Therapy Help

[SueB]

I have been trying to figure out how to get a better AHI. For the first year of using CPAP, the AHI was ok. But after a year the numbers went up - the AHI has varied between 6-13 for a while now. Up until now I couldn't figure out why I was getting those numbers. 

When I looked at Oscar for the history, I saw data for the worst and best AHI. I checked the difference in settings and found that the main difference was that the EPR was turned on after the first year. I was unaware of this as the technician had made the change. So I turned the EPR off and my AHI the first night was .2! So no doubt the EPR was not good for me. Any idea of why the EPR might increase the AHI? 

I also notice that the AHI is highest in the first hour or so. I had been using ramp. I will try now without the ramp as it seems the ramp also increases the AHI. I thought these features were supposed to help but it looks like they don't work for me. Below are the graphs with EPR and without.


       

Thanks
Sue

[UnicornRider]

Welcome Sue,

    Ramp is a feature that allows new *PAP users to become accustom to the fit and feel of therapy, pressure and mask. I suggest getting rid of Ramp as soon as possible. You have dropped ramp that is good.

    When you introduced EPR-3, you increased pressure to,  Min. 7 cmH2O, Max 16.5 cmH2O
 
    I would suggest you try EPR-3 at pressure,   Min. 9.5 cmH2O, Max 16.5 cmH2O.

     Try it for a few days to get used to the fit and feel of the new levels, then repost how it feels as well as Oscar sessions.

     Do you work shift work that would delay your  APAP session start time to  after 1am?

     Do you have a reason to consistently get up before 6am?

     I did that "shift work - early rise" for family needs for decades, not fun, nor healthy.

     If you nap or catch a second sleep later in the morning or afternoon you should wear your mask and utilize the therapy APAP offers during those naps and second sleeps.

       Sleep well, let us know how it is going for you.

        Try to organize your charts with the following links:

         http://www.apneaboard.com/wiki/index.php...ganization

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[SueB]

Thanks for looking at my graphs and for providing the link for how to organize the layout. I see that the recommendation is to add Snore to the initial graphcs, but that doesn't show on my graph options. Is there a way to add the Snore graph?

Re the times showing - I do go to bed late, and I always wake up between 5 and 7 Am. At this point, I turn onto my side and  I return to sleep without the mask as my sleep apnea is positional. While I use the CPAP, I am always on my back. I know this isn't ideal but I don't turn around as I sleep so if I fall asleep on my back, I am always on my back when I wake up. So far, my O2 levels are showing as ok when I sleep on my side.

For the EPR, I think that I will leave it off for now as I don't think I need it. Is the EPR just for comfort or can it help improve the AHI if it has the right minimum level?

I am also wondering if the Sensawake on Sleepstyle can also affect the AHI? It appears that the flow limits seem to follow the Sensawake.

[LazyBones]

Snore is a feature not offered by some manufacture or models. You may not have that feature,

SenseAwake is a feature that reduces pressure when the machine thinks you are awake, to ease you back into the pressure after you fall asleep. It probably does contribute to your AHI and Flow Limits.  It should be turned off.

EPR does provide some comfort for most people, but also can contribute to better AHI. You had EPR ON and EPR Level at 3 cmH2O on your "3 Nov OSCAR Report".

I would recommend you do leave the EPR on as we try to get your pressures dialed in to the sweet spot.

You should have a clinicians' manual for your machine. look here:  https://www.apneaboard.com/adjust-cpap-p...tup-manual

Try the new settings for a few days, please note how the therapy feels, how your body feels after therapy, and post results with an OSCAR report.