Need guidance on CPAP

[cpapmoma1]

Need guidance on CPAP

Got my sleep test in 2011 overnight in sleep lab
Knowing nothing about cpap, I was issued a brick-Resmed S9 Escape set on 8 fixed, and used that for 5 yrs.

When I got my Air Sense 10 Auto 6 mos. ago, I asked the Doc if any changes were needed to settings. He replied
"You're doing fine, and you ought to be able to find some help with that''.!!!!???? Soooo, here I am in a better place.

Had no idea what was going on before my computer guru got my Sleepyhead info. That showed big leaks until a
month ago. Now, leaks are super good and I'm hoping to get my treatment optimized now that leaks are better.

I do take some supplements for a laundry list of conditions. Can supply any other info needed including sleep test
and Doc report

Meds carvedilol-AFIB CHF
levothyroxin- thyroid surgery
eliquis=TIA
metformin- controlled diabetic
lisinopril- BP "

After thyroid surgery AHI dropped from 51 to 21 (a little obstruction going on there!)

Have had CSR at times. Probably real or not? Flow rate and flow limit show any problem?
Recently changed EPR from 2 to 1 for three nights. That did not go well. Had a CSR so scurried back to 2 EPR.
Don't know if any pressure changes might benefit or not.

I sure would appreciate input from Pugsy and any other cpap angels.

In general I usually feel pretty good- mouth breathing much improved with chinstrap and body adhesive.
sometimes sleep onset or mid night insomnia then I take a low dose melatonin and sleep in as needed

Sending one recent (6-2-18) SH report (typical with slightly higher than normal AHI) and
the two most recent with CSR (4-24-18 and 5-12-18). Thanks for your patience

[Pugsy]

I think that sometimes you need more pressure and sometimes you don't...makes you a prime candidate for the apap/auto mode.
I think auto mode with minimum of the 8 you are now using but set the max to 12 and lets just see what the machine wants to do.
Keep your EPR to what it is now since you already found out that you kinda like it. Don't blame you...I kinda like mine too.

I wouldn't worry about the CSR flagged stuff right now. Most of it is with OAs and not centrals and it might just be unstable breathing because of the OAs.

OAs and hyponeas...when you see many of those that means the pressure isn't doing a good job holding the airway open...you need more pressure. How much more is an unknown until you let the machine try to kill what it will want to kill.

Your Flow Limitation graph is also a bit active but doesn't surprise me especially with the OAs that are shown.
The airway is trying to collapse.

Let's get the OA and hyponeas reduced and then worry about the CSR stuff if you see much of it. At that time we can dig deeper to see just how scary it might look by zooming in.

[Julie]

She has other threads begun weeks ago...

[Pugsy]

She has other threads begun weeks ago...

I don't care. Don't have time to go looking for them and this one has all the information I need to respond appropriately.

To OP....do try to confine your comments to maybe just one thread because I have no idea what might have been mentioned in the other threads. So maybe try to keep this one as your current most active thread so we can have everyone's thoughts all in one place.
Makes the helping so much easier for us.

[palerider]

She has other threads begun weeks ago...

You *could* have been *helpful* and listed them... instead you just came across as snarky... and that's MY job.

[Julie]

If you insist

[RicaLynn]

She has other threads begun weeks ago...

You *could* have been *helpful* and listed them... instead you just came across as snarky... and that's MY job.

Oh PR, what would we do without you?

[cpapmoma1]

Thanks much, Pugsy.

I will be trying the pressure change and be more aware of my posting habits.


Any chance palerider has a white Stetson and a white horse hidden away somewhere?

Sleep well, folks.

[palerider]

She has other threads begun weeks ago...

You *could* have been *helpful* and listed them... instead you just came across as snarky... and that's MY job.

Oh PR, what would we do without you?

Probably much better all around. but then, I give the haters somewhere to focus their hate, which probably spares a bunch of other people

[palerider]

Any chance palerider has a white Stetson and a white horse hidden away somewhere?

Stranger things have happened

[Pugsy]

Any chance palerider has a white Stetson and a white horse hidden away somewhere?

Like he said...stranger things have happened.
He knows his stuff and speaks the truth. Just sometimes the way he speaks the truth gets him into trouble.

[palerider]

Any chance palerider has a white Stetson and a white horse hidden away somewhere?

Like he said...stranger things have happened.
He knows his stuff and speaks the truth.

There's a lot of stuff I don't know. But, unlike some people here (D.H., TedVPAP, ajack, etc), I've got a pretty good idea about the limits of my knowledge, and just keep my mouth shut when those things come around

[D.H.]

I agree that you should try APAP mode. Leave the low at 8. Try setting the high to 12 or even higher (perhaps all the way to 20 which is the machine capacity). If there you experience discomfort or more "Clear Airway" events (than before), then you lower the max until that stops.

Also, since turning down the EPR made it worse, see what turning it up does. You might not want to do both things at the same time, so that you can evaluate the effect of each without the other being in play.

Note that an AHI under 5 is generally considered "acceptable." However, a 5 means an event every twelve minutes (on average). This can't be good!

[cpapmoma1]

Actually, turning down the EPR was just a minor experiment. 2 is comfy for me for now. I'm cautious about any huge changes because some unknowns can trigger AFIB ( I think)


My AHI recently has been mostly under 2, so that's a big

[Jas_williams]

Any chance palerider has a white Stetson and a white horse hidden away somewhere?

Like he said...stranger things have happened.
He knows his stuff and speaks the truth.

There's a lot of stuff I don't know. But, unlike some people here (D.H., TedVPAP, ajack, etc), I've got a pretty good idea about the limits of my knowledge, and just keep my mouth shut when those things come around

The more I know the more I know I don't know but some people do not learn