New to CPAP - Could Use Some Help For Treatment

[chrotteg]

Hi everyone, 

I was diagnosed with very mild sleep apnea but I was feeling very tired throughout the day which is the reason I decided to get a sleep study. In my sleep study I had an AHI of 5.3 (split with 13 events OA and 13 events CA) but the reason we decided to try a CPAP was because I had 0% deep sleep and low REM which is not normal for my age of 25.  I have been using it for over two weeks now and have been logging data over a week trying to make adjustments. I have struggled with masks, opening my mouth, getting uncomfortable and ripping it off, rain-out, etc... However, I fell back on the F20 airtouch which I still can't use throughout the night (liners are in the mail) but I have had an increase in CA events. I have been trying to adjust my treatment since I started using OSCAR. I have raised my min, lowered my max (helped with OA events), and adjusted my EPR to work on the CA events. I thought it was getting better but I had another bad night last night which is why I am on here now. I know my numbers are good for the majority of sleep apnea victims, however, I still don't feel rested and wanted to try to exhaust my options first. I am attaching a few nights of images to show how I have adjusted my tratment over the last week. I know it is quite a bit of information but hopefully the more the merrier. Please let me know if you need anything zoomed in or what not. Thank you for your time and help!

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I wanted to include some more days that are recent for more information on what is going on.

[chrotteg]

[attachment=60903]I am curious as to what I did incorrectly or improve on to get some guidance with my treatment? I am trying to reduce the CA events from my original post as I wasn't diagnosed with that many events in my sleep study. Not sure if they are treatment induced or something else is occuring and they are false flags due to me waking up. I just recieved a F30i and tried it last night and the results are attached. I feel like I had a much better seal which resulted in less CA events as it seems to me the CA events follow the leaks that occur. But now, I have RERA events that I have never had before. Any help will be greatly appreciated.

[Deborah K.]

Your CAs are quite high, which is unsurprising since your sleep study showed that about half of your events were CAs. Some of what you see now could be treatment-emergent, but certainly not all of it.  Could you post a redacted sleep study?  It would help others who know more about high CA issues.  You might need a different type of machine, but I could not advise you on that.  Others on the board know a lot about it and will hopefully show up soon to help.

In the meantime, there are a couple of setting changes that could help your therapy and comfort.

Raise your starting pressure to 7.  Most adults are not comfortable with less than 7.

If you can, turn off ramp.  You are getting almost no therapy with it.  If you can't face turning it off, raise the pressure to 6.

[chrotteg]

Hi Deborah,

Thank you for the reply. In my more recent posts I have changed a lot of the settings you suggested. I turned ramp off and raised my min pressure to 6 and then 7. Which helped with my OA events. However I continued to have CA events. Raising it to 7 made it seem like I had more leaks and flow obstructions so I tried turning EPR back on. That is the short version of the many Oscar images I incorporated in my original post and what my settings are as of last night, which I posted in my comment I left earlier today. 

I would love to know if someone with CA issues could help and possibly help me figure out if this is false flags or treatment induced or I need to contact my physician. I unfortunately don’t have my redacted sleep study. The study they showed me with all the numbers in person is not online but just a summary version from my physician. I will contact them and see if they can send me the one with actual info.

[Deborah K.]

Post the result your doctor gave you anyway. It might help.

[chrotteg]

Great news, I found a hard copy of the sleep study. Attached it to this reply.

[chrotteg]

I am attaching a picture of last nights data and my CA events. I had two sessions, the first session went smooth but the second session went pretty bad. I am including an attachement of both session, one for only the second session, and one zoomed in on the CA cluster. I still am curious if these are false as leaks seems to be prevelant around the same time CA events occur. Unless someone can tell me that those leaks arent substantial but I don't really have experience with this to know. My next plan it to lower EPR as I raised it due to flow limits in previous nights. Thanks for the help.

[Deborah K.]

Your leaks are nothing to worry about.  They look high on your charts, but if you look at the panel on the left you will see that they are listed as 0.00.  This is because they do not reach the threshold where they begin to interfere with your therapy.  There is no setting you can use to reduce the CAs.  Please do not lower your EPR.  That helps make exhalation easier and reduces flow limits.  It might increase your CAs a little, but it's not worth the trade-off.  Comfort is a large component in pap use, and there are times when slightly higher numbers can equate to more comfort.

[chrotteg]

Any recommendation on what I should do? It seems I’m constantly getting nights where my AHI is what I was diagnosed with and I am not feeling much better with the therapy. I also feel like I’m the only thread on this forum that isn’t getting much involvement besides you which is disappointing as I’m stuck at what I should do, no matter how much I inform myself on things. I feel like a physician is going to laugh if I say I want an ASV for this so I was hoping to get more informed opinions before I go that route because I’m really not doing much better with therapy.