1 year and still tired!

[Scott C.]

Here is last nights chart, not sure why this image isn't a link?

[ajack]

If that was my chart and used a DS, I would go to 10-15 and see if the H come down and perhaps try 11-15. The DS is slow to react. There is also a bit of mask leak with pressure, so I would do a mask fit https://www.youtube.com/watch?v=qaVDkgrRhDM

[OpalRose]

Numbers improved a tiny bit. The fact that you slept better is good. I would try this for a few days, as one day does not make a trend.

The only thing I am leary of is seeing an increase in Clear Airways. It isn't bad right now, so just keep watch.

You could try to turn the flex setting to 1 or off.

[Scott C.]

"ajack" My mistake my 90% went to 10. Not 95%.  I did mask check was green so i guess that's o.k. Might be leaking when sleeping on side. Would you still bump the min. pressure to 10? up. Max. is at 15. Or should I stay at this for a few days?

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"OpalRose" set Flex at 1 last night down from 2. I used to have it at 3. Should i reset it or go for a couple more days? I slept longer but not sure if the quality was any better. Need more time I guess. Can you tell me more about the C.A. reading, whats "normal"?

[Marillion]

It's always better to have a few days of data to let your body adjust to new settings. Unless there is something drastically wrong.

[ajack]

These numbers aren't set in stone, I would keep the 15 as max, that gives a few cm above your current max. I think you will get better numbers with 10 as a min, I know it's a jump from your 6, then 8 and now me saying 10. I think seeing better AHI numbers will give you a sense of relief. You may be able to adjust back to 9 later. I originally thought 7 may do it. People have bad nights and the cpap setting has to cover them. I'd get into the good AHI numbers and then use that setting till things settled down. There is nothing like a good AHI to make it seem all worthwhile and the DS doesn't seem to react to the H you are having with 8cm.

I would find one of bonjour's posts, he has a good mask fit tutorial in his signature. You chart shows there is work to do on leaks with pressure.

[Marillion]

Good advice by ajack above! See my signature line for Bonjour's mask fitting guide.

[Scott C.]

Thanks for the input "Marillion". Have read most of Bonjour's mask guide.  "ajack" I think it's a mouth leak,  that is why I was trying the cervical collar. last night I woke up a couple times with dry mouth. I originally had a wisp mask. then I switched to the Dreamwear mask. Thinking about trying "tape' next just to see if the leak numbers would change before changing masks again. Have a busy day tomorrow so probably keep settings the same, maybe Thanks again for all the wonderful advise.

[OpalRose]

"OpalRose" set Flex at 1 last night down from 2. I used to have it at 3. Should i reset it or go for a couple more days? I slept longer but not sure if the quality was any better. Need more time I guess. Can you tell me more about the C.A. reading, whats "normal"?

Flex is a comfort feature, and is not a true pressure relief feature as with ResMed machines.
The most pressure relief you can get with Flex, regardless of setting is 2cm drop when exhaling, and is based on flow. So go by how you feel with it.  

You may need a higher minimum pressure, but I would give it a few days to see where everything settles.  Making a pressure change every day isn't going to allow you to see a trend.

The CA's on your graph are not excessive, so no worries.  If they increased along with raising your pressure, then that could be an issue, and may be one reason turn off flex.

[quiescence at last]

whenever I change my pressure settings even a little I get a few more CAs and after a few days it stabilizes or goes away. Everybody is different.

what I like about your current settings of 8 min and 15 max is:
1. your median (50%) pressure is your setting.
2. your flow limitations went down, your RERA score is non-existent, and your H went down, and (OA+H) also went down.

I would stay running at these settings for at least another 3 days and then check if the average of 95% pressures exceed 10. I would then possibly adjust slowly to approach 95% pressure minus 2 cm. [yours for one night is 11.7, so 11.7-2 = 9.7]. My first step would be to either 8.5 or 9 as minimum.

QAL