Therapy optimization and CPAP tuning

[Duck020]

Hi All,

I am new to CPAP, I am now in week 3 of my therapy journey. I engaged with a local company on a CPAP trial and I have used Resmed Airsense 11 APAP and now trialing Lowenstein Prisma 20A. I think all in all I am doing OK, I seem to be snoring less and don’t fall asleep on the couch as often as I used to, however I don’t feel like I am where I want to be yet in terms of overall tiredness reduction.

With the Prisma20A I am seeing a lot more information in my charts than I could see with the Airsense11. Specifically, I have a lot of Flow Limitations and seem to be having more hypopneas but less obstructive apneas.

For the flow limitations, what is the best way to get those under control? I have seen two options:

1. Increase max pressure
   
2. Change EPR / Softpap
   

Appreciate any advice or recommendations from the community.  Also, my trial will end soon and at that time I need to decide which CPAP (APAP) to purchase, I was wondering, looking at my charts if I should be leaning in any specific direction?

   

[PeaceLoveAndPizza]

You figured it out on your own. You need more pressure and more SoftPAP. I also suggest turning off Softstart.

Try the following:

Mode APAP(std)
Min pressure 8
Max pressure 12
SoftPAP 3
Softstart off

That should help with the flow limitations and hypopnoea events. We may have to tweak further, but it will be a good start.

There is a wiki on Löwenstein machines at the following link:

https://www.apneaboard.com/wiki/index.ph...timization

As to machine choice, Löwenstein machines are quite nice. We have more experience with ResMed machines, but as Löwenstein is becoming more prevalent we are learning as we go. I see nothing abnormal in your charts that would make me choose one over the other, except for my familiarity with ResMed.

[Duck020]

Thanks for the prompt response PeaceLoveAndPizza, appreciate it.  I made some changes as you suggested and its made a big difference already.  I bumped the min pressure up to 7, not 8 but I will continue to tune it over the next few days, I didn't want to change too much at once.  

I was also recommended to change the mode from standard to dynamic - what are your thoughts on this?

After changes
   

Before changes