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Need help with CPAP pressure - ravik - 01-23-2021

Hi,

Thanks for the help with CPAP in past.

I am still struggling with CPAP therapy after 3 years.

Currently, I am able to getg low AHI but I still wake up 10-15 times all night. FYI, I have very light sleep and CPAP does disturb it

I have also noticed my skin has become sensitive to cold and is tender during the day whenever I use the CPAP.

Lately, I was looking at other images posted here of pressure charts and the pressure is more uniform as compared to mine. (please see attached chart)

Can anyone explain why my pressure graphs has so many spikes? Why is it not smooth? Like stay at 9 then slowly decrease instead of falling back to 8 quickly.

Is there a setting to control it?


Thanks,
Ravi

RE: Need help with CPAP pressure - staceyburke - 01-23-2021

The dreamstation is slow to address apnea. I would move the bottom pressure to 9 the top to 12 and see what it looks like. It should smooth out your therapy.

RE: Need help with CPAP pressure - OpalRose - 01-23-2021

Respironics algorithm uses a “hunt and peck” search pattern (in auto mode only) by raising the pressure approximately 1.5cm to see if there is a need to raise pressure.  This looks much like a saw tooth pattern.

This up and down of the pressure isn't normally something that would be felt or noticed unless you are looking at the wave form, but some folk report that this "hunt and peck" feature disrupts their sleep.  That could be in your case.  

If you feel you notice it, or it disrupts your sleep, you can switch to Cpap mode, or you can still use Apap mode and keep the minimum and maximum pressure the same. Raising the min pressure is a good idea, but try your 95% pressure reading. I don't know what that is since you chopped it off in your statistics, but an example is
minimum 10 - maximum 10 (Apap mode). This would eliminate that hunt and peck feature.

RE: Need help with CPAP pressure - ravik - 01-23-2021

(01-23-2021, 04:01 PM)staceyburke Wrote: The dreamstation is slow to address apnea. I would move the bottom pressure to 9 the top to 12 and see what it looks like. It should smooth out your therapy.
staceyburke, thank you for your suggestions. I wanted to also mention that recently I have been also suffering from aerophagia, so increasing pressure is not gong to work for me.

Ravi

RE: Need help with CPAP pressure - ravik - 01-23-2021

(01-23-2021, 05:13 PM)OpalRose Wrote: Respironics algorithm uses a “hunt and peck” search pattern (in auto mode only) by raising the pressure approximately 1.5cm to see if there is a need to raise pressure.  This looks much like a saw tooth pattern.

This up and down of the pressure isn't normally something that would be felt or noticed unless you are looking at the wave form, but some folk report that this "hunt and peck" feature disrupts their sleep.  That could be in your case.  

If you feel you notice it, or it disrupts your sleep, you can switch to Cpap mode, or you can still use Apap mode and keep the minimum and maximum pressure the same.  Raising the min pressure is a good idea, but try your 95% pressure reading.  I don't know what that is since you chopped it off in your statistics, but an example is
minimum 10 - maximum 10 (Apap mode).  This would eliminate that hunt and peck feature.

OpalRose, that makes more sense to me. I am going to try changing the pressure to 9 CPAP (90% pressure) mode tonight and see. Thank you for your help. This board has helped me a lot with my therapy in past.

RE: Need help with CPAP pressure - OpalRose - 01-23-2021

ravik,
If you still experience Aerophagia with a pressure change of 9cm, try lowering it to 8.5cm. You can play around with this until Aerophagia stops. You'll have to find that "sweet spot" that helps you sleep, treats apnea and lessens the Aerophagia.

But most folk who suffer this will resort to a lower pressure in Cpap mode or Apap mode with the same pressure, in your case, 9-9.

RE: Need help with CPAP pressure - ravik - 01-23-2021

(01-23-2021, 06:31 PM)OpalRose Wrote: ravik,
If you still experience Aerophagia with a pressure change of 9cm, try lowering it to 8.5cm.  You can play around with this until Aerophagia stops.  You'll have to find that "sweet spot"  that helps you sleep, treats apnea and lessens the Aerophagia.  

But most folk who suffer this will resort to a lower pressure in Cpap mode or Apap mode with the same pressure, in your case, 9-9.

OpalRose, thank you for your suggestions, I will try and report in few days.

RE: Need help with CPAP pressure - ravik - 01-29-2021

Hi,

I have used 8.5 pressure for last few days. My sleep has not improved much. Today is really bad.

It looks like I am swallowing lots of air as I feel tight stomach and bloated tummy tight all day.

Any help to avoid this aerophagia will be great. 

I notice that I swallow more air when I sleep on right size than left side sleep position.

I really do not know what to do. Reducing pressure increases my AHI and can't sleep well.

BTW, I did not have aerophagia from start of CPAP for 2-3 years. I noticed it in mid 2020.


Thanks,
Ravi

RE: Need help with CPAP pressure - OpalRose - 01-29-2021

It seems even with using a full face mask, your mouth may he dropping open while you are sleeping and you could be swallowing air.

Are you aware of this? Are you waking up with a dry mouth?  Just trying to eliminate some possible causes for the aerophagia.  

Using a lower pressure plus EPR (in your case, use Afex set at 2) until you find the aerophagia lessening and still keeping your AHI at a reasonable number.

Others here have been able to conquer this and hope they will chime in.

RE: Need help with CPAP pressure - ravik - 01-30-2021

(01-29-2021, 10:15 PM)OpalRose Wrote: It seems even with using a full face mask, your mouth may he dropping open while you are sleeping and you could be swallowing air.

Are you aware of this? Are you waking up with a dry mouth?  Just trying to eliminate some possible causes for the aerophagia.  

Using a lower pressure plus EPR (in your case, use Afex set at 2) until you find the aerophagia lessening and still keeping your AHI at a reasonable number.

Others here have been able to conquer this and hope they will chime in.
OpalRose, yes, I am using F22 full face mask as I breath from mouth during sleep.


I can try EPR (aFlex of 2). In past this (aFlex) has caused my sleep disturbances but will give it a try again. I stopped using CPAP from last night due to too much bloating and very uncomfortable feeling in belly. 

BTW, I have tried using mouth guard for sleep apnea instead of CPAP with some success but not 100% in past. 

Now I am getting very worried about my sleep apnea treatment. Not sure what else I can try.