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[Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
#1
[Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
24M, healthy and active, 160lbs and about 5'11, also have a pretty long and skinny neck.

**Been going on for ~2 years now**
Symptoms:
  • Terrible sleep, waking up multiple times a night and often struggle to fall back asleep.
  • Jaw Clenching
  • GERD
  • Neck and Back Pain, both skeletal and muscular. Only really noticeable at night
Diagnosis: 
  • Home Sleep test (WatchPat) came back with ADI: 0.9, RDI: 9.5 (remRDI : 17.0, NonRemRDI: 7.4)
  • ENT saw I had an extremely deviated septum blocking around ~80% of my nasal airflow

Treatment:
  • Got a Septoplasty/Turbinectomy/Nasal Stenosis repair ~2.5 months ago, breathing is 1000% better, but my sleep didn't really seem to improve much at all.
  • Currently on APAP, starting on 7min 20max, with an EPR of 3. No improvement after a week so I bumped it up to 8, then after another week currently up to 8.4.
     
Included OSCAR results from last night, First one is from the entire night, second one is a zoom in from just before my first wake up in the middle of the night ~2am. 


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#2
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
I would not continue to raise pressure. 
Your events are mostly central, so increasing pressure may worsen them. I would however try reducing EPR to 1 cm or even disabling it. 

If you've only been using PAP treatment for a short while, I would just give it some more time. You may be just experiencing treatment-emergent central apnea. Your data looks fine, but you may be able to reduce your central events a bit more.
My get-up-and-go musta got up and went.  Cool

Download OSCAR for your sleep data.  
https://www.sleepfiles.com/OSCAR


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#3
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
I wouldn't change a thing setting wise.
You do have a manageable mouth leak, consider taping.  This is evidenced both in the leak rate and the zoomed view you provided.

Because of your COPD I would, at least periodically, monitor your O2 levels over night as a precaution.
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#4
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
(10-10-2022, 11:32 AM)Gideon Wrote: I wouldn't change a thing setting wise.
You do have a manageable mouth leak, consider taping.  This is evidenced both in the leak rate and the zoomed view you provided.

Because of your COPD I would, at least periodically, monitor your O2 levels over night as a precaution.

I actually do tape my mouth at night, but only a relatively small piece going vertically down the middle of my lips to hold them closed. I can try using a bigger piece tonight and see if that helps with the leak at all.
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#5
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
Also here is my WatchPat home study I had done in case it may be of any use.


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#6
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
there are two thing i would suggest turn epr down to 1-2 , try a full face mask if your not claustrophobic or a hybrid mask
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#7
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
(10-10-2022, 11:32 AM)Gideon Wrote: Because of your COPD I would, at least periodically, monitor your O2 levels over night as a precaution.

I think you may have gotten the COPD part from my signature. I do monitor my 02 levels though. 
I didn't see any mention of this in his post.
My get-up-and-go musta got up and went.  Cool

Download OSCAR for your sleep data.  
https://www.sleepfiles.com/OSCAR


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#8
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure?
You got me on that one (COPD)

I do stand by my suggestion for no changes, to not reduce EPR, at least based on the numbers.
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