Franko39 - Therapy Assistance

[Franko39]

Thank you for the suggestions. I'll try the EPR at 1 and report back.

Attached are the OSCAR snippets of some of my CA episodes, as well as my original sleep study.

Thanks again for your assistance!

[Franko39]

Post 2 - added sleep study photos.

[Deborah K.]

Your leaks are not too bad. They are not enough to interfere with your therapy.

[OpalRose]

I'm not sure the CA's are treatment emergent, as you show CA's on your sleep report. Have you tried EPR 1?

In addition, move your minimum pressure to 7cm.

[Gideon]

The close ups mostly show a disturbance prior to the CA events. This means those CA events are likely you holding your breath while tossing and settling back down. Not much we can do about that.

Your sleep study showed 37 minutes with oxygen at or below 88%, Medicare suggests supplemental oxygen at 5 minutes. That said any CPAP therapy typically improves on this. Are you monitoring your Oxygen SATs? Typically your doctor will not? I like to verify that CPAP therapy has resolved the low sat issue rather than just assume it has.

[Franko39]

I'm not sure the CA's are treatment emergent, as you show CA's on your sleep report.  Have you tried EPR 1?  

In addition, move your minimum pressure to 7cm.

I haven't tried EPR at 1 yet, but that's on my list to try (I've been slowing narrowing down my ideal machine settings).

Can you elaborate on why I should move the pressure min to 7?

TIA!

[OpalRose]

Just looking at your median pressure, which is closer to 7cm. If you're ok with a median pressure of 6.6, then hold steady with it.
But just make one change at a time. I am just curious to see if EPR 1 makes a difference in CA's.

Also, Gideon mentioned supplemental oxygen. Is that something you're monitoring?

[Franko39]

The close ups mostly show a disturbance prior to the CA events. This means those CA events are likely you holding your breath while tossing and settling back down.  Not much we can do about that.

Your sleep study showed 37 minutes with oxygen at or below 88%, Medicare suggests supplemental oxygen at 5 minutes.  That said any CPAP therapy typically improves on this.  Are you monitoring your Oxygen SATs?  Typically your doctor will not?  I like to verify that CPAP therapy has resolved the low sat issue rather than just assume it has.

I'm not monitoring my oxygen levels - I hadn't really focused on that TBH, as I thought the CPAP would fix it too (no doctor involved either). Would buying a pulse oximeter for myself work to monitor the low sat issue, or is there a better way to do so?

OpalRose - thanks for the additional info. I'll try EPR at 1 tonight and report back.

I had a couple more nights of data - the "CA" events were more pronounced on Sunday. I had some more severe leaks yesterday as well, unfortunately. Any suggestions/observations on this data would also be appreciated!

[Franko39]

I tried EPR at 1 last night and the CAs seem to have lessened significantly! It's only been one night, so I'll keep monitoring to confirm that this is a trend with the lower EPR - fingers crossed!

My leak rate is still kind of ugly, despite trying a chin strap (a cheap Amazon one). I've also tried mouth tape but found it uncomfortable and had troubles sleeping with it. At this point, would you suggest trying a full face mask, or letting the machine compensate for the leaks?

[OpalRose]

The leak graph looks like mouth breathing and some mask movement. It's not enough to hinder the Cpap, but does cause sleep disruptions.

Watch the type of chin strap you use. Most tend to pull the jaw back instead of up.

I know taping can be uncomfortable, but even those that use a full face mask sometimes still use tape. The other option would be a soft cervical collar that can help prop the chin/jaw from dropping open.

Are you using the Standard Response? For an experiment, change it to Soft Response for a night. This might help even out the pressure swings. And keep EPR at 1.