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[Diagnosis] 1st night APAP - please comment
#1
Hi folks.
After 2 weeks on my prescribed fixed pressure of 8, last night I tried APAP mode for the first time.

I would appreciate your comments on my Sleepyhead results, as they are a little different to what I had expected.
I had expected the pressure to remain on the lower setting (6) most of the night except when an event occurred, at which time it would rise to 8 or a bit over. Max set at 9. 'Response' set to 'Standard'


My sleep test showed an AHI of 43.1 - obstructives & hypops (no centrals) - longest obstructive was 81 seconds.

Fixed pressure of 8 has been very successful, with obstructives being a rare event over the past fortnight. More nights with no obstructives than with, & on the nights when I had some it was only 1 or 2, no longer than 10 to 15 seconds.

Moving on to last night on APAP, the number of obstructives jumped to 5, 3 of which were around the 25 second mark.

Certainly the pressure ramped up on these events, but what I am puzzled about is that it also ramped up on occasions when there were no events.

Earlier in the night it ramped up for the centrals (which I believe to be 'false centrals' - which my 'DME' agreed with) but appeared to 'learn' during the night as it did not ramp up to centrals later in the night. These do not concern me, but I am puzzled by the ramping up of pressure when no events of any kind were reported. Is this normal machine behavior?

I feel like I had a good sleep, & the AHI is low enough to not be of concern, but I have woken with the slight tightness in my chest that I experienced over the first few nights of machine use, but which had dissipated as my body became accustomed to working with the pressure.

I tried APAP mode in the hope of reducing the amount the machine worked, to minimise power usage & maximise comfort, but the opposite seems the case with an increase in obstructives & a higher 95% statistical pressure.  Yes only one night I know, but given the minimal changes to pressures I'm tempted just to go back to the fixed pressure of 8.

[Image: 33805785012_c8ce5bec46_b.jpg][/url]

[url=https://flic.kr/p/SsG8PW][Image: 33119898104_56da7ccebf_b.jpg]
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#2
An AHI of 1.3 with 50/50 CA and OA is hardly bad news. Any change is going to take some time to settle and give you a baseline. There is nothing wrong with fixed pressure, but you can't compare them until you've done this about 1-week.
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#3
Ta. I’ll give it a week then. Is that primarily about me adapting to the change, or about the machine learning about me?
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#4
The machine does not learn, it operates within the settings you make according to its program. People tend to be less predictable.
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#5
(04-10-2017, 08:11 PM)Sleeprider Wrote: The machine does not learn, it operates within the settings you make according to its program.  People tend to be less predictable.

Smile  OK, I had the mistaken understanding that some machines had an AI type of 'learning' capability, recognising the user's normal breathing patterns.
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#6
2lot a degree some machines have the capability of learninghow long your breaths are and then triggering a breath after you don't breath for roo long.  That would be for some Bilevel machines.  Mo st of us do not need that level of assistence and most PAP machines do not offer that capability.

You are using 2 cmH2O of EPR 
Which mean that your pressure varies that much on each and every bresth.   
And your exhale usually is below the 6 min in your range.

Llike SleepRisee said let you body get used to the new pressure and we will rrally tweak it in.

Your numbers say you are doing very well and you do not need major changes or believe me it would have been suggested.

The goal should be twofold.
1 minimize AHI over a period of time.
2 maximize your comfort of treatment.
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#7
Thanks bonjour. Together with Sleeprider you both make sense.
I guess my experimentation is about curiosity more than any need.
As it is all will probably change again very soon when my purchased Intellipap2 machine arrives from the US.

At that point I expect I'll be returning the hired Resmed & be 'starting again' ...... I was/am hoping experience over the next 2 weeks with the Resmed might give me an idea of whether to start off with the Intellipap2 in CPAP or APAP mode but have little idea as to how much experience is transferable between different machines. Until it arrives I'm uncertain how easy/difficult it will be to put my results data up on the forum, as I believe it will not be compatible with Sleepyhead.
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#8
It has a detailed reporting system so learn which charts to reproduce. I hope it gives better charts than my orig intellepap.

I'm sure it does APAP so if you turn off EPR the resmed should be similar to the intellapap2
That's what I would do.
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#9
(04-10-2017, 09:53 PM)bonjour Wrote: It has a detailed reporting system so learn which charts to reproduce.  I hope it gives better charts than my orig intellepap.

I'm sure it does APAP so if you turn off EPR the resmed should be similar to the intellapap2
That's what I would do.

It has 3 stage EPR (Smartflex) with adjustable flow rounding - which is similar to Resmed's 'Standard/Soft' options, thank goodness!  I've tried turning off the EPR on the Resmed & *really* didn't like it.

https://www.respshop.com/manuals/LT-2305...ochure.pdf
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