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Second night of CPAP use - requesting an Oscar chart review please!
#1
Second night of CPAP use - requesting an Oscar chart review please!
Hi! I'm a new user of an APAP (4-20, EPR set to 1) and I just finished my second night. I wanted to see if someone could please review my chart.

My in-lab sleep study gave me 16.2/hr AHI, and it said I had 5 obstructive apneas, 8 central apneas, and 133 hypopneas with 3% desaturation and arousals over the whole night.

I noticed my obstructive apnea dropped to a very low number, but my central apnea looks like it jumped up. I've read this can happen to new users of CPAP/APAP, but now my total AHI is 5.50. Are there any other insights that anyone can help me draw from this data? Much appreciated!


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#2
RE: Second night of CPAP use - requesting an Oscar chart review please!
Ha, I accidentally forgot to attach the image. Edited that in.
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#3
RE: Second night of CPAP use - requesting an Oscar chart review please!
If it were me, I would change the EPR to Full Time, I would be fine with EPR=1. I would also set my ramp pressure to 5.
I would also set my pressure min of 5.6 and a max pressure of 10.0.

I would not be too concerned about the CA score for the time being. if there are still a fair number of OAs and Hs in the charts over the next week, the thing I would do after a week is to increment the minimum pressure to 6.0.

QAL
Dedicated to QALity sleep.
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#4
RE: Second night of CPAP use - requesting an Oscar chart review please!
(01-25-2023, 02:48 PM)quiescence at last Wrote: If it were me, I would change the EPR to Full Time, I would be fine with EPR=1.  I would also set my ramp pressure to 5.
I would also set my pressure min of 5.6 and a max pressure of 10.0.

I would not be too concerned about the CA score for the time being. if there are still a fair number of OAs and Hs in the charts over the next week, the thing I would do after a week is to increment the minimum pressure to 6.0.

QAL

Hi, thanks for the response!

I wanted to understand this more - can you help me understand the reasoning behind each of your suggestions? I am really new to this all, so I appreciate your help!
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#5
RE: Second night of CPAP use - requesting an Oscar chart review please!
I would make the settings to 

Min 6
Max 9
EPR 3 set to FILL TIME (not ramp only)

Please post tomorrow.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: Second night of CPAP use - requesting an Oscar chart review please!
I typed the last response on an iphone, now I moved to the computer so I can type a little bit.

You asked why -

Max 9 Why because the highest your pressure went was 9.09  - no reason to have it at 20

Min 6 Why because 4 is the absolute lowest any machine can go.  It is usually to little of air for most people ( I have to have at least 9 or i am taking my mask off to take a breath)  And very important this gives you room for the EPR (Exhale Pressure Relief) to work 

EPR 2 Why It can be set from 1 to 3.  What it does is makes the exhale easier by the number you put in.  so for instance min 7 EPR 3 would make your exhale 4 - the lowest the machine can go.  But more importantly it helps with Flow Limits.

What are Flow limits - They are Apnea just like O and H events but they are not scored in the AHI.   You can see them in the flow limits chart.  When you have flow limits it disturbs your sleep and can either wake you up or stop you from getting deep sleep.  The Cpap machine you have raises the pressure when it detects flow limits to stop them from becoming larger and becoming H or O events.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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