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In praise of self administered pressure adjustments
#1
I've been cautiously tweaking my pressure up and down for about a year. I have Encore basic, which I understand is not as detailed as Sleepyhead. Nevertheless, I was able to see that my primary issue is hypopneas (while using cpap) not apnea per se. And it was suggested here that higher pressure helps with hypopneas. In the end, after trial and error and figuring out how to make the adjustments on my machine myself, I landed on 9.5 minimum pressure. This is only a .5 increase from my last self adjusted pressure minimum. (My DME had my minimum at 8). Bingo! for more than a month, my AHI has hovered around 1. I can live with that.

Talk about fine tuning!

Moreover, my 90% pressure has gone up to 10.5 on average. Before, with a lower setting, it was hard to get my 90% up past 10. Somehow, boosting my minimum has also boosted my 90%, which is what I want. Before, with a lower minimum, I would have nights with a relatively high AHI--2.5, say-- and a 90% of 10. Why didn't the machine kick in and respond to my hypopnea events? Who knows?

So I'm happy that my cautious experimenting has paid off. I don't know that a DME can fine tune as well as a nightly user of cpap. Not because they're not qualified, but because every individual user is different and DME's can't possibly pay that kind of close attention to the hundreds of people that they see. Again, in my case a subtle fine tuning has yielded great results.
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#2
Well done! A DME is not authorized to make any pressure changes not part of a prescription, but even your doctor would be unlikely to experiment with alternatives to fully optimize therapy. So we have data and automatic machines. I think if everyone took this level of interest and responsibility for their therapy, results would be a lot better. The doctors, suppliers and sleep techs all have a place in this game, but if the patient is not the chairman of the board, it can never be as successful.
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#3
People are fond of saying the Dr knows best. Truth is you are your best advocate, and must always be as educated as you can be about everything in your treatment regimen no matter what it is. CPAP is no different. If I didn't do all I did I would never have gotten where I am.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#4
Most Drs don't seem to have the time to review an individuals results and make changes. If they have lots of patients, they get hundreds of results from DMEs downloaded from machines. You have to be your own advocate.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#5
(11-11-2016, 08:25 PM)hegel Wrote: I have Encore basic, which I understand is not as detailed as Sleepyhead.

I've used EncoreBasic to do the same kind of fine tuning you did. It worked for me, too. But there was a problem that wasn't showing up on EncoreBasic. I had to use SleepyHead to look at my leak rate graph. There I saw significant chunks of time where the leak rate was elevated. Since my chin strap didn't remedy the situation, I tried a full face mask. Since then I've felt much more rested. Those leaks were waking me up, even though the amount of time spent in large leak was considered "acceptable". This is a case where the statistics (time spent in large leak) don't tell the whole story. You have look at the actual leak data, not just the statistics that summarize that data.
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#6
Thanks for the post. This is encouraging. Since starting CPAP, I have almost no apneas, but I still have enough hypopneas to have an AHI between 5 and 6. I am going to be fine-tuning too.
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#7
Just a quick note and observation:

I use EncoreBasic to print my data off for my sleep doctor, but other than that I use SleepyHead. SleepyHead starts up and runs much quicker, is easier to use in my opinion, and provides quite a bit more data than EncoreBasic provides.

If things are going well all that extra data in SH is not needed. But even so, it may be worth switching to SH simply because it starts up and runs so much faster than EncoreBasic does.

Questions about SleepyHead?
See my Guide to SleepyHead
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