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[Treatment] CPAP going well, but looking for advice on further improvements
CPAP going well, but looking for advice on further improvements
Hi all,

(See bottom for my questions if you don't want to read through my entire history Big Grin )   

I've had sleeping problems for at least the last 3 years, primarily categorised by tiredness and serious amounts of brian fog. 2 years ago I did an in-lab sleep study, which found nothing, although I got 0 minutes of REM and only 3 hours of sleep. 18 months ago I did a septoplasty and turbinate reduction on advise from my ENT, which helped my sleep for several months but things eventually went back to how they were (although the inside of my nose is very clear now).

I did a Watchpat recently and had:
  • pAHI 3% = 5.8
  • pRDI = 12.0
  • pAHI 3% (REM) = 17.6
  • pRDI (REM) = 26.5
  • No centrals
I was feeling terrible and didn't want to wait for an in lab study, so bought a Resmed AirSense 10 Autoset For Her partially covered by insurance.

I started with a F30i, but found it difficult to get a good seal and woke up having some kind of mini panic attack at one point. I then tried the P30i, which sealed well, but I found it uncomfortable at higher pressures (maybe due to the structure of my nostrils? Wasn't able to figure out exactly why). I've now settled on the N30i, which feels comfortable at any pressure.

I started at settings something like 5.0-9.0, EPR 1. Higher EPR felt uncomfortable, like I wasn't breathing in enough air. Over time, I've increased the minimum and slightly decreased the maximum as I sometimes felt like I wasn't getting enough air when it was on the low end and sometimes felt like the pressure increases through the night might be waking me up. I've also increased EPR to 2 and plan to increase it to 3 once I'm comfortable.

Currently I'm at 6.8 - 8.0 EPR 2, with the For Her algorithm. My numbers seem good, but I'm still waking up a few times throughout the night, sometimes taking the mask off for a bit. I'm feeling like I have significantly less brain fog, but still a little tired.

My questions are:

1. How do my charts look overall? My numbers seem good, and although I only have the Watchpat study, it seems like I may have the settings just about right and just need to continue to get used to my APAP.


2. Do my charts show anything that might explain why I'm waking up through the night? My thoughts are that I just need to get more used to my therapy, but I wanted a second opinion. I included an image showing a somewhat-zoomed in view on one time that I woke up.
     (I did take the mask off for 1 hour unfortunately.)


3. I notice sudden flow rate spikes every 10-30 mins through the night - is this normal? I had recorded myself sleeping pre-CPAP and noticed I made these kind-of snorting sounds (usually correlated with slight SpO2 3% dips - I haven't measured my SpO2 since starting CPAP though). I've included a zoomed in image of some of these spikes.


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