RE: First night with CPAP: Suggestions?
In regards to the obstructive and flow limit events, it indicates need for pressure to go up. As is you now begin at 4 due to starting pressure of 6 reduced by EPR of 2 to become 4. I would increase from 6 to 7 and see results. Your 95% reading of pressure was 7.76 indicates you were at that pressure most of the night.
If there's a leak of any sort, the machine pressure would go up to attempt to compensate. Depending on how large the leak was, it may reduce accuracy of reporting for that section of time.
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.
RE: First night with CPAP: Suggestions?
Your AHI is under 1, ignore all events. That is unless the events are actually disturbing you.
The flow limits, I have no problem with trying EPR=3, it should help with the pressure increases. Your numbers are excellent, minor changes for comfort are ok
on the mouth breathing, always work on the tongue technique. Keep the tongue on the roof of the mouth. While under pressure put tongue on the roof of the mouth,. Open your mouth, should be no air coming out, great, now lower the tongue, air coming out is expected. Now stop it. Get the tongue on the roof of the mouth and close your mouth, order is not important. Try talking, and eventually drinking. All that is practicing using the tongue technique. It took me almost a year, I guess I'm a slow learner
RE: First night with CPAP: Suggestions?
Results are very good however your high pCO3 would benefit by changing minimum pressure to 7.0 and using EPR full time at 3. I think you would realize long term improvement by using those settings.
RE: First night with CPAP: Suggestions?
(05-25-2020, 08:22 AM)SarcasticDave94 Wrote: Your 95% reading of pressure was 7.76 indicates you were at that pressure most of the night.
Please, correct me if I am wrong. I tought the 95% reading meant that 95% of the pressures recorded that night were under 7.76, which means I was at that pressure only 5% of the night, so it was an exception. Would that justify increasing the minimum to 7 (it can of course be done, it is not a huge pressure, I am asking that question just to be sure that I understand what 95% statistics mean on the software)?
RE: First night with CPAP: Suggestions?
As I understand it, the 95% pressure of X means you were at that pressure or above for 95% of the session.
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.
RE: First night with CPAP: Suggestions?
The 95% pressure is what you were at or below 95% of the time, or exceeded 5% of the time.
You do not need higher pressure for apnea therapy, this is to improve ventilation to lower CO2 by increasing EPR. A minimum pressure of 7.0 is actually 7.0/4.0 in bilevel terms, and is the lowest pressure that enables pressure support of 3.0 cm. This is in direct response to the hypoventilation diagnosis. The objective of the setting is to maximize tidal volume and reduce CO2.
05-25-2020, 09:28 AM
(This post was last modified: 05-25-2020, 09:29 AM by drmaestro.
Edit Reason: Timing
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RE: First night with CPAP: Suggestions?
I have added the 95% line to the pressure graphic (didn't know we had this option, very nice).
It seems that the pressure was over 7.76 for 2-3 times and only for short periods, so I am still inclined to think it means less than this value for 95% of the session. However, aiming for the 95% value as minimum pressure might probably decrease those events to. So, I'll try yo increase it to 7 tonight. Shall I also increase EPR to 3 at the same time or only 1 change at a time?
Edit: I wrote this message whitout seeing Sleeprider's message, so there might be overlapping info.
RE: First night with CPAP: Suggestions?
I stand corrected on what I had thought regarding 95%. Sleeprider had suggested pressure up to 7 and EPR 3, so it sounds like both at the same time.
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.
RE: First night with CPAP: Suggestions?
(05-25-2020, 09:25 AM)Sleeprider Wrote: The 95% pressure is what you were at or below 95% of the time, or exceeded 5% of the time.
You do not need higher pressure for apnea therapy, this is to improve ventilation to lower CO2 by increasing EPR. A minimum pressure of 7.0 is actually 7.0/4.0 in bilevel terms, and is the lowest pressure that enables pressure support of 3.0 cm. This is in direct response to the hypoventilation diagnosis. The objective of the setting is to maximize tidal volume and reduce CO2.
Is there a target tidal volume? I am 175 cm tall (should be around 5 ft 8 inches) and weigh around 100 kgs (220 pounds).
RE: First night with CPAP: Suggestions?
Your median tidal volume is 480 which is in the normal range, however your pCO3 is at the high range and your are indicating a concern for obesity hypoventilation syndrome. It's borderlie, however with the low pressures needed to control AHI, the settings I gave you with a minimum pressure of 7 and EPR 3 will result in maximum pressure support (EPR). I want to see if you tolerate that setting with comfort, and if so, it is the ideal settig to resolve the sleep study issues and OHS
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