Suggestions - Parent's CPAP OSCAR Charts

[captainsteubing]

Howdy Folks, 

Well, now that I believe my numbers are dialed in nicely on my machine, I've turned my attention to my Parent's. I've certainly learned a lot here via Apnea Board, certainly appreciate the willingness to help and think that with y'alls help I can help my parents with their treatment. I truly don't believe that sufficient time is spent by the docs to improve things.

For now I'll present my Dad's data. He's 83 years old with congestive heart failure and with severe sleep apnea. He's been on CPAP for a number of years. Currently using a ResMed S10 Auto, with SwiftFX mask. I was a bit shocked with what I saw on the graphs. His average AHI for the past 30 days is 5.74, I'm unsure if he may be on the wrong type of machine, but from what I recall there may be some contraindications with CHF and certain machines. Due to his age and stubbornness, I anticipate that I may not be able to get certain suggestions past him, but it's worth a try.   

Here is a sampling of a few recent nights of data.

[attachment=14745] [attachment=14746] [attachment=14747]

Thanks for your support, 
Captain Steubing

[jaswilliams]

I would suggest raising the minimum to 7 that will smooth out the pressure graph somewhat and likely reduce the Hypopnoea.

[foxfire]

Similar to, though not quite as bad, as what my Dad was experiencing before we found a doctor that uses EERS.

http://www.apneaboard.com/forums/Thread-...a-attached

[Sleeprider]

At 4-16 pressure with EPR 3, your dad is doing okay, but his pressure fluctuates considerably thrugh the night, and the minimum is insufficient to prevent a lot of the event. In addition his pressure support or EPR is inconsistent. A minimum pressure of 7.0 would actually start him at a pressure of 7.0/4.0 (IPAP/EPAP). This is the minimum starting point to maintain consistent PS. While I think a minimum pressure of 8.0 or 9.0 might be better, I think the argument for 7.0 is that it will be an improvement and will actually provide the same exhale pressure he starts with now, but his inhale will take less effort. That is a good thing and should really increase comfort.

I suspect that there is a positional component to the clusters of apnea, so just beware of chin tucking or using thick or multiple pillows.

[captainsteubing]

I would suggest raising the minimum to 7  that will smooth out the pressure graph somewhat and likely reduce the Hypopnoea.

Similar to, though not quite as bad, as what my Dad was experiencing before we found a doctor that uses EERS.

http://www.apneaboard.com/forums/Thread-...a-attached

At 4-16 pressure with EPR 3, your dad is doing okay, but his pressure fluctuates considerably thrugh the night, and the minimum is insufficient to prevent a lot of the event.  In addition his pressure support or EPR is inconsistent.  A minimum pressure of 7.0 would actually start him at a pressure of 7.0/4.0 (IPAP/EPAP).  This is the minimum starting point to maintain consistent PS.  While I think a minimum pressure of 8.0 or 9.0 might be better, I think the argument for 7.0 is that it will be an improvement and will actually provide the same exhale pressure he starts with now, but his inhale will take less effort.  That is a good thing and should really increase comfort.

I suspect that there is a positional component to the clusters of apnea, so just beware of chin tucking or using thick or multiple pillows.

Thank you so much jaswilliams, foxfire & Sleeprider. I really appreciate the suggestions. I'll see if I can bypass the "Grumpy Old Man", update his minimum pressure and hopefully see some better results. I suspected positional apnea also, so I'll make my Mom aware that it could be a problem and that there are ways to mitigate. 

I'll report back in after a few nights of the changes.