[CPAP] How am I going?

[darksauce]

Was suggested to try out a CPAP, did a sleep study and got a AH of 10.
Starting treatment on Monday the 24th of April.
Using the Resmed 10 Autoset with a range of different masks, finding the nasal pillows difficult to exhale with. Recently using the Resmed F20 with memory foam.

I find myself not sleeping as well and for less amounts of time - perhaps just not used to treatment yet?

I've attached my first 5 days - how am I going? Any suggestions or anything noticeable?

   
   
   

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And my remaining 2 days
   
   

[Melman]

Welcome to the forum. Your AHI numbers are good but pressure fluctuations due to flow limitations may be disrupting your sleep. They are most effectively controlled by EPR. I suggest a minimum pressure of 7 with EPR of 3. Most of your events are CA which should decrease as you adjust to the therapy

[Crimson Nape]

Hi darksauce!  -  

Although your AHI seems low, two items stick out to me.  The 6 cm pressure swing, which probably are causing arousals.  The second item is your low tidal volume.  If these were my charts, I would try the following:

• Turn off the ramp - This is keeping you from your therapy pressure.
  
• Raise the minimum pressure to 11 cm. To help with the tidal volume
  
• Raise the maximum to 13 cm. This will limit to a more comfortable pressure range
  
• Set the EPR to 2. This should reduce some of the flow limitations. The downside is it may increase CAs.  If they become excessive, we can always drop it back to 1.
  
• The pressures listed above have taken the EPR of 2 into consideration.
  

If you decide to try this, see how you feel after 1 night.  Please report back either way.

- Red

[darksauce]

Thanks for your suggestion Melman!
I will try and see how it goes

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Thank you also for your suggestions Crimson Nape!

I will try them and see how they go.

[darksauce]

Thanks Melman and Crimson Nape for your suggestions yesterday.

I (admittedly) tried Crimson Nape's suggestions for last night's sleep, and the numbers were much better.

   

I had no reported CA and H, LL dropped but OA increased.
I'm still struggling to fall asleep at a reasonable time (within an hour or two), and stopped the CPAP at 5am when the mask was getting too moist in the mouth (humidity is another thing I have to play with). I may trial the Resmed N20 mask instead to combat the humidity, but I think I should be sticking to the same mask for a bit longer.

What would you suggest is a good time frame to acclimatise to a mask? I traditionally have struggled with nasal pillows because the exhalations were difficult, but I haven't tried since changing the pressures and EPR, which should relieve the exhalation flow rates.

As always, appreciate all your suggestions and advice!

[Melman]

i wouldn't be too concerned about the increase in OA. It's very small. Given that you didn't see an increase in CA I suggest you give EPR 3 a try. You had some pressure changes later in the night due to an increase in flow limitations.

[Crimson Nape]

A mask is a personal preference proposition. When you find the right one, it will immediately feel like the one you have been looking for. For me, it is the F&P line of masks. I use, or have used, the Simplus, Vitera, Brevida, and now the Evora Full Face mask. They must have been designed using a model's anatomy that is close to mine. Finding the "right" mask has to be one of the most frustrating endeavors of CPAP therapy.

As far as your events, they appear to be from a positional orientation, something like chin tucking. Also, if you haven't been told, do not to expect to have an AHI of 0.0. They can happen, but shouldn't be expected. Your current numbers are actually below the 5.0 AHI, which is considered normal.

The bottom line now is, how do you feel?

- Red

[darksauce]

Changing to EPR3 definitely helped my exhalations - I no longer felt like I was fighting.
But changing to the N20, while it physically felt comfortable on my face, my goodness, the LL..
Woke up at around 4am and slept the rest without the mask.

I initially felt groggier when I woke up, but that's probably from the lack of real sleep.
But I definitely feel like my lung capacity has increased. My breathing feels more open today - how odd

   

I'll try again with the F20 with the memory foam and dial the humidity back, as that's given me the most comfortable sleep thus far.

Appreciate all the help, as always!