1st Week on CPAP

[Deborah K.]

Your flow limits are still quite high.  This might indicate that you need a ResMed AirCurve 10 Vauto, a bilevel machine that offers more treatment options than an Apap or Cpap.

I learned that I needed one based on my flow limits.  Below this post, there is a link to my long thread where Sleeprider and some others helped me get a prescription for the bilevel I mentioned above.  It has been a wonderful change for me.  I'm so grateful and happy!

[Cali929]

Your flow limits are still quite high.  This might indicate that you need a ResMed AirCurve 10 Vauto, a bilevel machine that offers more treatment options than an Apap or Cpap.

I learned that I needed one based on my flow limits.  Below this post, there is a link to my long thread where Sleeprider and some others helped me get a prescription for the bilevel I mentioned above.  It has been a wonderful change for me.  I'm so grateful and happy!

Thank your response. A different DME did question whether I would be better off with a Bipap vs Cpap, but since my sleep study was done with CPAP machine and my prescription was also for CPAP, my insurance would only cover Cpap atm.
Unsure if I will be able to switch this early even with a prescription but I will talk to my new sleep specialist tomorrow and see what he thinks.
I will read through the post you linked but it will be a little later this evening.
Anything other than my Flow Limit being to high that would suggest I would be better off on a Bipap machine....based off my 1st 8 day charts?

[Cali929]

Yes, still turn in EPR to 3 to start with tonight

The sleep specialist said overall my results from CPAP are good and he doesn't see a need for Bipap, he also said if I had done the sleep study & titration through him......he would also have put me on CPAP. He is not concerned about the Flow limit nor sees an issue with using EPR @ 3.
He had me change my fixed 8 pressure to auto between 8 & 12 and keep EPR @ 3.
I have attached screenshots of the 14th & 15th with constant pressure of 8 and EPR @ 3 and also attached the 16th with pressure between 8 - 12 with EPR @ 3.
I have also changed the size of my AirFit F40 cushion from medium to large starting the 15th......unsure if it fits better but does feel better, may leak more though.

1. Since I am topping out at 12 pressure during the night should I ask the Dr to increase max pressure to 15?
2. Give me your thoughts from the charts, thank you.

[jdougc]

Your obstructive apnea and hypopneas both went down with his settings, but the CAs went up, but they may go down over time
Consider raising your minimum to 9.0 cm for a few night and then 10cm if that is still your median
You only touched 12cm pressure briefly, so don't raise your maximum yet.

Don't over tighten the mask, let the air inflate it and try a mask test
Your leaks were affecting your therapy.

Lose the AHI chart and make the flow rate bigger.  See if you can change the Y of the flow rate to -65 to 65 more detail will show.
Right click near the 0 and go to the "y axis menu" and choose override.
   

[Cali929]

Your obstructive apnea and hypopneas both went down with his settings, but the CAs went up, but they may go down over time
Consider raising your minimum to 9.0 cm for a few night and then 10cm if that is still your median
You only touched 12cm pressure briefly, so don't raise your maximum yet.

Don't over tighten the mask, let the air inflate it and try a mask test
Your leaks were affecting your therapy.

Lose the AHI chart and make the flow rate bigger.  See if you can change the Y of the flow rate to -65 to 65 more detail will show.
Right click near the 0 and go to the "y axis menu" and choose override.

Can I ask the benefit of changing min pressure to 9 or 10 from 8?
Per my DME i'm not allowed to adjust settings without my Dr confirming a prescription for the changes (prob an Insurance thing). So I'll probably wait until monday and then send him a message with possible changes based on recommendations from this thread.
See if the chart looks any better......I made the changes

[jdougc]

The possible benefits of changing min pressure to 9 or 10 from 8 are twofold.
First the lesson of pressure swings which might lead to less fragmented sleep. I and others are sensitive to pressure swings.
Second this may diminish your flow limitations.


Lose the snore graph, it looks much better, see the flow rate details now.
I change the y axis on many graphs, like the flow limit, i went to 0.66 hard to figure that one out
Some like the mask pressure graph.
Some like the tidal volume.
I like the insp time graph and exh time graph and the resp rate. I manipulate them, check my last page or so.
just my personal preference

[Cali929]

The possible benefits of changing min pressure to 9 or 10 from 8 are twofold.
First the lesson of pressure swings which might lead to less fragmented sleep. I and others are sensitive to pressure swings.
Second this may diminish your flow limitations.


Lose the snore graph, it looks much better, see the flow rate details now.
I change the y axis on many graphs, like the flow limit, i went to 0.66 hard to figure that one out
Some like the mask pressure graph.
Some like the tidal volume.
I like the insp time graph and exh time graph and the resp rate. I manipulate them, check my last page or so.
just my personal preference

Is this better for the graph....see attached?
Since new to CPAP and Oscar (still trying to understand all the info in Oscar).........your suggestions of how to set up Oscar details is appreciated and since I have no preference, I can set it up exactly as you recommend atm.
My Leak rate is still high.......I think it was better with the medium cushion on the F40 last week and so might have to go back to it.

Also, you mentioned in the 1st reply that I should keep the same thread going so there is a history but I don't see other people responding.........Is this due to the title? Just concerned in case I have different questions later but don't get responses due to people thinking they have already seen the post.

[jdougc]

I am so jealous of your Oscar Layout. You nailed it
Of course someone with a lot of experience will want a different graph.

Your flow limits are still a bit high, you could increase your minimum pressure to 9cm but see if you get more leaks.
That mask is  is very comfy, but will leak as you mash your face into the pillow.

Your title is good also. I think the advisors, which i am not, are spread thin on so many new posts.
This kind of interaction keeps your thread near the top, so for awhile give updates

Have you tried zooming into the flow rate chart to 3 minute intervals and look at the breath tops?
Also what happens just before an event?
If you see anything interesting post 3 charts or do another post with 3 more zoomed in charts of your breathing or events.
I tried to lower the resolution on my charts, I went too far once and the chart was too blurry.

[Cali929]

I am so jealous of your Oscar Layout. You nailed it
Of course someone with a lot of experience will want a different graph.

Your flow limits are still a bit high, you could increase your minimum pressure to 9cm but see if you get more leaks.
That mask is  is very comfy, but will leak as you mash your face into the pillow.

Your title is good also. I think the advisors, which i am not, are spread thin on so many new posts.
This kind of interaction keeps your thread near the top, so for awhile give updates

Have you tried zooming into the flow rate chart to 3 minute intervals and look at the breath tops?
Also what happens just before an event?
If you see anything interesting post 3 charts or do another post with 3 more zoomed in charts of your breathing or events.
I tried to lower the resolution on my charts, I went too far once and the chart was too blurry.

I just got a call from my DME letting me know that they received my new 8-12 prescription. Through the conversation she let me know that if I adjust pressure settings, EPR etc it would not be an issue for my insurance.......Insurance just makes sure i'm using the CPAP to cover it.
So now I will increase lower pressure setting from 8 to 9 first and then 10 and leave the high setting at 12. How many nights on 9 should I be (or any other changes) before posting charts here?

[jdougc]

Use 9cm for 2 or 3 nights, unless things go south and post the chart and someone will help.