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[Pressure] Can I get some help to find good settings
#1
Can I get some help to find good settings
Hello, 

I've been using my CPAP since August 2022. But no matter how much I use it, I am always exhausted throughout the day. I got diagnosed with moderate OSA (AHI 19) after an at home sleep test. I unfortunately don't have the results. I got put on 6-20 pressure and only followed up with the respiratory therapist who kept upping the min pressure to 10. Eventually, I started developing mouth leaks, so I am now sleeping with mouth tape and chin strap. My AHI has always been "good" (<5). But I always wake up exhausted and am ready to fall back asleep right away. I have to take medication for Excessive Daytime Sleepiness just to be able to function throughout the day, but even then I am tired and can fall asleep. 

I also wake up multiple times in the night. I used to be a belly sleeper, before the APAP, then a side sleeper, but now I will frequently wake up on my back. I don't feel like I'm suffocating or anything, I just come awake. Sometimes I wake up to just change which side I'm sleeping on. 

I use Resmed P10 pillows, I have tried 3 different facemasks and a nasal mask and just wasn't able to tolerate them. I have almost always been able to consistently go through the whole night with my mask on. 

I should have posted here sooner. I have tried messing around with the settings multiple times to just no benefit. I changed my settings last night after reading some of the other posts so to be able to have a baseline. Any help anyone can give would be much appreciated. 

Looking forward to your replies. Thank you so much. 

   
   
   
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#2
RE: Can I get some help to find good settings
Hi ExhaustedApe!  -  Welcome
After looking at your screenshots, I think I would try the following:
 -  Turn off the ramp feature
 -  Set your minimum pressure to 11.0 cm
 -  Set the maximum pressure to 12.6 cm
 -  Set EPR to 3

This will limit pressure change induced arousals by limiting you to a 1.6 cm pressure range.  The EPR set to 3, your device's maximum, is to treat your flow limitations.  The ramp can restrict proper therapy pressure, and can be the cause of an arousal when it ends and progresses to your treatment pressure.

Try the above and see how you feel.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#3
RE: Can I get some help to find good settings
Thank you so much for the quick reply Red! 

I will try that and report back tomorrow! Just so I understand, my ramp feature is already off. Is there a different ramp feature I have to turn off?

All the best, 
Ape
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#4
RE: Can I get some help to find good settings
It appeared in one image like you had the ramp on.   My bad!   I forgot to mention to make sure the EPR is set to Full Time, like you currently have it set to.  I'll never understand why they offer a Ramp Only option.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#5
RE: Can I get some help to find good settings
Hey Red, 

Sorry it took so long to get back. I made the changes and did a few nights to see how it would go. I still have EDS and I feel like I m sleeping a bit worse some nights. Not sure what to do. Any advice?

           
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#6
RE: Can I get some help to find good settings
It would seem that you are sensitive to pressure increases. You may wish to try a static pressure to see if this makes you feel better. I would set the pressure to 12 cm. This can be achieved by either setting the min and max to 12 cm, or switching to the CPAP mode and selecting 12 cm.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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: Can I get some help to find good settings
Thank you! Will try it tonight and check back in. Do I keep EPR on?
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#8
RE: Can I get some help to find good settings
Yes, leave it to 3.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#9
RE: Can I get some help to find good settings
Perfect, will try it!
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