[CPAP] Double top flow rate

[ohno]

Hi everyone!
It is my first time here.

My problem is: I never wake feeling rested or good.
And wondering if these double tops is the cause.

How could I improve my sleep?

[Nightynite]

Hello, I’m no expert, but if I had flow limits like yours I would be on zombie mode.

Put your EPR on 3 and see if that helps. On your Flow limit 95% your at 0.15 Some people it may or may not mean much , but when I was that high I felt awful. You may be sensitive like me.

Higher EPR is what helps lower flow limits. If you get centrals , back off to 2.

[Deborah K.]

Your flow rate looks perfectly normal.  Your flow limits are high though.  We use EPR to help with these.  I suggest that you turn EPR on full-time, set at 3.  This should improve your treatment and comfort.  Also, most people are more comfortable with a range of pressure than using Cpap mode.  I suggest you switch to Apap mode and set your pressure range to 7-12.  Try those changes tonight, then post another chart tomorrow and tell us how you feel.  

P.S. Unless you had lots of CAs in your sleep study you don't need to worry about them at all. Use the EPR 3 setting.

[ohno]

Thank you, Nightynite and Deborah K, for your invaluable assistance. The EPR has indeed made a significant difference, resulting in my breaths appearing more rounded and free from double tops.

Initially, I began with an EPR setting of 3. Upon waking up in the middle of the night, I decided to check my AHI, which was at 3.8. Subsequently, I adjusted the EPR to 2 and concluded the night with a lowered AHI of 2.63.

Although I initially started CPAP therapy with EPR to ease into the process, it unfortunately led to CA.

It seems that I have a sensitivity to flow limitation and CO2.
What the next step should be? Any insights or recommendations would be greatly appreciated.

[Sleeprider]

I don't get particularly alarmed at CA events less than 4/hour with new users. The mechanism of an open airway is simply a momentary cessation of breathing. There is no obstruction or chest pressure created by this type of event, and breathing often resumes without arousal. This is preferable to seeing obstructive events or high flow limitation which increases respiratory effort, arousals and fatigue. As the use becomes more accustomed to the improved ventilation, the CA events eventually subside and go away. Thee are ways you can stabilize CO2 with EPR, but it's probably not worth it in this case. We can conserved exhaled CO2 by using Enhanced Expiratory Rebreathing Space (EERS). This is simply modifying the exhaust vent in the mask, and adding space where exhaled air does not get vented. Wiki here: https://www.apneaboard.com/wiki/index.ph...ace_(EERS) As I said, I would not bother doing this modification unless your problem is much worse.

[Deborah K.]

I think Sleeprider means you should set EPR at 3 again, and leave it there.