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Increased Treatment Pressure-No Noticeable Effect
#1
Hello everyone,

Over the past couple of weeks I have bumped pressure from 9 to 10 to 10.5 and to 11. The SD card report from the past 42 days, included with this post, shows about the same treatment level before and after increasing the pressure. I can't get enthusiastic about continuing to increase the pressure with my current machine. I'll be traveling over the next two weeks or so and plan to leave the pressure as is or, at the most, go up to 11.5 and maybe 12 to see if there is any improvement. Then, I will either try for approval of a new in-clinic study or obtain a used APAP machine.

Since becoming active in the forum I have a much better understanding of this apnea journey and hope to help myself and others in the long run. I three immediate family members currently using CPAP as I did for many years, "take what they give you and don't worry about details". There is also one that has been diagnosed with apnea but seldom uses the machine for various reasons. If I can help these family members in any way I will be happy.

By the way,practically every morning I feel rested when I get up and most nights I believe I sleep well. My increased pressure does not seem to cause a leakage rate problem.
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#2
Keep at it. It will be much better when you get a machine that is compatible with Sleepyhead software. I think then the folks here will be likely to help you better adjust your settings. For instance, currently it can't be gleaned whether you are having many or few Central Apnea events. Sometimes the instances of CAs can rise with increased pressures which leads to higher AHI scores.

The key lies in your last statement: "By the way,practically every morning I feel rested when I get up and most nights I believe I sleep well." While you definitely want to work toward getting your AHI under 5, the way you feel is ultimately the best test of whether the therapy is working for you.
Coffee
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#3
Stan: If that's your true name and address on the PDF attachment; I highly recommend you delete the attachment; and in the future, find a means to redact personal information for reasons of medical privacy.
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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#4
hi stanleydean,

I think you are wise to not mess with the pressure while on travel. So many other variables already come into play, you won't be able to tell much about what the effect of the pressure change is until you get back home to a stable routine again.

justmongo made a good catch on your personal data if you didn't intend publish it. If you can't edit your original post (you can for a while, then the edit button goes away) then ask a moderator for help. You can do that by clicking on the Report Post button.

The best news is you are already feeling better and getting restful sleep.

Saldus Miegas
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#5
Best way to ask for moderator help is to see who is moderating the forum by going back one level.
Moderators for this forum are: DeepBreathing, PaulaO2, Sleepster, SuperSleeper.
Then look in who is online to see if a mod is online.
At present, moderator DeepBreathing is online. A PM to a mod will get help.

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
I did a recent shift to CPAP and tried each setting from about 7 to 12, each for 3 or 4 nights. I noticed that results did not make too much sense. There is so much variability in each night that I could not see a gradual better score as I was increasing the pressure.

It is still a potentially good thing to do, and maybe if I had done this more gradually I would have seen the averages gradually diminish.

Three things I did take from this were (1) I did feel better at higher pressures of 11 and 11.5, (2) aerophagia (swallowing air) set in at 12 cmH2O, and (3) ironically higher readings at 10.5 cmH2O almost like a boundary.

Here are my trial nights and their average RDI score (AHI plus Respiratory based awakenings), in the last to first order.

Nights RDI Setting
3 6.72 C-Flex x3 CPAP Fixed 12 (cmH2O)
2 4.94 C-Flex x2 CPAP Fixed 11.5 (cmH2O)
6 2.26 C-Flex x2 CPAP Fixed 11 (cmH2O)
3 12.30 C-Flex x2 CPAP Fixed 10.5 (cmH2O)
5 4.05 C-Flex x2 CPAP Fixed 10 (cmH2O)
2 5.07 C-Flex x2 CPAP Fixed 9.5 (cmH2O)
3 6.80 C-Flex x3 CPAP Fixed 9 (cmH2O)
1 3.39 C-Flex x3 CPAP Fixed 8.5 (cmH2O)
3 7.20 C-Flex x3 CPAP Fixed 7.5 (cmH2O)

I chose to set my APAP at 11 min and 12 max A-Flex x1. Over 11 days, my RDI was 4.32, better than any of the settings I had tried with minimum set in the 5 to 8 cmH2O range.
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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#7
You said you made the changes over the past couple of weeks.

Changes should be made then data gathered over several weeks before another change is made. We usually recommend at least 10 days between changes. This is because there are soooo many variables that go into a night's worth of sleep. We look at trends, not day-by-day data. While each night's data is useful and necessary, you need to look at the larger picture when trying to determine optimum pressure ranges.

This means, yeah, it's going to take a while. But it is necessary.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#8
ya, i agree with the staff here. take it slow. gather data.
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