Therapy Optimization

[RavzN]

Hello all,

I was diagnosed with severe OSA (AHI 57) back in December. Since January I have been using a ResMed AirSense 10 auto to treat my apnea. For the last 4 months, my average AHI has been 4.14.

As of June, I switched to a nasal pillow mask (P30i) from a full face mask (F20) due to mask leakage, which has improved my average AHI to 3.21.

While I do feel somewhat better, I feel my apnea is not being optimally treated.

From what I've read, the CPAP device should have its minimum and maximum pressures defined and not left to auto, and by setting these pressures, it can prevent apneas from occurring.

I am hoping that from my attached data, some of you might be able to analyse it and help me with defining these pressures or providing
other recommendations.

Thanks

[jdougc]

Welcome to the forum,
Are you on any medications that affect your breathing or sleep?
Do you have any health issues that  affect your breathing or sleep?
Can you post a copy of your sleep report with your personal info redacted.

We need to see the device settings.
Your minimum pressure is too low for an adult, set it to at least 8 cm you median is slightly higher than 8 cm. 
Your Flow Limitations are too high and causing your pressure to increase throughout the night. Are you using EPR? Set EPR to 2 or 3, you might see an increase of CAs though, keep an eye on that.

Are you using lanolin to provide protection for your nostrils?

[Old Steve]

Welcome to the forum...


A minimum pressure 4cm is the pressure for a child, an adult should normally "start out" with a minimum pressure of 7cm and in your case maximum of 14cm.  Your flow limits are a bit on the high side, to help with that raise the EPR to 3.  Try these setting for a few nights than post some more charts. It is quite possible that your minimum pressure may need to be raised more. 
 Your May 20th chart appeared to show some positional apnea (apnea clusters). This will not be helped by pressure increase, but by finding a position that you do not chin tuck and close down your airway.  I have positional apnea, the only thing that worked for me was to stay off my back and sleeping on my side. There is a link lower on this page that will give you more information on positional apnea. 

Good luck with your treatment.

[RavzN]

Hello and thanks


Are you on any medications that affect your breathing or sleep? - I am using Metformin and Atorvastain 
Do you have any health issues that  affect your breathing or sleep? no
Can you post a copy of your sleep report with your personal info redacted. I will request it from my Doctor

We need to see the device settings. - I have now attached it
Your minimum pressure is too low for an adult, set it to at least 8 cm you median is slightly higher than 8 cm. Thanks - I will adjust it tonight
Your Flow Limitations are too high and causing your pressure to increase throughout the night. Are you using EPR? Set EPR to 2 or 3, you might see an increase of CAs though, keep an eye on that. Its currently set to 2

Are you using lanolin to provide protection for your nostrils? I am not - actually did not know about this, I shall get some 

[RavzN]

Welcome to the forum...


A minimum pressure 4cm is the pressure for a child, an adult should normally "start out" with a minimum pressure of 7cm and in your case maximum of 14cm.  Your flow limits are a bit on the high side, to help with that raise the EPR to 3.  Try these setting for a few nights than post some more charts. It is quite possible that your minimum pressure may need to be raised more. 
 Your May 20th chart appeared to show some positional apnea (apnea clusters). This will not be helped by pressure increase, but by finding a position that you do not chin tuck and close down your airway.  I have positional apnea, the only thing that worked for me was to stay off my back and sleeping on my side. There is a link lower on this page that will give you more information on positional apnea. 

Good luck with your treatment.

Hello - thank you for the suggestions, I wil change them out as suggested and see how it goes.

I mostly sleep on my side, but I do recall one of the nights sleeping on my back for a bit - I will pay more attention to that now