[CPAP] Steve1975 - Therapy Help

[Steve1975]

Hi,

I have been using CPAP for 5 weeks, and generally it has been going well. I started using it because various fitness trackers were telling me that I had low SPO2 saturation overnight. I live in Macau China and we don't have access to the same health care system that I would expect back home. My doctor recommended CPAP due to snoring, large tongue, tiredness, Silent Reflux/GERD, swollen Uvula, and lots of waking up. I have not had a sleep study, but i was able to rent the Airsense 11 and it has improved my snoring, tiredness, SPO2 drops. 

At first, I was getting lots of leaks, so I dropped the pressure from 20 to 14. I've also started side sleeping, the CPAP machine does not seem to be able to stop my Apnea if I sleep on my back though. Side sleeping has been hard to get used to, but a body pillow has really helped to keep me in the right position. 

I still get some low SPO2 reading from time to time, but not as bad as before. The Silent reflux/GERD seems to be better, or at least more silent. No more Uvula swelling, which I think was caused by snoring and throat blockage. 

I was hoping that somebody would be willing to look at my readings to see if any improvements could be made. 
Feb 16th - What I consider to be a great night.
Feb 18th - OK, but with an SPO2 drop.
Feb 19th - SPO2 drop, linked to eating a large meal 2 hours before bed.

Thanks in advance

Steve

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Attaching OSCAR Stats & Overview.

[staceyburke]

Things look good.  A couple of things.  Most of your leaks are not a problem but they are mouth leaks and you need to keep an eye on them.  If they get to the place there is a gray area that means the leak is to much for the machine to compensate.  If that happens you may need a full face mask or tapping the mouth.

You do have some flow limits and to control them we use EPR.  To use EPR you need to set the min to 7 or higher and EPR to full time (I can't see if you are at full time) and EPR 3.

[Steve1975]

Thank you for taking the time to reply, it is appreciated. 

I bought mouth tape, but I'm reluctant to try it because of the beard. I will give it a go.

EPR is currently set to Full time and 3cmH2O, but I will try raising the minimum pressure to 7 as you suggest.

[Steve1975]

Hi,

I tried a minimum pressure of 7 and had more mask leaks and lower SPO2. I will try for a few more nights.

Steve

[staceyburke]

The night you put up your high was 9 and your min was at 7 most of the night.  So it was not much different than what you had.

[Steve1975]

Good point! I will keep trying.

Thanks for the advice.

[Steve1975]

Hi Stacey,

Thanks again for your assistance. I switched from a nasal mask to a Nasal Pillow mask earlier this week and it has done wonders for my large leaks! Do you mind looking at my latest OSCAR report and let me know what you think?

I do the spikes in my heart rate look normal? I think most of them seemed to be linked to movement. 

Thanks!

[jdougc]

Nasal cradle masks are very comfy, but leak too much as you have seen.
Lose a few charts, Snore , AHI, and time at pressure.
Change the height of the flow rate change, make it much bigger to show more detail. also dbl click on the 0.0 on the left axis to change the range.

Your ramp pressure is too low, raise it to 7cm for 5 minutes, not auto.

Your flow limits are too high and caused you pressure to go up through the night.
Epr is set to 3 already, so you may have to raise your minimum pressure higher to lessen flow limitations. Consider using a minimum of 8cm for a few nights and see how you feel.

[Steve1975]

Thanks for getting back to me.

After a week of using Nasal pillows my AHI has dropped to 0.5 which seems like a result! Do you still suggest making changes to the treatment, or is this classed as a win? I was told that anything below 5 is good.

[jdougc]

How you feel during the day, is much more important than an AHI under 5.
If you feel good through the day, than that is a win. And don't bother with charts unless you want to help others or have questions.

Can you post your recent charts?