Cpap data

[Mazus]

Hi, I got a Resmed Airsense 10 Autoset a week ago, and probably stupidly, tried to adjust the settings to get my AHI down within the first week, since it jumped up from what the CPAP machine at the sleep study gave me, which was a 3(down from 26 on my side and 30 on my back without it, with my O2 going down to 86%), to an 8-10 at home, and I can feel the difference compared to the sleep study place. I don't know where to take the settings from here, so I figure I'd post the OSCAR data and someone could look at it. Interestingly, it seems as if as when I increased the pressure from 11-12 to 12-14, I haven't been getting up like every 2 hours to use the bathroom, which I assume is good. Anyway, here it is, attached.

[Pugsy]

Read this for future detailed report sharing. Don't need all those graphs but do need larger images of the graphs we do need.
Hide the calendar as well.
viewtopic/t158560/How-to-post-images-for-review.html

You are maxing out your max pressure setting for prolonged periods of time.
Is there any special reason you limited the max to 14?
I suggest increasing the max to 20 and see what happens. Your minimum of 12 is probably okay for now and we need to see what happens when the machine can go higher. It wants to fight but it can't fight fully with such a restricted maximum.

And yes...getting rid of the nocturia is a great boon and it means the therapy is working.
We just want it to work a little better.

[Miss Emerita]

Pugsy, what would you think about suggesting an increase in EPR, given the very active flow limitation graph?

[Pugsy]

Pugsy, what would you think about suggesting an increase in EPR, given the very active flow limitation graph?

Goes back to my usual "make one change at a time" thing if at all possible.
See what happens to those FLs once the machine can actually fight them better. Might be enough. Might not be enough but if that's the case then visit the more EPR thing along with the usual sleeping position thing as the maybe REM thing.

I like to keep it simple if I can and I also have been having problems typing long novels and explaining every little potential thing.
I just can't do it like I used to and since sometimes simple and easy works....that's why I didn't go the small novel route with all potentials. The old arthritis in my right thumb and wrist is really causing me to limit my typing when I can. This getting old isn't for sissies.

I would maybe have suggested more EPR if I was also suggesting an increase in the minimum right now because it might be needed from a simple comfort thing if someone was needing more minimum but at this point there is no proof that more minimum is needed in this situation with such a tight range.
Now if he comes back and says he limited the max because of aerophagia or something like that then for sure we increase more EPR availability since it is obvious we need more max.

[Mazus]

Hmm, yeah I guess I'll try increasing the max a bit tonight, thanks. Oh, and the EPR at 1 seems perfectly comfortable at this level so perhaps I'll leave it for now unless it bothers me. Anyway, do I make a new post, or just go back to this one if I wanted to post the data from tonight's sleep tomorrow?

[Pugsy]

Anyway, do I make a new post, or just go back to this one if I wanted to post the data from tonight's sleep tomorrow?

Keep to one thread (this one) for the time being. Makes it easier to know history and follow progress or what may have already been discussed or advised.
Also you can post random questions in this thread. Will be easier for you to keep track of as well.

[Miss Emerita]

Thanks, Pugsy. Sorry to have stressed your wrist and thumb, but as always I learned a lot!

[Mazus]

Ok, here's last night's data after the adjustment to 11-16. My AHI seems to have gone down, which is good, but it appears to still be maxing out on the pressure, so I may increase it a a bit more more next night. I just didn't want to jump it up to 20 max in one night just in case it did something weird, perhaps that's me just needlessly worrying.

Edit: Oh, and I lowered the minimum to 11 since it seems like I get kind of uncomfortable when it's 12 or above while i'm awake, maybe I'll bump the EPR up to 2 or something.

[Pugsy]

perhaps that's me just needlessly worrying.

Yep, that's what it is.
The machine won't increase the pressure without a good reason and the reason is the airway is still collapsing.

Go ahead and increase EPR if you think you are more comfortable with it but don't be afraid to open the max up. You need what you need and the machine won't go there if you don't need it.

[Mazus]

Hi, I'm a little confused as to last night's data, I set the machine to 11-20 and it seems to have maxed out on the pressure at points, but the total AHI hasn't gone down compared to the previous night. Also, I woke up with a headache. Can you guys tell what's going on?

[Pugsy]

What position do you seem to primarily be sleeping?
On your back or on your side??

Are you experiencing much nasal congestion?

Don't worry so much about the AHI right now. It's not horrible by any means and we don't sleep the same each night anyway so there might not always be a lower AHI with an increase in pressure.

[Mazus]

Ah, I'm pretty sure I'm sleeping kind of on my side on my side(well, sorta turned but not completely), but I may be sleeping on my back, since sometimes I wake up that way. Oh, and I'm also getting an Airfit f30i from the DME company due to fitting/leak issues I've been having with the Airfit f20(it's leaking at the nose bridge and blasting air into my eyes) so I'll presumably be able to sleep on my side as I normally do without the mask getting uncomfortable.

And in terms of nasal congestion, I was experiencing it when I first got the machine, but then I turned the humidity down to 1. However, it still seems to be consuming a fair amount of water from the tank per night even at that setting(it has to be going somewhere), so I may turn off the humidity completely and see what happens. What makes you ask about the nasal congestion?

[Pugsy]

What makes you ask about the nasal congestion?

Sometimes the flow reduction that goes along with nasal congestion fools the machine into thinking there are flow limitations in the airway and the machine will increase the pressure trying to fix something that isn't in the airway.
All it measures is air flow but it doesn't know where the air flow might be reduced at.
More pressure won't fix flow limitations from nasal congestion.....but the machine will sure try. So the maxing out at 20 cm might have been from nasal congestion and not necessarily airway related. Your flow limitation graph is fairly active so I was wanting to rule in or out nasal congestion causing the machine to seem to need to go to max.

Sleeping on your back is well known to increase flow limitations as well....and also worsen OSA and cause a need for more pressure.

I suspect you are most likely on your back more than you realize. That's common.
What you can do is try to rig up something to try to make sure you are on your side if at all possible and I know first hand it is easier said than done.

How did you sleep last night? Soundly for the most part or lots of arousals or awakenings?

How long did the headache last? Are you prone to having headaches in general?

Your AHI isn't really high enough to make me think a low oxygen headache IMHO. So I don't know what to make of the headache complaint at this point. Lots of things can cause headaches but sleep apnea headaches are usually low oxygen headaches.
You didn't have enough events to really impact O2 levels all that much unless something else is going on with oxygen levels that we don't know about.

[Mazus]

About the sleeping on my back, I'm guessing I wind up turning onto my back since the weight of the tube sticking out of the front of the mask winds up creating a pulling force on the mask when I'm on my side, and that's kind of uncomfortable. I can fall asleep if i position myself carefully, but I can only assume that i shift when i'm sleeping. I may use a pillow to sort of prop up the tubing so I can sleep on my side tonight, and see what happens then. With this airfit f30i thing, the tubing attaches at the top of the head, so presumably it'll be a bit different. I've also heard of people using some sort of thing to prop up the tubing over the head of their bed so it doesn't flop all over the place, so I might see what I can do there.

And I slept pretty soundly I suppose(I did wake up twice to use the bathroom though, but I otherwise wasn't restless, I feel fine aside from the headache).

I still have the headache though, and it's been a few hours, so that has me thinking it might be something else. Usually the headaches I get when I wake up(pre-cpap, as well as one night when I had an AHI of 14 despite it a few days ago, with a ton of flow limitations on the graph for some reason) go away pretty quickly. This morning/afternoon headache thing seems to have become a trend over the last few days too(forgot to mention it in the post on Wednesday, now that I think about it), so I guess I'll send a message to my doctor about it.

Also, on a note semi-related to this current topic(well, still related to CPAP), how long does it take to see general improvements from CPAP treatment? I'm more awake than I was and taking far less naps(that happened rather quickly), but my memory/focus is substantially worse than it was when I was a teenager, but I'm only 23. Well, I've snored my whole life, but my short-term memory got significantly worse pretty quickly when I was around 16, along with my parents complaining that my snoring had gotten louder, along with it seemingly sounding like I'm choking as well(I don't know why none of us thought to schedule a doctor's appointment over this). it gradually got worse after that but kind of plateaued during college(well, the year of it that I had, anyway, had to drop out). But yeah, I was kind of hoping for an improvement when I first got the machine, but have also heard that it's kind of a gradual thing.