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need help adjusting settings CPAP
#1
Grin 
need help adjusting settings CPAP
Hello everyone, 

I have been using CPAP for approximately 2 months now. I was diagnosed with mild OSA with AHI of 5.7 about 2 years ago... I now know from meeting with a respiratory therapist that my real AHI is much higher and that the number recorded in my machine is not accurate. Anyways, I am sticking with it for the long haul now as my blood pressure has started to creep up and I want to be as healthy as I can be. also, the fatigue/brain fog is severe and some relief from this would also be welcomed. 

When i started, i was on pressure setting of 8-15 APAP and was not able to stay asleep. My RT mentioned that CPAP would likely suit me better rather than APAP so I switched to ranges anywhere from 6-8cm CPAP with EPR setting to 3 initially. I was able to fall asleep comfortably and stay asleep for longer than before, but i was still fatigued and felt like i was not rested the next morning. My RT then looked at the data and surmised that my pressure was not high enough and I was having obstructive events over and over again that lead to many arousals throughout the night. he suggested i try pressures anywhere from 10-12cm, also to turn EPR off as this could be contributing to my collapsed airway/loss of pressure support and report back. he also suggested that since i mouth tape to turn off humidity. the last few nights i have been doing so but have still been waking up throughout the night and feel like i got 2 hours of sleep even though i got 6-8. I will post some photos of a couple nights with lower pressure and EPR ON as well as the most recent nights with higher pressures and EPR OFF. 

My question is basically where i should go from here with the settings and pressure? I would absolutely KILL for a night without interruptions but that is seeming to feel almost impossible at this point. I will press on but i do need some help from other more experienced users. thanks to everyone in advance and please let me know if you need any further information. 

PLEASE NOTE-every one of these mornings I felt similar fatigue, restlessness and as though I was asleep for 2 hours total. thanks again. 


             
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#2
RE: need help adjusting settings CPAP
*bump*
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#3
RE: need help adjusting settings CPAP
here are the same photos with the calendar out of the way. sorry about that!

           
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#4
RE: need help adjusting settings CPAP
I posted this earlier but I don't see the reply so here goes again.

You have (on your last 2 nights) have your EPR set for ramp only. It is not doing anything with that setting. You need to turn on EPR to full time set to 3
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: need help adjusting settings CPAP
thank  you for your reply. Do you think that the EPR was therapeutic in some way? My RT had said the EPR was collapsing my airway during exhalation phase and to turn it off.
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#6
RE: need help adjusting settings CPAP
Your RT was partially correct. Your EPAP pressure controls your OAs and Hypopneas, to a certain degree. By using EPR, it reduces your set pressure by the number you set in cm H2O. This is the cause of the airway collapsing. To overcome this situation, you should increase your pressure setting to account for the EPR reduction. Currently, your pressure setting is 6-10. If you used an EPR of 3, you should set your pressure to 9-13 to compensate for the reduction of the EPR value.

I hope this makes sense.

-- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: need help adjusting settings CPAP
thank you so much for your response. I was also wondering if you had any recommendations based upon my data to suggest i need more pressure?
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#8
RE: need help adjusting settings CPAP
OK, turn off the ramp. It is not your friend. Your description makes me think you are probably sensitive to pressure changes, and this is causing arousals. Your numbers look good, so this is an attempt to get you feeling better. Either set your AS10 to CPAP mode and a pressure of 12, or set both min and max pressures to 12. Set the EPR to Full Time, and a value of 3. Take her for a snooze and see if you feel better, no change, or worse.
To recap:
  • Ramp Off
  • EPR 3 - Full time
  • Pressure to 12

Please report back here.

-- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: need help adjusting settings CPAP
here is from last night...



my mouth taping was suboptimal so more leaks than usual but i did wake up more than a couple times last night with issues with aerophagia. not a great night. picture posted below. also, i am waiting on a bleep eclipse, hopefully that helps!

My AHI may be low but I feel like I am waking up 5+ times each night feeling very uncomfortable... and am not feeling rested. My biggest priority is to be able to finally sleep through the night something I havent been able to do for years.


   
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#10
RE: need help adjusting settings CPAP
You didn't set the EPR to 3 - Full time.

-- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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