newbie questions

Hi I don't know what i'm doing with CPAP machines or computers.I'm new to all of this. I just finished my 6th night with a CPAP machine. I'm tolerating the mask much better than I thought I might. I have got in 8 hours each night and haven't ripped the mask off yet. The win so far is I haven't had to get out of bed to go pee for the last 3 nights. Yea! Before it was once or usually twice per night. The myair app has showed over 20 AHI every night I've used the machine. I just got a SD card . Just downloaded OSCAR and tried to cleanup the report and post it here. Should I be below 18.96 yet? I'm happy with not having to get out of bed to pee. I just don't know what to expect about better AHI number or how long it takes to feel like you're sleeping great?
I'm glad i found this forum . Looks like a huge amount of info here. I apologize if I didn't post this correctly but I will try to do better with coaching. Thanks

Welcome to the forum.

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Are you spending much time in the middle of the night awake with mask and machine on?
Like the 4:30 to approx 5:30 time frame?

Yes...your AHI should be lower than 18.

When you had your sleep study...What was the diagnosis? What was the recommendation?

No, not awake for over a few minutes adjusting mask. I'm trying to attach sleep study. Dr just said I have sleep apnea, try CPAP, come back in 6 weeks. Can I try something different? Thanks

Try turning off EPR.
No other changes.
If you don't know how it is explained in the manual.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

If you can't get comfortable without EPR so you can't fall asleep....choose to use EPR during "ramp only" and then use the ramp feature.

Let's see if we get lucky and the centrals reduce if EPR is not used.

Turned off EPR. Slept ok. AHI lowest I've ever got! What next? Thanks for the help.

Try increasing the minimum pressure to 8 cm....this is only an effort to reduce the hyponeas or any OAs. We don't expect it to do much with the CAs/centrals.

i'm still trying to figure this all out.
after one night just below 7 AHI the next 2 were 13 then last night this 16.06 Do I drop the pressure back to 7 where I had it on my best night? Do I change something else? Do I just hope it'll get better? I've only been on this a total of 10 nights so I'm not giving up. I just hope it'll improve. Thanks for any ides.

The central apneas....those clear airway flagged events....aren't caused by pressure and changing the pressure is unlikely to make any difference in their numbers.

You need to be getting with your sleep doctor and see what his/her plan of action is going to be if those centrals don't reduce in numbers.
Sometimes they will reduce on their own and sometimes they don't....when they don't people often need a different type of machine.

Tweaking the pressures.....really only affects the hyponeas and obstructive apneas. Won't do much of anything for the central apneas.

You might take some time to try to figure out of the central apneas/ CAs are real asleep flagged events or more related to arousal/awake breathing.

http://freecpapadvice.com/sleepyhead-free-software

Well it's been 2 1/2 weeks since i started this. The obstructives are apparently fixed. What about all these centrals? Do I just keep trying and hope it gets better? The sleep doctor wants 6 weeks before we change anything.
The pessimistic part of me says after 6 weeks he'll just want another dr visit , then he'll want another sleep study, then another dr visit to discuss and prescribe something different. So my question to you guys is should I just go buy a Air curve 10 ASV or whichever model fixes centrals and try it? Are the bi-level Vauto ASV or whatever machines as automatic as this Air Sense 10 Autoset that i'm currently using?
Maybe i'm too impatient and this will all fix itself. I've read on here a lot about trying to determine if the graph results are real or just a lot of false positives from waking up. I think , yes some are false positives, but I'm guessing a lot are real. If they are real and if they don't improve it just seems like it would be faster, easier, and probably just as cheap to buy a different machine and play with it ( and hope you guys could help me dial it in) than go down the road of more doctor visits and sleep studies.
So what do you think? If i need to just keep trying what I've got longer that isn't a huge problem. I'm not sleeping as well as I'd like. I don't feel refreshed every morning like I had hoped but it's not worse than before I started cpap. And my wife likes that the machine fixed my snoring. Thanks for any ideas ,thoughts, or even criticisms.

Min pressure needs to be more like 12 to reduce the obstructives, you might need something like EERS or a different machine.

A question for the experts: it appears that xskier is going to get a boatload of centrals with a minimum pressure higher than 7. Meanwhile although the hypopneas do improve a little with increased pressure, they don't seem like as big a problem as the CAs -- the HI stays at less than 3 even at lower minima. So wouldn't a good strategy be to avoid higher pressures and stay at 7 for a while, with EPR off? That would allow for a period of time to see whether the CAs will abate. (They weren't prominent in the sleep study.)

Miss Emerita wrote: ↑

Sat Mar 14, 2020 10:42 am

A question for the experts: it appears that xskier is going to get a boatload of centrals with a minimum pressure higher than 7. Meanwhile although the hypopneas do improve a little with increased pressure, they don't seem like as big a problem as the CAs -- the HI stays at less than 3 even at lower minima. So wouldn't a good strategy be to avoid higher pressures and stay at 7 for a while, with EPR off? That would allow for a period of time to see whether the CAs will abate. (They weren't prominent in the sleep study.)

Well....the doctor is doing the "wait and see what time brings" approach. Can't say as I blame him/her because sometimes the "wait and see and give it time" thing actually does work. It is highly unlikely that the doctor is going to change their way of doing anything.

I don't think that the pressures themselves (as in if we used more minimum) will necessarily make the centrals worse.
So there probably isn't anything magical about 7 or 10 or even 12 minimum in this situation.
Probably would need an experiment with a much higher minimum to confirm my thoughts.
The machine wants to try to kill the FLs most likely...it ignores the centrals. Are the hyponeas that are seen much of a problem??? Not in the numbers per se but when seen in conjunction with the FL graph (assuming not nasal congestion related) we could maybe go way out on a long skinny limb and try to kill off the hponeas a little more and reduce the FLs and see what happens in terms of sleep quality and the data shown.

So someone could maybe experiment with more minimum and see what happens while they are in the process of "giving it time" since it is unlikely they are going to be getting a new machine anytime soon even if they are able to find an ASV and afford to pay out of pocket for it because without the doctor being on board there is no chance of insurance kicking in.

The obstructive components of the AHI amount to hyponea at 1.72 and OA of 0.23 and the unclassified is unknown and so small it really isn't much of a factor either way.
So 1.95 per hour obstructive component to that AHI. Is it worth trying to kill off....maybe...more minimum is what is needed though.
Will the more minimum make the centrals worse....don't know until it is tried but I doubt it.

Will killing off more obstructive stuff make any difference with the centrals? Unlikely IMHO but not impossible. I have seen it happen so I know it's not totally impossible.

My thoughts are....fix or try to fix what we can fix with this machine at this time and set the centrals on the back burner for now.
That would mean more minimum (and probably a lot more minimum) and see what happens with the centrals one way or the other.
If it were me....there are probably several experiments I would try while I was "giving it time" and before I would be looking to rob a bank and find an ASV machine I could buy on my own.
I would try fixed pressure of 10, 11 and 12...I would try gradually increasing the minimum and keep auto mode.

Sounds like a plan. I can increase the minimum pressure and see what happens next. Thanks.

At least it will give you something to do while "giving it time".
And miracles do happen while people are giving it time.

I was thinking about one person I helped quite a while back and every fiber in my body told me she needed ASV due to her centrals and not much obstructive stuff happening but in a wild hair moment we decided to just blast the hell out of the obstructive stuff and the centrals went away. I don't know if we had just given it enough time and they would have faded anyway...or if blasting the hell out of things was the cause...but they went away.