New APAP user, looking for input

[cpaponyoface]

I struggled for the first few nights, but was able to keep the mask on all night last night.
My sleep test indicated an AHI3% Calculation of 66.7 per hour.

I'm not getting the impression that my provider will give my situation his full attention, so I'm here to request any suggested changes to the settings, to improve the result.

Night of April 21st

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Any feedback is appreciated

Sean

[cpaponyoface]

A new screencap of last night, hoping for some input on my settings - thanks!

Around 2:20AM I woke up and took the mask off for a few mins.

[Pugsy]

Looks like you need more minimum pressure for sure....probably around 8 cm and maybe more maximum if you find you are hitting the max very often. Though with more optimal minimum pressure you might find that the machine won't need to go to the max as often.

If you can't go from 5 minimum to 8 minimum comfortably in one step...go up in 1 cm increments and watch the data along the way.
Give yourself 3 or 4 nights at the new increased pressure so you can adjust more easily.

[cpaponyoface]

Thank you, Pugsy!
I'll try increasing the minimum tonight.

[cpaponyoface]

Upped the minimum pressure from 5 to 8 last night, see below. Additional pressure didn't bug me
Would you guys suggest running at this pressure for a period of time, or increasing minimum again, maybe to 10? Thanks

Side note, I hope this isn't a placebo - I feel great, no 3pm crash, better retention, quicker in making decisions, recovering more from this weeks workouts... list goes on.

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[Pugsy]

Stick with these settings for a few nights. The bulk of your AHI is ClearAirway/Central apnea events and more pressure won't fix those and could potentially make them worse.
If you still see this number of CAs....then I would suggest is turning off Flex exhale relief for a night and see what happens. Sometimes Flex exhale relief can be a trigger factor in central events.

I don't like making changes based on one night if at all possible or it's urgently needed.

[cpaponyoface]

Will do.

Thanks for the input

[cpaponyoface]

Last night's data is missing the flow chart. All other nights, it shows the flowchart. Any idea what would cause this?

[Pugsy]

Did you forget to put the SD card back in the machine before you went to bed or maybe it didn't get inserted fully?

Missing SD card is the most common reason for no flow rate graphs.

[cpaponyoface]

FlowChart issue resolved, must not have been fully inserted.

I've posted two more nights data. I'm considering moving my minimum up again, maybe to 9? Is this a logical move?
That said, under 5 AHI is a big change for me - feeling good.

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Thank you.

[Pugsy]

Again roughly half the AHI is CA/central apneas and more pressure won't fix those.

You are hitting the max of 12 at time when you are having obstructive stuff (OAs, hyponeas, snores, FLs) which points to the machine wanting to go higher to prevent the obstructive stuff but it can't.

Unless more max causes aerophagia I would raise the max open it up to 20 unless it causes aerophagia issues) first and see what happens and then maybe increase the minimum to 9.
If allowing the machine to go higher causes aerophagia issues then I would leave things at 12 max and just increase the minimum again.

You are real close to optimal settings both on paper and in terms of how you feel.

[cpaponyoface]

Ok, great reply.

I will increase the max to 20 and leave min for now.

Once I've done so, an aerophagia issue would be noted by waking up and burping air?

Appreciate the insight

[zonker]

Ok, great reply.

I will increase the max to 20 and leave min for now.

Once I've done so, an aerophagia issue would be noted by waking up and burping air?

Appreciate the insight

to me, aerophagia means gas trapped in the stomach which is very hard to dispel.

[Pugsy]

Aerophagia that is bad is more than just a little extra burping or farting. It can cause a very painful distention of the abdomen and the air just won't move on out and it can cause nausea and generally feeling horrible the entire next day.

If it makes you sick or hurts a lot....we don't want it.

[cpaponyoface]

Hi There,

I let things progress without making changes, until last night.
I tried the above suggestion to turn off flex exhale (mine was set on P-FLEX)

I had the best AHI score since I started using the CPAP

Questions:
It shows no CA's, where previously I had many. Can it still detect a CA with no flex exhale on?

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