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Cpap Pressure Inquiry
#1
Cpap Pressure Inquiry
Hi Guys

So happy to have found this website and discovered Oscar.  Look forward to engaging with everyone : )



I was hoping for some assistance with interpreting my data. My pressure is 10-16 but I continue to get an AHI of 9-12. 

Before I adjust my pressure settings I decided to download Oscar first. From the data I've noticed every night my AHI is normal except for usually two periods where I experience a big spike (AHI of 25-34 for almost two hours). When the spike happens my pressure is 15 (while my max setting is 16). I've attached the data for you guys to see. 

My question is..

1) Would upping the pressure help? When the AHI spikes...my pressure doesn't max out at 16..it remains at 15..

2) Is it normal to have spikes like the ones I have? Is it something to be concerned about? I'm really tired throughout the day. I'm trying to remain patient though, as I've read it takes a couple months for some people to feel better. 

Any suggestions from you guys would be appreciated. Thanks guys.


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#2
RE: Cpap Pressure Inquiry
First welcome to Apnea board. Your problem is classic and has been solved time and time again on this forum. The clustering of obstructive events is the signature, and your chart could easily be an example. Please read the following wikis:
Positional apnea: http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar: http://www.apneaboard.com/wiki/index.php...cal_Collar

Pay attention to the reviews linked in the soft collar wiki. You're going to kill this, but you need a collar.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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.
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#3
RE: Cpap Pressure Inquiry
After you get the collar, it'd be great if you could post another chart. Could you revise the format a little bit? There are just a few key graphs, and if you stack them in your screenshot, it'll be easier to see what's going on:

Events
Flow rate
Pressure (not mask pressure)
Leaks
Snores.

There is no need to include other graphs in your screenshot.

I'd also suggest turning off VS2. Phillips doesn't make clear exactly what that is supposed to measure, and the flags tend to clutter up the chart.
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#4
RE: Cpap Pressure Inquiry
Thank you so much guys. Wow that made a big difference!

AHI went down significantly with your suggestion. AHI was 1.80 and 3.10 for the past two days.

I'm attaching the data you requested. Do you guys have any other suggestions? Honestly I"m super tired still. Sometimes I feel like Cpap makes me more tired then not having it on. I've read about sleep debt and hoping it's that and these adjustments will make the difference needed. Fingers crossed

Sorry. Here's my files.

last file.


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#5
RE: Cpap Pressure Inquiry
Impressive improvement and resolution of most of the positional apnea is great progress. What collar did you go with? The remaining events are mostly related to flow limitation and the BEST way to treat that would be with bilevel pressure support. If you had been issued a Resmed Airsense 10 Autoset, we would use its EPR (exhale pressure relief) to fully deal with this. The Philips machine is far less helpful, and all we have is CPAP pressure modified by Flex. For the flow limits, and associated snoring, RERA and hypopnea, the answer is an increase in minimum pressure. Start at 9.0 minimum, and increase until some of those problems resolve. If you can get a Resmed Autoset or Vauto, you would feel much more rested. I recognize your options in Canada are limited.

Your daily calendar blocks our view of the settings and other important data. Please turn it off by clicking the triangle in the date line. What is your Flex setting?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#6
RE: Cpap Pressure Inquiry
Hi

My mom had a collar she used a couple years back. It isn't very sturdy so I will look to get a better one.

Flex is at 2. Should I take it to 3?

I will also increase my minimum pressure tonight.

Here is more data as you requested.


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#7
RE: Cpap Pressure Inquiry
I don't think flex at 3 will improve things, and could make it worse. The problem is it isn't bilevel and it uses an algorithm to predict when your will take the next breath and returns pressure before you start. This causes a sync problem in a lot of people. Did I ever mention I don't particularly care for Philips machines?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#8
RE: Cpap Pressure Inquiry
That sucks. I'm assuming bilevel is a much more expensive machine. I will try to speak to my therapist and see if they can do anything...

I'm just so tired when i wake up. Hopefully things will improve over the coming month.

Anyhow thanks a lot...at least i'm under 5 AHI now : )
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#9
RE: Cpap Pressure Inquiry
The Resmed Airsense 10 Autoset is roughly the same price as Philips Dreamstation Auto CPAP, however profit margins tend to be larger on Philips, and they are very aggressive with exclusive marketing contracts and sales incentives.  Your therapist will tell you there is no difference.  We know better.  In the image below, look at the respiratory wave and the mask pressure. That is what bilevel pressure looks like, and Philips doesn't do it. Note how quickly and smoothly the Resmed responds to flow limitation and obstruction to restore normal breathing. Look at your own respiratory flow up close and see how your machine responds to minor respiratory stumbles. I'll save you the work, it doesn't until it becomes an event.

Ask your therapist if she is aware that Philips samples respiratory flow data at 5 times per second compared to Resmed's 25 times per second. Imagine running your computer 5-times faster with more data. There are many differences, and we see the results time and time again on the forum.

[Image: attachment.php?aid=9631]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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