Still tired with CPAP

[SarcasticDave94]

Sometimes CA may increase if your pressure varies quite a bit. If the cap at 10 Max doesn't address it, we'll look at data and try to diminish pressure changes a bit more.

[benvirnop]

Hello !

Indeed, you seem right, it looks, I don't tolerate high pressure.

I really wonder what does this cycle matches (Asleep when pressure is high awake when pressure is down?)

Note : on second part I didn't manage to sleep (AHI is 0) however pressure went high I am not sure why.

I think the Autoset overreact on my flow limit, maybe I should give a try on AutoSet soft response setting ?

Many thanks

[benvirnop]

Tried a new setting this night : 

Mode : Autoset
Response type : soft
Min pressure : changed from 7.0 to  7.4
Max pressure : 9

It looks max pressure is way too high. I am not far from constant pressure

It's impressive to see this consecutive Central Apneas

It's so sad I can't set Pressure support between 0 and 1. I thought of changing the unit to hPa hoping the EPR will follow the unit chosen but 1hpa > 1 cmh2o

[SarcasticDave94]

OK, does either of these last 2 setting groups make you feel comfortable while asleep? Are the CA or maybe some other aspect impacting sleep comfort. Some PAP users must just accept some CA but keep them in exchange for better sleep with PAP therapy. In other words, our new plan of attack is settings that you felt were most comfortable to sleep with. OSCAR numbers are the means to see what the therapy does and where problems may exist, but the goal is not to get zeros all across the chart, but to minimize things to a level that you can sleep comfortable. So where was it more comfortable, this recent Soft response or prior? The one where you were more comfortable is the one to go with. We can still revisit the settings to adjust as your body gets used to PAP.

[benvirnop]

I am pretty confortable while asleep with all these settings above. It was a little less confortable when i raised the minimum pressure to 7.4 and changed to soft response type, I even think it would be OK with min pressure at 6, and EPR made it better i had less sensation of forcing to breath) however I can easily deal these settings.

What makes it a bit complicated is that I don't have easily identifiable symptoms (like pain in the head, globally I am sure I feel better than before first use of APAP 4 months ago but I haven't waked up a morning feeling fully rested either) That's why I rely a lot on OSCAR and try to figure out what might have gone wrong.

I always used Autoset mode with normal response type except yesterday (I mentioned and will mention it explicitly each time to make it easy to follow).


Thanks a lot for your great help, you're really changing my life !

[benvirnop]

I continued my quest of better nights  (I bought a Full Face Mask meanwhile thanks to reviews on your board    it's really comfortable  ) 

I finally thought I found the great setting for me the day before yesterday I had a really refreshing night    with the following settings CPAP mode at 7.0 EPR OFF.  
I kept the same exact settings the following night, but it was not as good with 4.6 AHI.



Considering this bad night and looking at OSCAR I don't really know how to adjust the settings to myself

Do you think I should give a try with this exact settings to find out wether it was an exceptional day ?

Considering the pressures, I don't know which direction to go (CA and Hypopneas are quite evenly distributed)

Do you think a VAuto machine might help in the future? (to play with trigger sensitivity / PS between 0 and 1) ?
Do you think a ASV machine might help in the future ? (As it seems to handle pretty much any breathing difficulty?)

[jaswilliams]

Your fixed pressure seems very good the remaining events are all CA's there is nothing you can do about the CA's and they are consistently inconsistent and will vary from night to night if your sleep is disturbed they will be higher

[SarcasticDave94]

Yes jaswilliams is correct. CA/central apnea are consistently inconsistent, giving down one night up the next. And with your PAP machine the best action we can take is to Avoid them. These CA should normally not be too disruptive, but there are some PAP users that these are disruptive. Are they hindering your sleep? Without looking at the data for a minute, did you sleep badly with the higher CA?