[Pressure] Advice on pressure settings

[adeeb897]

Hello, I'm looking for any advice on finding the right pressure settings for my device. A few months ago I did an at-home sleep study, got a diagnosis/CPAP prescription, and then spent a lot of time trying to find the best settings on my own. After getting inconsistent results, I gave in and went to a sleep doctor and I got an in-lab sleep study, but so far they've just told me what I already know.

Here is my CPAP data from the last couple nights:

   
   

These are using the settings the sleep doctor recommended. Here is the last time I used the CPAP before I met with the sleep doctor, when I was playing with the settings myself.

   

[jdougc]

Welcome to the forum,
Please post a copy of the sleep report with your info redacted.
Lose the AHI chart, not helpful.
Your machine settings are not showing up and they are needed.
You need 7 1/2 to 8 hours of sleep to get effective therapy. 

How are you feeling when you wake up?
Are you on any medications that might affect your sleep or breathing?
Do you have any issues that might affect your sleep or breathing?
You may want to use your machine while reading and watching TV to get used to it and the mask.
You can left dbl on the numbers on the left side of the Flow Rate chart to zoom in and see more clearly the flow rate, If you can do that and lose the AHI chart, repost.

[adeeb897]

Here is all the information I got after my sleep study, I didn't get any charts.

TECHNICAL: The study was done using a full overnight polysomnographic montage. This includes electrooculogram, electroencephalogram, electromyogram of the chin and anterior tibialis muscles, electrocardiogram, nasal and oral airflow sensors, chest and abdominal movement sensors, pulse oximetry, snore monitor as well as body position monitor.
 
SLEEP ARCHITECTURE: Total recording time was 8.9 hours with a sleep time of 5.5 hours. Sleep efficiency was 62%. Sleep latency was 26 minutes. Neither stage REM nor stage N3 were achieved during the study. 90% of sleep time was spent in stage N2 and 10% in stage N1.
 
BEHAVIORAL ASSESSMENT: The patient slept both on his side as well as in the supine position. He achieved a score of 11 on the Epworth sleep survey and score of 0.69 on the Zung self-assessment tool. Minimal snoring was documented.
 
CARDIAC ASSESSMENT: Normal sinus rhythm was maintained with an average heart rate of 72 beats per minute. No malignant arrhythmias were noted.
 
ASSESSMENT OF LIMB MOVEMENTS: A total of 341 periodic limb movements of sleep were scored, 82 of which resulted in arousal. This was a leg movement index of 62 per hour with a leg movement arousal index of 15 events per hour. This phenomenon is of possible clinical significance.
 
RESPIRATORY ASSESSMENT: During the study, the patient was observed to suffer a total of 3 central apneas and 88 hypopneas. This extrapolates to an overall apnea-hypopnea index of 16 events per hour. Breathing-related events were associated with oxygen desaturations rating to as low as 88% as compared to a mean oxygen saturation during sleep of 95%. Prolonged periods of hypoxia were not observed.
 
IMPRESSION:
1. Moderate obstructive sleep apnea syndrome with an apnea-hypopnea index of 16 events per hour.
2. Breathing-related events were associated with oxygen desaturations ranging to as low as 88%.
3. Frequent periodic limb movements of sleep were present, and resulted in a leg movement arousal index of 15 events per hour.

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Both with and without the CPAP I always wake up with a headache and never feel rested. I am on Lexapro, which apparently can suppress REM sleep, but I've been having poor sleep way before I started taking it. I'm not sure what could be causing it - I also went to an ENT and they didn't see anything glaringly wrong. But there was one time I woke up and felt mucus in my throat making it harder to breathe, but I'm not sure if that's always the issue.

And here are the new screenshots. I tried double clicking on the Flow Rate but it didn't seem to change much. Let me know if there's anything else I should change!

   

   

   

[Deborah K.]

Your Oscar page needs some help.  Touch the fn key to copy your chart.  Usually, that shows what we need and leaves off what we don't. Make sure we can read to the very bottom of the Flow Limits.  

Right now, you have a huge number of CAs.  They could be treatment-emergent or, more likely, something else that others will interpret. Don't be discouraged.

[adeeb897]

Your Oscar page needs some help.  Touch the fn key to copy your chart.  Usually, that shows what we need and leaves off what we don't. Make sure we can read to the very bottom of the Flow Limits.  

Right now, you have a huge number of CAs.  They could be treatment-emergent or, more likely, something else that others will interpret. Don't be discouraged.  

Thanks for letting me know! Here are the updated charts, let me know if the layout is missing anything still!

   

   

   

I appreciate the help! 

[jdougc]

Charts look much better.
I was told to raise the trigger to high or highest to minimize the CAs.

[adeeb897]

Charts look much better.
I was told to raise the trigger to high or highest to minimize the CAs.

I see, I never tried changing the trigger setting, I'll try that tonight!

[adeeb897]

Looks like that helped a lot!

   

[adeeb897]

Looks like I'm able to consistently get around 5 AHI with these new settings. Thanks for the help @jdougc and @Deborah K, I'm now at a pretty good spot where I don't even necessarily have to tweak it any more so your advice has been greatly appreciated!!

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Since I'm also still getting accustomed to the mask, I'm planning to keep using these settings for a week or so to see how many more CAs/OAs can be resolved on their own.

In the meantime, if anyone sees any obvious areas for improvement please feel free to let me know!

PS: 5.0 over 5.0-20.0
Humidity Level: 5
Ramp pressure: 4
Ramp time: 45 minutes
Temperature: 28° C
TiMax: 2 seconds
TiMin: 0.3 seconds
Trigger: Very High

   

   

[Deborah K.]

It would be great if you would lower your ramp time to 10 minutes. That way, your therapy will kick in faster.