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Has 'mild sleep apnoea' been redefined numerically?
#21
Ok now Asjb... You're in France, Sleepster's in Texas -- the twain shall never meet. He meant no offense.

So how about let's just reset this discussion?

When last I checked in with you, I suggested you increase your minimum pressure just a little. Did you do that? What are your results looking like now? Please update us with your latest statistics and we can go from there.

The only thing any of us want around here is for all of us to succeed.

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#22
(05-23-2015, 10:18 AM)Asjb Wrote:
(05-23-2015, 09:00 AM)Sleepster Wrote:
(05-23-2015, 04:21 AM)Asjb Wrote: Please could you explain why a first step to try and improve my continuing symptoms on CPAP treatment would not therefore be to start with trying to find a pressure setting that achieved an AHI of less than 5?

I agree that tweaking your pressure to try and get a lower AHI is the thing to do. That's what your doctor is doing. What I and others are saying is don't freak out because your AHI is a bit above 5.

Dear Sleepster,

You have clearly never met me. It would be accurate to say I have never <freaked out> about anything in my life...

It can be rather discouraging to ask something on this forum as a <newbie>.

I think I may not bother again.

Perhaps I should have instead said don't be disappointed because your AHI is a bit above 5.
Sleepster
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#23
(05-20-2015, 05:34 PM)retired_guy Wrote: [quote='Asjb' pid='114236' dateline='1432147312']
...and if you haven't already, tell the ramp feature to go away.

I did that, and I have had two nights of 0.0. My min pressure is 5, and ramp was 4, so... yeah, exactly.

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#24
@JV - your min 5 EPAP is like if I had a start pressure of 6, seeing that your PS=1. My machine type counts pressure by IPAP, and EPAP + PS = IPAP. Congrats on AHI of 0!

@ASJB - Sorry to hear you are still uncomfortable with the current level of well-being. As it happens, the AHI you are experiencing is also suboptimal. There are some patients consistently under AHI of 1 and still have unrested feelings and insomnia. It is safe to assume there is something else that is at play in those cases.

I have done many little adjustments that were intended to get me consistently below AHI of 5, but I have been only mildly successful. In my case, the feelings part worked out well, so I don't feel I need to hurry through the process. This week I had 4 nights under 5, and a weekly average of 4.82. Last week I had 3 nights under 5, and a weekly average of 5.07. Three weeks back I had 6 of 7 nights under 5 and an average of 2.54. So I am only about 60% successful.

I think there is high potential that PaytonA's comment may be more to the point in your case. Hypopnea (as the machines record it) seems to be directly related to flow reduction, not to obstruction. Why you have hypopnea is still in question. To me, the results you have shared suggest to me the hypopnea is an indication of non-OSA. For this reason, your idea of going to CPAP of 9 seems like a great place to start, or similar to the retired guy's suggestion - trying a band of 8 to 10 cmH2O with an EPR of 2.

A screen shot of a recent night with flow and pressure (and I would add FL flow limitations to it) would help us answer the great hypopnea question better.

Hope you soon gain the success in well-being you need and deserve.

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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#25
(05-23-2015, 09:00 AM)Sleepster Wrote:
(05-23-2015, 04:21 AM)Asjb Wrote: Please could you explain why a first step to try and improve my continuing symptoms on CPAP treatment would not therefore be to start with trying to find a pressure setting that achieved an AHI of less than 5?

I agree that tweaking your pressure to try and get a lower AHI is the thing to do. That's what your doctor is doing. What I and others are saying is don't freak out because your AHI is a bit above 5.

I think Asjb's point is that the doc is not doing anything to try and improve the treatment. Asjb is still symptomatic and the AHI could stand some improvement so why (other than mental laziness) is the doctor not taking any action at all.
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#26
(05-24-2015, 03:37 PM)PaytonA Wrote:
(05-23-2015, 09:00 AM)Sleepster Wrote:
(05-23-2015, 04:21 AM)Asjb Wrote: Please could you explain why a first step to try and improve my continuing symptoms on CPAP treatment would not therefore be to start with trying to find a pressure setting that achieved an AHI of less than 5?

I agree that tweaking your pressure to try and get a lower AHI is the thing to do. That's what your doctor is doing. What I and others are saying is don't freak out because your AHI is a bit above 5.

I think Asjb's point is that the doc is not doing anything to try and improve the treatment. Asjb is still symptomatic and the AHI could stand some improvement so why (other than mental laziness) is the doctor not taking any action at all?

Oops. Sorry, guess I hit the wrong button.
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