My initial prescription based on a titration study was a constant number.
After a couple of weeks of high AHIs I turned on auto mode and based on the data and advice from members here I narrowed the range down to a span of about 4cm and continued on auto mode. Btw the high-ish AHI was the number predicted by the titration study, but I wanted to try for AHI below 5 which I think is the goal.
I am avoiding mentioning numbers because my question is philosophical and I use other threads for detail analysis and feedback on specific data.
Today the doc (PA) said auto mode is good for zeroing in to about 95% on the therapeutic pressure and next step is to peg a constant pressure at the therapeutic level. Then he said he would advise the DME to set the pressure (never acknowledged nor asked if I was messing with it).
So I asked if they always prefer constant and he said yes it helps eliminate incidents if you remain constant at the therapeutic level.
So I am left to wonder about a few things...
.. It makes sense to me that once you know the best setting then a constant pressure level would eliminate the incidents normally required to ratchet up to therapeutic level in auto mode and thereby reduce AHI.
.. I also have observed that determining this therapeutic level takes some experimenting. My initial titration study recc was 4 cm away from today's recc based on my going rogue and setting the machine on auto. If I hadn't done that we could be six months of 60-day tweaks to arrive at this number.
.. I'm not sure we have determined it yet because my AHI is still high-ish. But I'm willing to set to the level we (i.e. my trusted apnea board experts) and my Doc PA all agree is pretty close and see if the AHI outliers go away.
So bottom line question: is the constant pressure the way to go (if it can be determined) or is auto pressure preferable while accepting that incidents are required to arrive at the optimum pressure each night to make them go away?