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Just received CPAP, need help with titration
#1
Just received CPAP, need help with titration
Hi, I had a home sleep study which diagnosed me with mild sleep apnea AHI of 8.4 and RDI of 19.2, I just received my CPAP machine (Resmed Airsense 10 Autoset) and I was given a general pressure setting of 4-20cm H2O. I have an in-lab sleep study but it's months away due to covid and I'd like to get started on treatment as soon as I can.

Should I just start with 4-20 and see how I sleep? Could such a high pressure setting be dangerous?
Also are there other settings I should take care of?

Thanks for any replies.

Sleep report: https://imgur.com/a/ldJEUo7
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#2
RE: Just received CPAP, need help with titration
I would have you consider adding in EPR full time. Default PAP at 4-20 is not going to do much to help until you edit to make the setup your own. EPR/exhale pressure relief reduces min pressure to help with exhale and adds pressure support equal to a BPAP.

Min of 4, 5 is typically pediatric levels. 6 up more for adults in common thinking.

To do so, you'd need to follow the math logic. The default pressure 4 is the lowest your PAP can possibly go. So the math is this pressure 4 minus EPR 0 equals 4, pressure 5 minus EPR 1 equals 4, pressure 6 minus EPR 2 equals 4, pressure 7 minus EPR 3 equals 4, and so on.

Having said this, your choice but I'd try pressure 6 EPR 2 full time. Tell us how you feel with that. And get the free tool, OSCAR to see your own data. You'll need to put an SD card in the PAP before sleeping to capture data. You'll be about to Attach OSCAR screenshot to your post and we can assist better with this.

It's not guaranteed you'll reach 20, so I'd not be concerned. The machine I should be on is a ventilator that reached 50, so it's not a big deal. Other settings? Humidity about 4 Auto and see what you get. If you have a heated hose, go with about 75°F and see. And it'll be great to get one if you don't have it yet, it combats rainout that's the condensation in the tube. Options will be a hose cover and hose hanger.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Just received CPAP, need help with titration
Thank you for your input, it makes sense I'll try that.

Should I use the ramp mode or is it unnecessary?
Once I get the OSCAR data, should I post it in this thread or create another one?

Thanks again
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#4
RE: Just received CPAP, need help with titration
I'd have you consider avoiding Ramp unless you really need it to get used to PAP. Then wean yourself off. ResMed triggers ramp every session start if it's turned on. The problem with it is when Ramp expires it can cause sleep disturbance.

For continuity keep the therapy conversation and OSCAR posts here. This is your therapy thread.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Just received CPAP, need help with titration
I'll do that, thank you.
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#6
RE: Just received CPAP, need help with titration
Everything Dave has suggested is correct. You will not need the clinical sleep lab titration once you have used the machine and optimized the settings using the free Oscar software and input form the forum. Initial settings of minimum pressure 6.0, maximum pressure 12.0 and EPR full time at 2 with Ramp Off should offer enough range and be comfortable to get started.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Just received CPAP, need help with titration
Thank you all for the help, it was actually not how I thought it would be the pressure was bearable but it was a bit weird to sleep with it, I could only wear the mask for a few hours. Overall, not too bad for a first night I think. I downloaded OSCAR It would be great to have your input on the data.

OSCAR data: https://imgur.com/a/XAA5rDW
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#8
RE: Just received CPAP, need help with titration
You should be able to "Attach" your OSCAR file in a post. Just below the post textbox is the attach area. Imgur shouldn't be necessary.

See circled are in image for example. First choose file, Add Attachment, wait a second for upload in the background, then Insert into post. You should see a code [attachment=*****]
I suggest previewing before the Post Reply.

[attachment=37680]
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Just received CPAP, need help with titration
OSCAR shows a bit of flow limits but all else looks very good. Consider EPR 3 and see how this goes. However, if you're happy as is, just keep running.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Just received CPAP, need help with titration
Well done, FYI, the only chart we need is the first one, unless you have questions on another.

Click the Triangle on the calendar to minimize it or use F12 to take the screenshot which will do it for you. This is for NEXT TIME.

Your flow limits are a little rough while you are falling asleep.

I actually wouldn't change a thing. The real and most important thing now is how do you feel. Please be very critical with your response to this question, both to us and to your doc when you speak to him. Your comfort is now King.

To get better acquainted with your machine, go to bed early and watch a movie, TV, The Lions getting Slaughtered, read a book. ANYTHING that is normal to you. Do this masked up and pressurized just to get better used to the machine.
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