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My wife first day on the CPAP - Any feedback welcome - Printable Version

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My wife first day on the CPAP - Any feedback welcome - ericmsilver - 06-11-2020

I have been on one for a month and overall I think it is working well.

Denise started last night and this is here chart for the first night.  It is not easy on her for sure but telling her to be patient.

Diagnosed with Severe Apnea with AHI > 30.

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RE: My wife first day on the CPAP - Any feedback welcome - Gideon - 06-11-2020

I would dial her EPR back to 2 and see what happens to her Central Apneas.
Min pressure should be no lower than 4 + EPR = 4 + 2 = 6


RE: My wife first day on the CPAP - Any feedback welcome - Gideon - 06-11-2020

And please be very specific with how she feels.

Have her read a book, watch TV, Play games on her phone while using her CPAP at pressure, something she enjoys really doesn't matter what it is. This is just to help he get used to it.


RE: My wife first day on the CPAP - Any feedback welcome - ericmsilver - 06-11-2020

Curious but from looking at the chart what indicates that she has central apnea?


RE: My wife first day on the CPAP - Any feedback welcome - Gideon - 06-11-2020

Clear Airway is Central Apnea.  It is called "Clear" because of no obstruction as determined by FOT, Forced Oscillation Technique, basically a 'sonar' pulse that looks for obstruction.  
A determiner of Central Apnea is no 'electrical' signal is sent to initiate a breath, and no chest or belly expansion occurs, neither of which is measured by any CPAP.  The FOT is an accepted method of determining that the apnea is central apnea.  Because these are not measured, ResMed decided to call this event a "Clear Airway" event.  Somewhat confusing isn't it.


RE: My wife first day on the CPAP - Any feedback welcome - Sleeprider - 06-12-2020

CA events are very common in new users, and can result from changing position in bed, changes in sleep stage and reduced CO2 from improved ventilation. That is why a reduction in the EPR is recommended. A minimum pressure of 6 and EPR 2 will ensure she receives consistent EPR or pressure support through the night. I notice she is using ramp and there are numerous spikes in the respiration rate during that period that suggest arousal or perhaps an event. The machine does not record events during ramp, and when pressure is this low, we recommend you turn ramp off if it is tolerated. This will give her more air as she tries to go to sleep and should be more comfortable than the fixed pressure of 4.0 without EPR. She is going to do better with the settings suggested by bonjour, and should see fewer pressure fluctuations and events.


RE: My wife first day on the CPAP - Any feedback welcome - ericmsilver - 06-12-2020

That's a great advice.  She did not do well at all last night. She ended up stopping it at 1:30.  Everyting based on charts went awire and end up with AHI around 20!

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Here is the 4th chart and her current settings:

I am going to call her doctor and get the sleep study records and charts today.

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it looks like she had a mask leak.


RE: My wife first day on the CPAP - Any feedback welcome - Sleeprider - 06-12-2020

That cluster at the end is positional apnea. Read the positional apnea wiki and soft cervical collar. It this pattern continues, you will need that information. It did not show up on the first night, so we can wait and see. The settings you posted seem to be from yesterday. If ramp is on, please change to Auto instead of 45 minutes. As I said, ramp off is the preferred option.

https://www.apneaboard.com/resmed-airsense-10-aircurve-10-setup-info
http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea


RE: My wife first day on the CPAP - Any feedback welcome - ericmsilver - 06-12-2020

She is a slide sleeper.  Will make the changes on ramp tonight .

Thank you


RE: My wife first day on the CPAP - Any feedback welcome - Gideon - 06-12-2020

Note how pressure went to max. No amount of pressure will correct this Positional Apnea / Chin Tucking

Waking and restarting will normally clear this type of event, at least temporarily. Not using the CPAP does no good at all for this type of event.