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Sierra

Sierra
Joined Jul 2018
Bio

CPAP: AirSense 10 AutoSet

Max Pressure: 13 cm

Min Pressure: 12.2 cm

Ramp: Auto

Ramp Start: 9 cm

EPR: 3, Ramp Only

Mask: ResMed AirFit P10 Nasal Pillow

Canada

Sierra
Joined Jul 2018
Bio

CPAP: AirSense 10 AutoSet

Max Pressure: 13 cm

Min Pressure: 12.2 cm

Ramp: Auto

Ramp Start: 9 cm

EPR: 3, Ramp Only

Mask: ResMed AirFit P10 Nasal Pillow

Canada

I have never had a titration study done as I went straight from a home sleep test to an APAP machine. However, my understanding is that they basically increase pressure in steps until your obstructive apnea stops. And if at some pressure CA events start to show up they back off from that pressure. It is all done in one night, or in some cases half a night (split study), so not a lot of data is collected.

It is not uncommon for CPAP pressure to cause central apnea, and if you did not have an significant amount of CA during the normal sleep study (without pressure), and it shows up with pressure, then the cause is somewhat obvious.

What I have found in my case is that the data goes kind of "mushy" with no real distinct cut off where obstructive apnea stops and central apnea starts while increasing pressure. One of my theories is that hypopnea can be either CA in nature (just reduced breathing effort without a full stoppage), or OA (flow is physically restricted). So, unless you look at each event close up with the SleepyHead expanded scale feature, you don't really know what they are. I also see events close together where a CA event turns into an obstructive event.

At the end of the day, I just did extended (2 weeks) at each pressure in CPAP mode and kept track of the AHI. My objective was to find the minimum AHI, and not worry so much about the breakdown of the total. What I did find is that my ResMed AirSense 10 in Auto mode did not find the optimum pressure well, and wanted to run higher than necessary pressures. I currently use 11 cm fixed, but the Auto mode wanted to run up to 15 cm or more. I think in part it was responding to hypopnea that were really central in nature, and more pressure caused more of them, not less.

There are not many doctors or sleep technicians that are willing to take the time do do all the testing to figure this out. All the detailed data is on the SD card, and they never even want to look at the SD card. Only summary data gets sent wirelessly, not the detailed data.