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[CPAP] Survived the first night! What in the world is going on with this data? - Printable Version

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Survived the first night! What in the world is going on with this data? - djbradford1996 - 08-01-2020

First night using my APAP, and I've got to say, I feel so well rested! I was so afraid after reading some horror stories, but the results have been markedly better. My AHI when doing the study was 21. Last night using the machine for the first time with settings of 5.0 pressure max (trying titration of pressure up 0.2 each night to find the sweet spot) seem to have dropped me wayyyy down, which is awesome. However, I was wondering if someone could help me understand what in the world could have caused such a massive flair up of hypopneas/events in the short window they mostly all appear in the graph attached? Mask leak was under 5 all night, so I'm pretty sure it couldn't be that. Is this just a data error?

Also, is it odd that someone starting at 21 AHI could drop to under 2 in just one night of a pressure at 5? Makes me wonder if I needed this PAP in the first place. I'm attaching my study results if anyone feels like digging into them a little bit. Thanks in advance to anyone that can help out this new papper! Thanks

RE: Survived the first night! What in the world is going on with this data? - Canuck 2 - 08-01-2020

Interesting sleep report, it indicates you are a loud snorer also. Snoring can indicate you are getting close to OA(Restricted throat passage) because those are  first symptoms IMO.
If you want to lower the pressure more on your machine you could turn on your EPR to 3 and what that does is lowers you exhaust pressure when exhaling (Not sure how comfortable that would be.)
You should see a spike in your snoring and more OA possibly. Sounds like you are thinking why have the machine at your low readings and I'm curious also.
I have been using CPAP, auto machines for many years and I'm not a expert like some here but the only way to custom your machine is set it for your comfort pressure levels.
Just having a few alcohol drinks would drive up your OA I'm thinking as for the CA that is another type of apnea that is caused by the brain and even a high end Cpap machine has a hard time dealing with those but turning on your EPR to 2 or 3 will act like a Bi level pap machine to help you with those CA's & might make you feel better in the morning.
The sleep report does indicate issues so don't throw that out the picture so to speak.

RE: Survived the first night! What in the world is going on with this data? - bonjour - 08-01-2020

Welcome to the forum.

Not bad for a first night, not common, but not uncommon either.

On the charts, the up arrow next to the date, click that to eliminate the calendar.
Always provide a full night view to put everything in context.
Flow Limits drive pressure with ResMed devices so that chart is always important.  

see the flow rate prior to 1:10, how 'smooth and even it is, that is normal quiet sleep.

What follows is likely a disturbance, and my guess for now is that the CA events are you holding your breath as you toss.
During your zoomed view, at least, you have elevated flow limits, RERAs are a clue here as they are a series of Flow Limits ending with Arousal.  Also, your Flow Limit Stat has them a bit higher than we like to see them.  To see what happened we need to see a zoomed view from 1:10-1:13 and a 2-minute view of a couple of CA events.

Your min pressure of 5 is problematic for many adults in that they perceive difficulty in breathing, kind of like breathing through a straw.  6-8 is where most adults feel comfortable.  How does it feel for you?

You have a very good machine that is extremely versatile and we are going to make use of that here.  First Your numbers are very good, your doctor will be very pleased. Normally with these numbers we only tweak for comfort.  We are going to reduce your Flow Limits.  To do that we are going to use EPR, a comfort feature, but it is far more than that.

Hypopneas, Flow Limits, RERAs are best treated with a difference between inhale and exhale pressures, this is called "Pressure Support" or PS.  so we are going to implement EPR = 2 Full Time.  To do this we will have to raise your min pressure to 6, don't worry, your actual min pressure will be the machine's minimum of 4 as EPR subtracts from the pressure.  This gives you a PS of 2.

So set Min Pressure = 6
Set EPR = 2, Full Time
and set Ramp off, at these pressures you do not need it.

RE: Survived the first night! What in the world is going on with this data? - Dormeo - 08-01-2020

Congratulations on an excellent first night! To answer one of your questions: the severity of apnea and the amount of pressure needed to treat it are unrelated. People with very severe apnea may only need low pressures; people with mild apnea may need high pressures.

Next chart you post -- could you show the whole night? There's something about the segment you show here that puzzles me. It looks as though you maximum pressure is 5. The statistics in the side panel tell the same story. The notation saying the pressures were "guessed" also is puzzling.

So, would you go into the clinical settings (see Setup link above) and check whether your maximum is truly 20? If it isn't, set it to 20 and be sure to push the round button to lock the new setting in. You'll also be making the changes Bonjour is recommending, I hope.

I think you will like having some more pressure on inhalation, plus the EPR, as Bonjour has suggested.