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New charts !!!
#11
RE: New charts !!!
(07-12-2017, 10:31 AM)Marillion Wrote: Great progress for sure!  But I would wager if you follow the advice above you will do much better than 6 on a consistent basis.

Which info............from robysue or sleeprider?
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#12
RE: New charts !!!
yep. ajack, sleeprider, and roby sue all had good potential things to try. nearly all the past week records you up in about the 11 to 12 range for most of each and every night. I had to look at some of them close to see that the data had changed, because the nights looked so similar.

If these were mine, in light of the CAs caused in the past, I would make changes slowly. I would pick my next step as 10.5 min to 12.5 max. Increasing the max by more than 1 (to any more than 13) just wouldn't be my first move. Spending a week at each setting is not a bad move, and that is what I would do at this point.

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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#13
RE: New charts !!!
(07-12-2017, 12:36 PM)quiescence at last Wrote: yep. ajack, sleeprider, and roby sue all had good potential things to try.  nearly all the past week records you up in about the 11 to 12 range for most of each and every night.  I had to look at some of them close to see that the data had changed, because the nights looked so similar.

If these were mine, in light of the CAs caused in the past, I would make changes slowly.  I would pick my next step as 10.5 min to 12.5 max.  Increasing the max by more than 1 (to any more than 13) just wouldn't be my first move.  Spending a week at each setting is not a bad move, and that is what I would do at this point.

QAL

I'm at 9 min and 12 max. Ill change them tonight to 10 min and 12.5 max for a couple of days. This sounds good?
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#14
RE: New charts !!!
yep. and I would not expect this to have a great effect on the AHI, maybe between 5 and 9.

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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#15
RE: New charts !!!
(07-12-2017, 03:49 PM)quiescence at last Wrote: yep. and I would not expect this to have a great effect on the AHI, maybe between 5 and 9.

QAL

Yea my AHI was 9. I know not many people think this is good but from 38.4 to 9 I think is major progress.
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#16
RE: New charts !!!
(07-12-2017, 11:56 AM)trickyneedsleep Wrote:
(07-12-2017, 10:31 AM)Marillion Wrote: Great progress for sure!  But I would wager if you follow the advice above you will do much better than 6 on a consistent basis.

Which info............from robysue or sleeprider?

Both!  They are both experts.
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#17
RE: New charts !!!
(07-11-2017, 12:18 PM)robysue Wrote: trickyneedsleep,

Your usage is indeed much improved.

Your AHI numbers are still too high, but you knew that already.

I'll throw in my 2 cents of advice with some comments:

1) I don't think you have enough CAs to worry about.  Use the Flex setting that is most comfortable and natural feeling to you.

2) When posting daily data, please post the event chart. It's not showing up when I look at your images. Likewise, for some reason the scales on your SleepyHead graphs are not showing up when I look at the images. That makes it hard to evaluate the leak data.

3) The leaks appear to be well controlled until the end of the night. Any chance you tend to sleep on your back at the end of the night?

4) If you are looking for advice on how to tweak the pressures, here's what I'd do:
  • For a cautious, more slow approach, I'd bump the pressure range up to 10-14 for 3 or 4 days, and then if needed, bump it up again if the AHI doesn't come down. (My guess is that you may need several rounds of "bump the pressures up by 1cm, use them for 3-4 days, and then bump it up again" before your AHI starts to come down.)
  • For a less cautious, speedier approach, I'd use a 10-20 (or 9-20) range for 2-4 nights to see just how high the machine wants to go. It clearly wants to go higher than you are letting it go right now, and the question is how high does the machine want to go and what kinds of things drive the pressure increases?  Once you have 2-4 nights of auto-titration, we'll have enough data to make an intelligent guess as to what your min and max pressures should be set at.
Note: The only real downsides to using an APAP range of 10-20 for a few days are: (1) Increased chance of large leaks, particularly at higher pressures and (2) increased chance of triggering aerophagia problems.  If you're not having any problems with aerophagia, I'd recommend using an autotitration range of 10-20 for a few days.  If you are having problems with aerophagia, I'd recommend going slower and increasing the pressures by no more than 1cm at a time.

1. What is the FLEX setting?
2. What is aerophagia?
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#18
RE: New charts !!!
(07-13-2017, 10:28 AM)trickyneedsleep Wrote: 1. What is the FLEX setting?
2. What is aerophagia?
Flex is the exhalation relief system on PR machines. It reduces the pressure (by a variable amount) at the beginning of each exhalation, which makes it easier to exhale. Look in the clinical set up menu to see if Flex is turned off or on. If Flex is turned on, you should be able to get into a trial mode where you can compare the way Flex = 1, 2, or 3 feels and pick the one that feels the most natural to you.

Aerophagia is the fancy name for "air in the stomach". Some people (like me) have real problems with swallowing air while on xPAP. If enough air gets trapped in the stomach, it can hurt quite bad. More moderate amounts of air can lead to more burping and farting during the morning after you get up.
Questions about SleepyHead?  
See my Guide to SleepyHead
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#19
RE: New charts !!!
(07-13-2017, 08:04 AM)trickyneedsleep Wrote:
(07-12-2017, 03:49 PM)quiescence at last Wrote: yep. and I would not expect this to have a great effect on the AHI, maybe between 5 and 9.

QAL

Yea my AHI was 9. I know not many people think this is good but from 38.4 to 9 I think is major progress.

Dancing awesome - I like when I guess just close enough to call it a success.  you are truly succeeding, though.  you got this.  the same settings for tonite and another one, and hope those are closer to 5.

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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#20
RE: New charts !!!
You can adjust up slowly, there is no rush. It's heading in the right direction. I still think min 11 and max 15 is about right and I'd try it at some stage. The dreamstation can be a bit slow to react sometimes, but as you work your way up to 11, we can see if that is going to be enough.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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