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Advice for new users wanting to "tweak" settings
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jackazz76 Offline

Preferred Members

Posts: 25
Joined: Aug 2012

Machine: S9 Escape Auto
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: H5i
CPAP Pressure: 5-7 tentatively
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: North Eastern US

Post: #31
RE: Advice for new users wanting to "tweak" settings
(09-22-2012 08:59 PM)zonk Wrote:  Whats simulated apneas?

Hey Zonk (et al.), So much happening here that I abandoned this thread, apologies to the community. I held my breath for 15 seconds to see if the auto would up the pressure and it didn't until I exhaled. I've since learned (from my girlfriend) that that is not how apneas work, I have read, but since I am asleep when the events occur... have not witnessed them first hand.

I would like to set the Auto to 6-12, my advised setting is 7, but that was only after I had slept (uncomfortably of course) for about 4-5 hrs. Of course as other people say, there are a lot of variables that could affect what the ideal pressure is. It "feels" like very little pressure with the new mask (Quattro) than with my original mask (Phillips).
10-13-2012 09:00 AM
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jackazz76 Offline

Preferred Members

Posts: 25
Joined: Aug 2012

Machine: S9 Escape Auto
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: H5i
CPAP Pressure: 5-7 tentatively
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: North Eastern US

Post: #32
RE: Advice for new users wanting to "tweak" settings
(09-22-2012 11:51 AM)PaulaO2 Wrote:  And changing your pressure after only a month is not advisable. If you feel good and the AHI is below 5, don't muck with it.

PaulaO2, My AHI was usually below 3, spiking up to 6 or 7 at times. I was upping my pressure based on how I felt mostly, but also trying to reach that golden ZERO AHI that some people are able to get. After my near 1cm increase, I went from about 6 days a week of feeling "narcoleptic" down to about 1 or 2 days a week and felt a little better energy-wise.
10-13-2012 09:30 AM
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jackazz76 Offline

Preferred Members

Posts: 25
Joined: Aug 2012

Machine: S9 Escape Auto
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: H5i
CPAP Pressure: 5-7 tentatively
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: North Eastern US

Post: #33
RE: Advice for new users wanting to "tweak" settings
(09-22-2012 08:55 PM)Sleepster Wrote:  What was it that made you unhappy?

It's called CPAP-induced central apnea. You can easily tell by looking at the data whether or not it's happening to you. I doubt increasing the pressure by 0.8 cm would cause much of an effect. You could probably get almost the same increase by changing from a full face mask to a small nasal pillow.

Sleepster, Thank you... I definitely do NOT want to create more health issues for myself, I believe the apnea is actually secondary to different but possibly related health issues.

What made me unhappy is that I had not noticed any real change after about a month. Looking at the numbers from the titration study, I saw that they upped the pressure 1 at a time and I was only at my prescribed dose for maybe half an hour, like you said, I did not feel .8 would be dangerous to me. But, I should probably be a bit careful, I am not a doctor as many people here start there posts saying.

I can't do the nasal pillows, I feel air starvation when I try to push myself to only breathe through my nose. Not sure how badly deviated my septum is, but I know that I need to breathe through my mouth.
10-13-2012 09:38 AM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #34
RE: Advice for new users wanting to "tweak" settings
(10-13-2012 09:30 AM)jackazz76 Wrote:  PaulaO2, My AHI was usually below 3, spiking up to 6 or 7 at times. I was upping my pressure based on how I felt mostly, but also trying to reach that golden ZERO AHI that some people are able to get. After my near 1cm increase, I went from about 6 days a week of feeling "narcoleptic" down to about 1 or 2 days a week and felt a little better energy-wise.

Stop changing your pressure settings. Put it at the setting prescribed by your doctor and leave it there. For at least one month.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(This post was last modified: 10-13-2012 11:51 AM by Sleepster.)
10-13-2012 11:49 AM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #35
RE: Advice for new users wanting to "tweak" settings
(10-13-2012 09:30 AM)jackazz76 Wrote:  but also trying to reach that golden ZERO AHI that some people are able to get.

Keep in mind that even when your AHI is zero you can still be experiencing apneas and hypopneas, as well as other sleep disordered breathing phenenomena.

The AHI is not the end-all and be-all measurement of the treatment of sleep disordered breathing.

It's simply one relatively important indicator. Keeping the AHI measured by a CPAP machine under 5 is also just a very fuzzy indicator. That number 5 comes from the fact that an AHI under 5 as measured in a sleep study indicates that the patient doesn't qualify for CPAP therapy according to the standards set by the medical research community.

Measurements of the AHI during a sleep study are problematic because the patient is sleeping in a strange place, is hooked up to a bunch of wires and sensors, and is being monitored.

There is nothing "golden" about any specific AHI reported by a CPAP machine. You have to look at trends, and even then you have to interpret those trends with care.

People who over-interpret their AHI and adjust the pressure too often would probably be better off with a machine that doesn't report their AHI.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(This post was last modified: 10-13-2012 12:04 PM by Sleepster.)
10-13-2012 12:03 PM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #36
RE: Advice for new users wanting to "tweak" settings
As an example of over-interpreting the AHI, I've been looking at the on-screen display several times a week and seeing that sometimes the 7-day and 30-day averages are 1.2, and sometimes they're 1.3. I feel better when I see the 1.2, even though I know there is no rational basis for that feeling.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-13-2012 12:11 PM
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jackazz76 Offline

Preferred Members

Posts: 25
Joined: Aug 2012

Machine: S9 Escape Auto
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: H5i
CPAP Pressure: 5-7 tentatively
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: North Eastern US

Post: #37
RE: Advice for new users wanting to "tweak" settings
(09-24-2012 07:48 AM)jdireton Wrote:  Jack,

I'll leave the doctor bashing to others.

Your profile says you have an S9 Escape Auto. This machine doesn't collect efficacy data, only usage (compliance) data, so what are you basing your decisions on?

You also state that you had the machine set to auto 5-11 and then say you changed to CPAP 7 to 7.8. Switching your machine from Auto to CPAP is a huge change compared to just adjusting the CPAP up 0.8 cmH2O. 7 cmH2O is a fairly low treatment pressure to begin with (a good thing) so going up 7.8 shouldn't worry anyone.

Let us know some of your numbers and such. There's a lot of folks here that can share their experience and maybe give you some good advice!
Hello J, My OSA is considered mild though my study seemed pretty short to me and I spent very little time in REM. Total AHI for 338 minutes slept was 8 (told by a sleep tech friend that that is VERY low). The majority occured in NREM sleep and zero in REM (though I only had 18 minutes in REM sleep). Also the vast majority in supine position. Most incidences were Hypopneas btw.

Not sure what numbers you want to know:
stage N1 60minutes
stage N2 259 minutes
stage N3 0
stage N4 18 minutes Total sleep efficiency 83.7

latency to sleep onset and to stage 2 were very good, latency to REM was more than 3 times longer than the top of their range. I should note, I take 1mg of Xanax 4 times a day, once right before bed... seems that should even help reach a deeper sleep.

I'm 36, 5'12" (hehe, dummies) and underweight if anything at 130 lbs, though a solidly built waif I am.

Zero central, average duration 24 secs with longest at 29. SaO2 was 90% rising to 92% during short REM stage. Respiratory arousals 27 and spontaneous arousals 18. Number or awakenings 16 (yuck). Min heart rate 56, max hr 94... also says under EKG summary, in the section title "ECG Arrhythmias"... NSR, not sure what that means.

During the second study to fit for mask and titrate, I spent FAR less time on my back... so my AHI was a measly 0.3 with only one hypopnea and one apnea both when I was supine (37 minutes supine, 174 non-supine... first study was 242 supine, 96 non-supine). This ones ecg said NSR W/PVC. Seems that my titration with ONE apnea was not a very good qualifier of a typical night for me. The escape auto does show "some" data, it shows your AHI, time used as well as "mask events". It is lacking duration of event, mask leakage and central vs obstructive.

I appreciate your knowledge about there existing only one study correlating higher pressure to CSA, I'd assume roller coaster enthusiasts would all have it if that were the case... and of course the doggie that likes to hang his head out the car window. The Auto was put on by the clinician at my DME mostly because I asked him to and he said that doctors don't really understand the technology involved in "APAP", my script called for CPAP set at 7 though and that is where I changed it to.

The reason I opted against auto is that I wasn't sure it was working, yea I know, for 800 bux for a modified aerobed inflator with sleek design, it SHOULD work and I was being silly. Dont-know . Doc (pulmonologist by trade) was not in favor of auto and wanted a couple months data set at his setting and style. He does seem good, though he was even a bit hesitant to allow me to turn on the ESR function (same as C-flex).
10-13-2012 06:32 PM
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jackazz76 Offline

Preferred Members

Posts: 25
Joined: Aug 2012

Machine: S9 Escape Auto
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: H5i
CPAP Pressure: 5-7 tentatively
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: North Eastern US

Post: #38
RE: Advice for new users wanting to "tweak" settings
(10-13-2012 12:11 PM)Sleepster Wrote:  As an example of over-interpreting the AHI, I've been looking at the on-screen display several times a week and seeing that sometimes the 7-day and 30-day averages are 1.2, and sometimes they're 1.3. I feel better when I see the 1.2, even though I know there is no rational basis for that feeling.

Thanks Sleep, I wasn't being totally willy nilly, I WAS being impatient though. I gave it about a month and still felt like garbage all the time. I've been "undiagnosed" for about 10 yrs with a myriad of symptoms, some seeming neurological but that all checks out. Only other diagnosis, apart from being insane, is orthostatic HYPO-tension. Went from hard working energetic fit young lad to feeling like I'm 90 years old and broken down so I couldn't wait any longer.

If I remember right I increased it slowly too, something like .2 then waited two nights then another .2. I've got to start checking back here, it IS a great place, I've just been distracted. Posted my thread right after returning from doc and then forgot to check back in... trying to catch up on responses.
10-13-2012 06:39 PM
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jackazz76 Offline

Preferred Members

Posts: 25
Joined: Aug 2012

Machine: S9 Escape Auto
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: H5i
CPAP Pressure: 5-7 tentatively
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: North Eastern US

Post: #39
RE: Advice for new users wanting to "tweak" settings
The discussion on pressures and diving, etc are pretty fun. But from the practical standing, every full face mask has vent holes, I'm sure this relieves some of the pressure at the mask side. It seems logical to me, though my logic is often incorrect, that the diameter and shape of the tubing could also influence the mask side pressure. Some of the pressure is hitting the side of my face, the mask isn't perfectly pressurized (I don't believe). Oh yea, the practical setting, when set at 7 I sometimes get a bit air hungry... when I take a normal deep breath, it seems the machine can't really keep up with how much air I need. Someone likened the pressure of a sneeze, but what about bad hiccups or whooping cough, you intake air pretty forcefully in those instances.
10-13-2012 07:26 PM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #40
RE: Advice for new users wanting to "tweak" settings
(10-13-2012 07:26 PM)jackazz76 Wrote:  The discussion on pressures and diving, etc are pretty fun. But from the practical standing, every full face mask has vent holes, I'm sure this relieves some of the pressure at the mask side. It seems logical to me, though my logic is often incorrect, that the diameter and shape of the tubing could also influence the mask side pressure. Some of the pressure is hitting the side of my face, the mask isn't perfectly pressurized (I don't believe).

Those things do tend to affect the pressure, but the machine is designed to maintain the correct pressure despite them. But if your leak rate is exceptionally high the machine can't maintain the correct pressure. That's why it's so important to have a data-capable machine that lets you know when your leak rate is unacceptably high.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-13-2012 09:57 PM
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