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+--- Thread: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? (/Thread-Supposed-UARS-No-benefit-from-APAP-after-3-weeks-continue-to-increase-pressure)
[Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - SteveIsTired22 - 10-10-2022
24M, healthy and active, 160lbs and about 5'11, also have a pretty long and skinny neck.
**Been going on for ~2 years now**
Symptoms:
- Terrible sleep, waking up multiple times a night and often struggle to fall back asleep.
- Jaw Clenching
- GERD
- Neck and Back Pain, both skeletal and muscular. Only really noticeable at night
- Home Sleep test (WatchPat) came back with ADI: 0.9, RDI: 9.5 (remRDI : 17.0, NonRemRDI: 7.4)
- ENT saw I had an extremely deviated septum blocking around ~80% of my nasal airflow
Treatment:
- Got a Septoplasty/Turbinectomy/Nasal Stenosis repair ~2.5 months ago, breathing is 1000% better, but my sleep didn't really seem to improve much at all.
- Currently on APAP, starting on 7min 20max, with an EPR of 3. No improvement after a week so I bumped it up to 8, then after another week currently up to 8.4.
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - upsman - 10-10-2022
I would not continue to raise pressure.
Your events are mostly central, so increasing pressure may worsen them. I would however try reducing EPR to 1 cm or even disabling it.
If you've only been using PAP treatment for a short while, I would just give it some more time. You may be just experiencing treatment-emergent central apnea. Your data looks fine, but you may be able to reduce your central events a bit more.
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - Gideon - 10-10-2022
I wouldn't change a thing setting wise.
You do have a manageable mouth leak, consider taping. This is evidenced both in the leak rate and the zoomed view you provided.
Because of your COPD I would, at least periodically, monitor your O2 levels over night as a precaution.
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - SteveIsTired22 - 10-10-2022
(10-10-2022, 11:32 AM)Gideon Wrote: I wouldn't change a thing setting wise.
You do have a manageable mouth leak, consider taping. This is evidenced both in the leak rate and the zoomed view you provided.
Because of your COPD I would, at least periodically, monitor your O2 levels over night as a precaution.
I actually do tape my mouth at night, but only a relatively small piece going vertically down the middle of my lips to hold them closed. I can try using a bigger piece tonight and see if that helps with the leak at all.
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - SteveIsTired22 - 10-10-2022
Also here is my WatchPat home study I had done in case it may be of any use.
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - Psychotech - 10-10-2022
there are two thing i would suggest turn epr down to 1-2 , try a full face mask if your not claustrophobic or a hybrid mask
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - upsman - 10-10-2022
(10-10-2022, 11:32 AM)Gideon Wrote: Because of your COPD I would, at least periodically, monitor your O2 levels over night as a precaution.
I think you may have gotten the COPD part from my signature. I do monitor my 02 levels though.
I didn't see any mention of this in his post.
RE: [Supposed UARS] No benefit from APAP after 3 weeks, continue to increase pressure? - Gideon - 10-10-2022
You got me on that one (COPD)
I do stand by my suggestion for no changes, to not reduce EPR, at least based on the numbers.