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Titration Suggestions? - colins22 - 02-09-2023
I am a 21 year old male who has been using a ResMed AirSense 10 set at 5-15 pressure for about a month. I have sleep apnea despite being really skinny so I assume my apnea is just due to my physical structure. After using the CPAP for a month, I have only noticed very minor improvement in my symptoms. My AHI has been below 5 which is good but I would like to get it lower. Most of my events seem to be Clear Airways. I understand it can take more time to recover and see the full benefits but I would love for someone to provide me some insight/suggestions on my machine settings to speed up the process.
Thanks for your time and please let me know if you need any more screenshots/data.
RE: Titration Suggestions? - Sleeprider - 02-09-2023
Colins22, welcome to Apnea Board. Your current therapy is 5.0 to 15.0 pressure with EPR at 3.0. The EPR (exhale pressure relief) is very similar to bilevel pressure support, which is simply the difference between the inhale and exhale pressure. Your maximum pressure rarely goes above 8.0, and all of the events on your chart are CA rather than obstructive. We would like to learn more about your diagnostic sleep study, and especially the proportion of central to obstructive events that was observed before starting therapy. We can optimize your settings to address the issues we see in these chart, and what appears to be minor CA with relatively little OA. I think you need to cut your EPR back to a setting of 1 and continue with a minimum pressure 5.0 and maximum pressure 10.0. I'm pretty sure your overall 95% IPAP pressure will be reduced and CA diminished. It's possible we will see more flow limitation, but we need to reduce the current EPR of 3.
RE: Titration Suggestions? - colins22 - 02-09-2023
(02-09-2023, 05:36 PM)Sleeprider Wrote: Colins22, welcome to Apnea Board. Your current therapy is 5.0 to 15.0 pressure with EPR at 3.0. The EPR (exhale pressure relief) is very similar to bilevel pressure support, which is simply the difference between the inhale and exhale pressure. Your maximum pressure rarely goes above 8.0, and all of the events on your chart are CA rather than obstructive. We would like to learn more about your diagnostic sleep study, and especially the proportion of central to obstructive events that was observed before starting therapy. We can optimize your settings to address the issues we see in these chart, and what appears to be minor CA with relatively little OA. I think you need to cut your EPR back to a setting of 1 and continue with a minimum pressure 5.0 and maximum pressure 10.0. I'm pretty sure your overall 95% IPAP pressure will be reduced and CA diminished. It's possible we will see more flow limitation, but we need to reduce the current EPR of 3.
Thanks for the fast response Sleeprider! I have attached my diagnostic sleep study below.
I should mention that my sleep study doesn't seem too accurate because I remember experiencing extreme insomnia and not being able to fall asleep for basically the whole night, and sleeping much into the afternoon. However the test says otherwise. I also took Remeron (a sleep aid) which could have affected my results. My doctor says my numbers would have been much higher if I would've had normal hours and not used a sleep aid. I could only include 3/6 photods from my sleep study. Let me know if you need the other pages such as the oximeter data (lowest was 79%).
Your insight and recommendations are greatly appreciated,
Colin
RE: Titration Suggestions? - Sleeprider - 02-10-2023
I'll stick with my original suggestion of minimum pressure 5.0, maximum 10 with EPR 1. The main purpose is to verify we can reduce the CA evnets with the lower EPR. Once we see results we'll go from there.
Sleep studies suck. With some luck you won't have to go through that again.