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How am I doing?
#1
How am I doing?
           
One week in.  Made the changes that were suggested by this board.
Starting pressure 6.  Ramp cut to 15 mins  Flex 2
I see improvement.  I started with a 13.5 AHI
Is there something else I should be doing?
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#2
RE: How am I doing?
It looks like snores are driving the pressure up until you hit around 14cm. I'm guessing this is where your going to end up as a minimum pressure.
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#3
RE: How am I doing?
(03-31-2018, 12:45 PM)Walla Walla Wrote: It looks like snores are driving the pressure up until you hit around 14cm. I'm guessing this is where your going to end up as a minimum pressure.

I always snored. Will that stop?

Also  I see the pressure go up due to the snores and then snores stop and pressure stays up. Is that stopping the snoring?
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#4
RE: How am I doing?
(03-31-2018, 11:53 AM)Mttnkatt Wrote: One week in.  Made the changes that were suggested by this board.
Starting pressure 6.  Ramp cut to 15 mins  Flex 2
I see improvement.  I started with a 13.5 AHI
Is there something else I should be doing?

There is something that does not seem quite right on your starting pressure and ramp. Perhaps it is a SleepyHead problem or a setup problem. First, SleepyHead thinks you have the minimum pressure set at 4 cm. If you really do set the minimum at 4 then I don't think the Ramp can even work.

Based on your data I would suggest setting your minimum pressure at 12 cm. Maintain the ramp at 15 minutes, and there should be a Ramp Start pressure setting made available. I would suggest about 7 cm for a Ramp Start Pressure. Do you have a Clinical Manual to assist you in your setup? If not, just Google "dreamstation clinical manual pdf" and you should find a link to one you can access. See pages 4-18 to 4-23 for the Clinical Menu options.

I agree with Walla Walla that you will likely end up higher for minimum, but 12 is a good start, and you could try steps up of 0.5 to determine the optimum point. I would suggest that you should be able to achieve an AHI in the 1.5 to 2.0 range once optimized.
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#5
RE: How am I doing?
Well done, your events are down and going in the right direction. However yes, there is more that can be done to improve your nights sleep.

There is a cluster of events between 4.15 and 4.45 which indicates that you may have rolled onto your back and your chin is tucking in. The pressure went up to about 18cmH2O to deal with this.

As a back sleeper myself, I had loads of clusters which I tried to prevent by training myself to fall asleep on my side. However I still would find myself on my back in the mornings. Some members advice putting an obstruction to the back to prevent this. With a soft neck collar keeping my chin up the events cluster have been eliminated. The collar also helps to keep my mouth closed as I use the nasal pillows. If you employ such a device you might find that you can reduce your upper pressure.

There are also some events occuring at lower pressures. It appears you have a flex of 2(?) This is a guess as I am not familiar with the Dreamstation but Resmed's equivalent is EPR. So with a lower level of 6cmH2O, in effect your EPAP which deals with obstructions is 4cmH2O. It appears at 5.15am to 6.15 am there are quite a few hypopneas, RERAs which may be eliminated by raising your lower pressure to at least 8 if not 9cmH2O.
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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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#6
RE: How am I doing?
Mittnkat, You should get yourself a copy of the Clinic manual for your machine. It tells you about the settings on your machine and how to access the therapy settings. Just go to the private files section for members and you can access it there. I myself am not a big fan of using Ramp. It just delays the treatment needed to prevent apneas from forming. You have to get use to the pressures sooner or later anyway best to just jump right in.

Normally snoring goes away once you have the pressure at the level needed to prevent apneas. If you decide to change pressures just hold the large knob and ramp button in for 5 seconds and the Therapy menu will appear on the screen.
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#7
RE: How am I doing?
Apnea Infant made a good point with respect to positional issues. I agree that you should increase the minimum pressure but also strongly suggest you deal with positional issues that cause you to tuck your chin toward your chest. It not only occurs when sleeping on your back but can also occur when sleeping on your side. As your chin moves down to your chest it causes a constriction in your airway which reduces flow. Compare how breathing with your chin elevated feels with how it feels with your chin is tucked down to your chest. You will notice a significant difference. A soft cervical collar which can be purchased for $10-12 locally or from Amazon will prevent your chin from tucking. It may sound uncomfortable but it's not. Another option is to use a firm pillow that can be configured to keep your head in position to prevent chin tucking. Many find a buckwheat chaff pillow to be very effective. I use both  the CPAP fit pillow ($50 from Amazon) and a soft cervical collar and have eliminated significant flow restrictions. In my case, pressure adjustments were helpful but eliminating the flow restrictions caused by flow restrictions also contributed greatly to lowering my AHI.
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