Help a newbie interpret the results?

After an app telling me I snore like a bear with a chainsaw battling a train, and a sleep test showing my oxygen levels dropping precipitously, I was prescribed a CPAP. I'm almost 4 weeks in to the trial period through the equipment vendor. The machine itself is a Dreamstation Auto CPAP, and I've tried out three masks so far. Brevida Nasal Pillow, Respironics Wisp Nasal Mask, and Respironics Nuance Nasal Pillow. I'll be trying a full face in the next few days, for when I've got some nasal congestion (allergies!). In retrospect, it was pretty foolish of me not to keep track of which mask I wore each night of the trial period, but it didn't actually occur to me until it was too late.

I'm actually finding the whole CPAP thing surprisingly easy. I got a CPAP pillow, the masks have all been relatively comfortable, I'm sleeping well, and I want to be fully compliant like a good little patient. I have my post-trial appointment with my sleep specialist coming up, and the vendor has provided me with the results of my trial. And despite fiddling around on Google, I'm having some trouble interpreting the results. I've found definitions, but not much in the way of layman-friendly descriptions and "the ideal range is X-Y" information. I'd like to not waste too much of the specialist's time by asking those questions when I go in, so I hoped perhaps someone here might be willing and able to take a peek and help me get a better idea of what I'm looking at. http://imgur.com/a/TiANK

I'm also very open to hearing any recommendations on pretty much anything CPAP you have to offer a noob!

As an aside, In this trial period, the demo tubing I was provided with AND the tubing attached to one mask were perforated by cats because they are evil little brutes. Fortunately, I discovered self-sealing silicone tape and Snugglehose.

Thanks in advance for any info or advice you're able to provide!

Hi, couple of things... you shouldn't need the ramp at all considering your low pressure setting, but at least lower the time up to pressure by a lot - 45 mins is huge just to get to 5 (or even 9). Most of us turned it off altogether in the first week.

Second, you should know that a high EPR setting (of e.g. 3 as yours is) usually ends up with a higher AHI - not by a lot, but a bit - which in your case isn't important as your #'s are still low, but something to keep in mind... do you really need it at 3?

And 3rd, not sure what program you're using, but it's all about 'compliance', something only the insce. co's care about. If you want more comprehensive data, more useful for possible future tweaks that we often do to pressure, etc. download (free) Sleepyhead software and follow the instructions re posting, etc... requires a bit of reading, but it's worth it.

http:// sleep.tnet.com/resources/sleepyhead
and the same + /shorganize (and that's not a typo).

Thanks! These settings were all entered by the vendor/consultant. Presumably to help me get used to everything. I haven't fiddled with anything except turning off the air heating and turning the humidifier up a click.

Regarding the EPR, I've found that I sometimes I at least partially exhale through my mouth - I've heard the lip-flapping recorded on my snoring app. Will a lowered EPR likely make that better or worse - or does it matter?

The vendor/consultant initially said it was likely they'd recommend the Dreamstation for me, indicating it's sort of the most popular and versatile. Is there any reason I should ask about a different model? It turns out my insurance is pretty good, so I'm not restricted to the cheapest possible or anything.

Thank you for the info! I really appreciate it.

The EPR is a 'facilitator' feature, not therapy in itself and is generally used when people have trouble exhaling against strong pressure... it is quite possible you don't need it at all, but the fact you do exhale (but not inhale?) from your mouth could mean your pressure is higher than it needs to be, but without seeing e.g. some SH reports, it's hard to say for sure what's what. The 'vendor/consultant' is called a DME - 'Durable Medical Equipment' provider and only (should, anyhow) gives you what he/she's told by the doctor, though can help with various aspects of adjustment, etc. The trouble is, while your DME might be terrific, knowledgable, etc... most are motivated by sales vs altruism, something to keep in mind, especially as many are also surprisingly ignorant about apnea and/or the equipment.

I believe the DS is a good machine, but others will probably give more info (and you should look at it, with its pix, reviews, etc on Cpap.com).

Little tip - if for any reason you try on full face masks (vs nasal) do it lying down because your face changes a lot then, changing the mask fit.

dreamstation machines don't have EPR.

No, but he's not using one yet... just expects to get one.

EPR is exhale relief on a ResMed brand machine.

He is indeed using a DreamStation machine right now on a trial basis and may well get another one full time after trial period is over.

EPR and Flex relief are both forms of exhale relief and that is where any similarities end...they go about the exhale relief in totally different manners.

DreamStation is a Respironics brand machine (which he does have right now and what the report images he shared point to) and that exhale relief is called Flex relief...A Flex when in Auto adjusting pressure mode and C Flex when in fixed pressure mode.
The setting of 3 on the Flex relief doesn't necessarily equal a 3 cm reduction in pressure. Respironics Flex relief is based on how forcefully one breathes or the flow rate and the most reduction it will offer is 2 cm drop even at the setting of 3 and then only if there is room to drop 2 cm.
Pressures need to be 6 or higher for Flex to even kick in.

Just because the ramp setting is set for 4 to start with and for 45 minutes per the report...doesn't mean that ramp is even being used...just means if it is used that is the setting. With Respironics machines the patient has to push the ramp button for ramp to kick in.
Per the Encore report that you shared....minimum pressure is 5 and max is 15.
Your AFlex setting of 3 is a moot point until/if/when your pressure goes to 6 or above anyway.
Your AHI is nice and low. Overall average pressure is 8.5 and leaks are minimal. All point to very decent therapy.
There's a lot more to the Encore software report than what you shared (which may have been all you were given).
And to be honest what you were given isn't particularly useful because they are just the summary overview graphs and not the detailed graphs.

Here's an Encore detailed report


SleepyHead is what most of us use. Same data but presented visually a little differently and without the headaches that Encore brings.
Some examples here
https://sleep.tnet.com/resources/sleepyhead/shorganize
and
viewtopic/t103468/Need-help-with-screen-shots.html

Julie wrote:No, but he's not using one yet... just expects to get one.

oh?

ZzzCatcher wrote: prescribed a CPAP. I'm almost 4 weeks in to the trial period through the equipment vendor. The machine itself is a Dreamstation Auto CPAP

Oh well... get out the handcuffs PR.

Julie wrote:Oh well... get out the handcuffs PR.

seriously? that's your reaction to someone that makes a correction?

Ramp...is a comfort feature...use it if you wish or feel the need. Personal choice. A person as to get to sleep first and foremost and if ramp use helps...hey, anything is fair game.

With Respironics machines in auto mode...when ramp is used and the airway tries to collapse the machine will suspend ramp and go about fighting the airway collapse and when that is over if there is still ramp time available it will go back to ramp.
So the old way some people think that "in ramp things aren't treated" is not true with Respironics machines when in auto mode and using ramp...it's always been this way.
Now with the new Smart Ramp that the DreamStation has available...people using fixed pressures can still get treatment if needed when using ramp and fixed pressures. Works the same as in auto mode except the pressure won't do anything other than whatever fixed parameter has been setup.

With a Respironics machine there's a separate button to push if someone wants to use ramp. Just because the clinical menu settings show ramp being on for 45 minutes doesn't mean it happens every night automatically as soon as the machine gets turned on.
A person has to push the ramp button to start ramp in addition to having it turned on in the clinical setup menu.
This is different from the way things are done with ramp and other brands of machines.
With my ResMed machines there is no separate button for turning ramp on...it's all done in the setup menu area.