Gperry - Therapy Thread

[Gperry]

Hello everyone, I'm new to the forums. I hope I did this correctly.

I seem to sleep fine the first half of the night. I wake up at some point feeling pretty good. But when I go back to sleep I get woken up multiple times and I feel worse when I actually get up for the day.

Overall I feel much better since starting cpap but the second half of the night is almost not worth going back to sleep.

If you have any questions I am happy to answer them. Any help is greatly appreciated.

           

[Sleeprider]

Therapy looks solid, but with lots of sleep transition CA events. Was central apnea noted in your diagnostic sleep or titration study? You might be able to reduce that by using EPR 2 instead of 3. I don't see a flow limit or obstructive issue, so using less EPR may be a good solution to reducing CA.

[Gperry]

OK I will lower the epr. The worst part of therapy for me is not being able to exhale. But I've come this far I'll get used to it again.

[Sleeprider]

If it makes it any easier, you can drop pressure by 1 on maximum and minimum. It's not clear to me why your CPAP is pushing pressure higher with only CA events anyway. If you have anyway to record or be aware of your sleep position it might help explain the episodes of higher pressure and more events. Some members have video recorded their sleep to see if there is a relationship to sleep position.

[Gperry]

I recently bought a wedge pillow set that keeps me more upright, and I am sleeping much better in the first half using it. However I may need to record myself as I have no idea what im doing in my sleep. I wake up pretty close to the position I fall asleep in but I see what I can do.

Also I never got any results from any of my cpap related tests (i had a very crappy doctor, I have a new one who at least seems knowledgeable) but I will se if I can get copies.

[Gperry]

I forgot to put the card back in the machine last night so there are no graphs ( i have it back in now so it will be there tonight ). I set my EPR to 1 as it didn't bother me nearly as bad as I thought it would. Same thing happened though, I woke up about halfway through the night feeling great, went back to sleep and had the CAs. I have turned off the EPR all together and I really don't feel too much of a difference so I will be leaving it off either way.

Any other suggestions as to changes I could make to help with the CAs? I will be seeing my pulmonologist  today and will report if she sees any suggestions she has. But I kind of want to hit this from every angle. The second half of my sleep seems to ruin the first half so I will try whatever I need too.

Thank you so much for taking the time to respond and helping me out.

   

[Sleeprider]

Well if the summary data is any indication, the reduction of EPR did not have much effect. It will be interesting to see if the pulmonologist wants to follow-up on the high intensity clusters of CA. I think it might be worthwhile to see how much these impact oxygen saturation by using a recording pulse-oximeter. At some point, the only thing that will resolve the centrals is ASV if you don't respond to the CPAP optimization strategies.

[Gperry]

Ok, this was last night with my min settings upped to 11.4. At least part of the cluster near 3am was because I was awake. The machine seems to like counting my regular breathing as apneas I guess. Overall I felt much better this morning.

Hoping this keeps progressing. If you have any additional advise I will happily take it. Again, thank you for the help so far.

   

[Sleeprider]

This one looks better. EPR off and higher minimum pressure. Next chart consider displaying minute vent instead of snore.

[Gperry]

Here it is with minute vent visible.