I think I noticed slightly more stable oxygen levels and more refreshing sleep.  The past week my sleep was poor for no apparent reason to me and the Oscar data substantiates this.  I've tried to set new pressure constraints with but I can't seem to pinpoint why I'm getting such event clusters.  I'm diligent with wearing my pillow mask, it's comfortable.  The only trend I believe is more clear airway events at higher pressures?  

I'm 36yo 5'9 175lb male with athletic build.  Past medical history only high cholesterol which has been controlled with statins since my mid 20's.  If this even matters... I've adhered nightly and will continue to do so.  I was so excited to get my machine but now I'm getting dejected and slightly worried about my results.  

ANY insight to what's going on or advice would be so much appreciated.  Here are my last 3 nights.

           

[Lucid]

Hi, SleepGuy86  What is your machine exactly?  AirSense 11 isn't Vauto, is it?

I'm partly asking in order to bump your question up so that someone with more knowledge will take a look at your data and advise.

[70sSanO]

You appear to have central/clear airway apnea issues. Whether they are caused by the PAP treatment, or are a sleep disorder will become noticeable over time.

I fought central apneas for years and it can be a cat and mouse if your machine doesn’t treat it.

Unfortunately I don’t think a home sleep study can pin point the titration you need if you have central/complex sleep apnea.

People here can help with some tweaks. I eventually got an ASV machine. Prior to that I was trying to find an obstructive/central compromise that never really solved it.

John

[SleepGuy86]

Hi, SleepGuy86  What is your machine exactly?  AirSense 11 isn't Vauto, is it?

I'm partly asking in order to bump your question up so that someone with more knowledge will take a look at your data and advise.

Sorry, thanks for noting that.  It's the Autoset, not Vauto.

[KeepSmiling]

Did your study show Central apnea events? If yes, post it.

If you did a titration, post it.



Oct 31, around 2;30 oxygen fell. Machine also reacts to flow limitations.
Oct 31 3:30 having CA with pressure low.

If your Sleep study showed you have Central or mixed then worry about. It is common to have Central apnea when first starting cpap therapy. Runaway Central apnea may happen at higher pressures. Come of yours are happening at low pressures. If other events are controlled and CA is not decreasing worry about it. It is important to know what the sleep report finds.

I do not understand why you keep lowering the minimum pressure. I would increase the minimum pressure to 7.5 cm you can set the maximum to 10 (the highest you reached was 10.4).

Your body will get used to the pressure and settle down.

[SleepGuy86]

My in-home study was just a nasal canula, pulse oximeter and a heart monitor... all I was told was an AHI of 5.4 with mild OSA, enlarged tongue/septum deviation/hypertrophy of nasal turbinates.  

I haven't been set up with a follow up titration study, but I will inquire and request one.  I was setting my pressures more out of trial and error than anything and hoping for a better result.  I will mention just last night I changed my EPA from 3 to 2 with a substantial decrease in o2 desaturations and AHI down by 50%.  Will continue to monitor

[KeepSmiling]

That makes sense, because EPR each number is 1 cm of water. You lowered the EPR and gained one cm of pressure on your minimum.

If you left the EPR at 3 and increased the minimum pressure by 1 cm, you would still get the same usable minimum pressure.

Since the minimum pressure delivered is 4 cm, to get the benefits of EPR of 3 the minimum pressure should be 7.