Pressure settings for UARS treatment

[cate253]

Hi, I am a newbie diagnosed with possible UARS after a home sleep study (AHI 1.4, RDI 14). I picked up an aircurve vauto that I have been using for the past week. I've been tinkering with the settings a little but I'm still learning how to read the data and it feels like I'm shooting in the dark. I use the machine with the dreamwear nasal mask, but it hasn't been as comfortable as I'd hoped. I am mostly a side sleeper and I feel like I have to adjust the mask many times over the night.

Since I started using the machine, I've been waking up with mild headaches, an unbearably stiff neck, and I definitely feel more tired than before.

These are my current settings:
Mode: VPAPauto
Min EPAP: 7
Max IPAP: 25
PS: 5

Ramp: 10 minutes
Ti Max: 2.0s
Ti Min: 0.3s
Trigger: High
Cycle: Medium

I've attached the OSCAR charts for the past three nights. I would appreciate any advice on how I can adjust the settings on my aircurve vauto for better results. Thank you.

[JoeyWallaby]

Is this your first CPAP machine?

[cate253]

Is this your first CPAP machine?

Yes, this is my first machine and it's only my first week using it.

[slowriter]

You have the right machine, and pretty good starting settings. 

I think you're going to have to be patient; it will likely take time for you and your body and brain to adapt to this.

It took me months before I started to sleep better, and my numbers were worse than your's are for a long time. So at least give it a few weeks ;-)

Any reason you need ramp?

Not sure on the headaches and stiff neck. Maybe others have ideas?

[Gideon]

Welcome to the forum

First your numbers are good and thus you don't want to chase them. At this point how you feel is very important.

You are experimenting with different levels of pressure support, that us good, but now I ask, which feels better and why?

On the chart with PS = 5, see how rough the flow rate is on the left when you started? We call that SWJ or sleep wake junk. Ignore it.

See the real smooth part of the flow rate. That represents smooth uninterrupted sleep.

We need to look at the flow for interuptions which means looking at 2 minute segments. We need to identify your normal and flow limited breathing to see if the changes you make are having a difference.

[cate253]

Thanks for the replies! So far I've woken up tired all three days but I reckon part of it is because I'm not used to it yet, like slowriter pointed out. That said, PS = 5 was probably the best of the three days. I felt crappiest with PS = 4.4. I woke up exhausted and too tired to move. I had to take a nap to feel somewhat normal again, and naps are rare for me.

I've attached more charts with the flow rate zoomed in (PS = 5). Does that help?

[cate253]

Oh and will turning off the ramp help?

[Gideon]

Almost ALL of the more experienced members here feel the ramp takes away from therapy time and don't use it, but is a necessity for new users getting used to CPAP. Try it without a ramp.

[cate253]

Thanks bonjour. I'll try it without the ramp and post the chart.

[Sleeprider]

My first suggestion was going to be to turn off ramp. The second one is to change Trigger Sensitivity to high. I think that may eliminate a lot of the CA events. Your results are pretty good, and with PS 5.0 the flow limitations of UARS seem to be tamed. Not many people get to start therapy in a machine like the Vauto.