(05-12-2013, 11:11 PM)Nord Wrote: I am just completing a 14 day trial with a RESMED S9 Autoset. With this forums help and a bit of studying the subject I have analysed my data from the SD card with RESMED SW and Sleepyhead and found a fair amount of OSA and CSA events (OSA about 1/3 and CSA about 2/3), with some few Hypopnea events as well.
I am having an average treated AHI 5.45 (AHI ranging from 2.3 - 16.8 per night), Min pressure 5, max pressure 12 at EPR3. (Resmed S9 Autoset with FX Mirage Nasal mask)
I have included some of the data from Sleepyhead below:
Recent AVG 7days AVG 30 days
AHI 5.65 6.32 5.45
Hours per Night 10:05 09:21 09:41
Average Pressure 7.97 7.45 6.54
95% Pressure 10.40 11.76 11.62
Average Leaks 0.94 1.97 1.82
95% Leaks 18.00 20.40 18.00
I am feeling better after most mornings, except after nights with "high events". I am reasonably sure that I benefit from the APAP therapy. Can anyone help and recommend what kind of machine I require APAP, Bilevel, or ASV?
Hi Nord, welcome to the forum!
Your data looks pretty good, especially for just 2 weeks on PAP therapy.
Too early yet to tell whether you need more than the S9 AutoSet, which is a great machine.
Turning EPR down (gradually, maybe one notch a week) to 2 or 1 or Off may improve the CA Index (average number of clear airway apneas per hour).
Using EPR can increase (make worse) the CAI number, for the minority of patients who are susceptible to central events. Some long-time CPAP users have found that their CAI numbers improved a lot when they turned off EPR.
At the same time, it is fairly common for the CAI to become smaller anyway during the first few months of CPAP therapy as our system gets used to the pressure while sleeping. So you may be able to turn EPR back up, in a few months time.
Your starting pressure of 5 is way lower than your 95% pressure of close to 12, your max. This may make the machine spend a fair amount of time working up to the pressure you occasionally need to treat obstructive events, allowing obstructive events until it reaches the needed therapeutic pressure. If it were me, I would probably gradually (maybe one cmH2O a week) raise the minimum pressure from 5 to 8 or higher.
I would probably also gradually raise the max pressure to at least a couple higher than my 95% pressure, to around 14 or higher.
Let's consider: Your pressure is most often around 7 or 8. If many or most of your central apneas are occurring around 7 or 8, I would think that shows that CAs are occurring not only or predominately at high pressures like 10 or 11, but pretty much independently of pressure.
On the other hand, if your central apneas occur predominately at pressures of 10 or 11 and only very rarely at 7 or 8 where the pressure spends most of its time, then I would tend to think the higher the pressure gets the more central apneas will occur, and therefore I would reconsider whether I wanted to raise the minimum up to 8 or higher, or raise the maximum pressure to around 14 or higher. I would try to find some happy medium where the AHI number is smallest, or where the average length of time spent in apnea is minimized.
If you can swing it, I suggest getting a Pulse Oximeter, such as are available from Supplier #19
on the Supplier List, a link for which is at the top of most Forum pages.
The wrist-mounted oximeters are more expensive but more comfortable. (There are several threads on the forum which discuss Oximeters.)