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Duration of Clear Airway Events
#11
RE: Duration of Clear Airway Events
My interpretation is that the first one is misclassified. It coincides with a flow limitation; and you are flat-topping on inspiration just before it.

The second, at 2:35:30 looks "real" but is only about 10 seconds.

Looks like you have a Flex setting of 1. why would you need Flex at a pressure of 5 cm-water?
That drops your EPAP to 4. EPAP holds the airway open.

Your results are still quite good. No need to tweak if you're comfortable with it.

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#12
RE: Duration of Clear Airway Events
Yes!  The flow limitation leading to the apnea is classic.  This is obstructive.

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#13
RE: Duration of Clear Airway Events
Thank you all for your input.  I really appreciate it.
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#14
RE: Duration of Clear Airway Events
I would turn off flex if I was you and set your minimum to 6 for now to allow for proper air flow. For me, 6 would actually be not enough air. But as mentioned above, your numbers are good. You don't have to change anything if you don't want to.
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#15
RE: Duration of Clear Airway Events
Thanks Marillion.

One thing I've noticed is that sometimes, especially at the beginning of the night while I'm trying to fall asleep, it seems like the machine is just a fraction of a second behind in responding to my inhalations.  I start inhaling and then half a second later the pressure pops up to deliver the air I need.  I find it distracting and I think it prolongs the time it takes me to drift off.  

Is that what you're talking about with the Flex setting, or is it something different?
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#16
RE: Duration of Clear Airway Events
The flex setting reduces your exhalation pressure by whatever number it is set at. It is a comfort setting designed to make it easier for newer users to adapt to the machine and find it easier breathing out. The thing is, it also reduces your constant treated pressure also by whatever number it is set at. If you can try to do without it and it doesn't bother you (lower minimum pressures where you are at should not be a concern) it would help you get more air and keep the treated pressure at a more constant level.

Speaking for myself, I tend to get more CA events when I use EPR (the Resmed equivalent) so I have turned it off entirely. If you still have the "ramp" setting enabled, I would also turn that off.
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#17
RE: Duration of Clear Airway Events
Awesome, thanks for the advice.  I'm sure that some tweaks here and there will help.  All in all, it's been easier to adjust to than I feared it would be.  I'm still feeling very tired most days, but on the plus side, I'm finally actually sleeping at night instead of laying there feeling like I get a shot of adrenaline every time I started to drift off.
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#18
RE: Duration of Clear Airway Events
It will become easier and easier over time to sleep with your equipment. Before long it will be second nature and you will feel more comfortable with than without it.
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#19
RE: Duration of Clear Airway Events
flex and pressure relief are two independent things the machine does.  please read thru the post:  
http://www.apneaboard.com/forums/Thread-...#pid206250

flex can either leave you flat or seem to second guess your inhale, and is dependent on the setting but also on flow of each breath that immediately preceded it.

good luck, and I still think you are fine at current settings for the near future.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#20
RE: Duration of Clear Airway Events
as quiescence said and linked, I would turn down the a-flex, this can be sensed as a lag when a breath triggers a gradual return to full pressure (rise time)
" Respironics calls their pressure relief C-Flex, A-Flex, or C-Flex+. C-Flex lowers the pressure on exhale and quickly ramps back up to the prescribed pressure. A-Flex, available on Auto CPAP machines only, lowers the pressure on exhale and gradually increases the pressure during inhale. This allows for a more fluid breath. "
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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