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Switched to APAP
#1
Hello everyone, I have been on CPAP since June 11th. I was put on 10 cm h20. I have a Respironics System One. I use the Resmed AIr fit P10. I love the machine and the mask. I was on it for a month and was getting AHI's of around 1.7 to 3 until I decided I needed a chin strap that then put me down to 0.6 to 1.2 AHI. My omly problem was that at a constrant 10Cm h2o, I was very bloated during the day amd expelling it a lot. When I found out that I could set my machine to APAP, I did so and set it for 8 to 13 cm h20. After doing that I no longer had the bloating and I noticed my 90% is 9, so I have not been hitting my prescribed 10 cm. However, since going to APAP, my AHI"s have increased to 2.6 to 3.3. I know that I am ok if I am below 5 but I am wondering if I should set my lower limit closer to 10 if it gives me better readings? I am afraid I will go back to the bloating then. Should I stay where I am at and be comfortable and forget about the higher readings, or try to adjust for the lowest AHI?
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#2
Welcome to the forums. You indicate you're using your machine in APAP mode. Is this a PRS1 60 Series Auto (560P), or a Pro 460?

The answer to your question depends on the composition of your apnea events. You can download the Sleepyhead software for free and install it on a computer to read your SD card from the machine. http://www.sleepfiles.com/SH2/ Using the software and being able to identify the types of events, and when they occur and at what pressure is going to help you figure this out, and to give us information that will allow more accurate feedback.
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#3
It is a REMstar Auto (System One 60 Series). I have been using Sleepyhead since I started, not quite sure how to read everything. I have only been on auto for just under a week, so maybe I need to give it more time.
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#4
Okay, when looking at sleepyhead daily summary data, you will see each even has an index value. The sum of OA, H and CA is your AHI. There is also information on flow limitation, snores and leaks. What is the typical distribution of events? Do apnea events happen in clusters, or are they distributed through the night? How do leaks, snores and flow limitations look? Are the values high or low?

After about 8 posts you will be able to post the graphs. Here is a tutorial on how to post what we're looking for. https://sleep.tnet.com/reference/tips/imgur

Getting back to your original question, what is more disruptive for your sleep, apneas or air ingestion? It's okay to trade off at the levels you are at. A low level of AHI rather than pain of air ingestion may be the choice you ultimately make.
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#5
Those of us with aerophagia have to find a best compromise between apnea events and pain and discomfort. I think that this is where the auto mode can be very beneficial enabling one to operate at a lower overall average pressure and still be able to prevent most of the obstructive apnea events.

Best Regards,

PaytonA
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#6
(07-21-2015, 03:00 PM)PaytonA Wrote: Those of us with aerophagia have to find a best compromise between apnea events and pain and discomfort. I think that this is where the auto mode can be very beneficial enabling one to operate at a lower overall average pressure and still be able to prevent most of the obstructive apnea events.

Best Regards,

PaytonA

Payton, did you increase your min EPAP? I thought you were running lower pressures. (Although I recall your machine selection was based on ability to supply >20cm-H2O)
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#7
No, I am running min EPAP 14.0, max IPAP 20.6, PS 4.0. That seems like it is just enough reduction of the average pressures from bilevel 16/20 to reduce the aerophagia. It has made my AHI slightly higher on the average but not too bad. I did not come up with aerophagia until after I had been PAPing for 4 years or so. It took me a while to figure out what was going on. I thought at first that the back pain was muscular and I do have some of that too.

Best Regards,

PaytonA
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#8
(07-21-2015, 09:22 AM)tsmith3605 Wrote: Should I stay where I am at and be comfortable and forget about the higher readings, or try to adjust for the lowest AHI?
I would not worry about AHI at this stage, comfort is more important
AHI would sort itself out in due course

Sleep-well
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#9
Hi tsmith3605,
WELCOME! to the forum.!
Much success to you as you continue your CPAP therapy.
trish6hundred
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#10
Welcome to the Forum!

It looks like you have got some good answers. Sleep-well
Regards;
Lex Cool
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