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New guy needing advice
#1
New guy needing advice
Hey folks, I started CPAP about 3 months ago and absolutely love it. I have a Phillips dreamstation with a respironics dreamwear nasal pillows mask. I have been reading the wiki on here about trying to decipher all this info and its a bit overwhelming. I originally started out with a 4-20 cmh2o with a 30 minute ramp and my AHI was usually 2.5-3.5. I asked the folks that issued me the cpap about adjusting the pressures because at 4 I felt as I was struggling to get enough air and I got the "tisk tisk, you will die if you touch the pressures" speech. I started reading on here and other places and have since adjusted my machine to no ramp and I tried 8-20 with better success and recently changed from 10-17 and its a bit better. 

After looking at the pattern of changes I think I was going to maybe try 11-17 and add ramp back on because 10 is already a bit too much but still bearable. I would appreciate any help you all can provide. Here is a couple screen shots of the past few nights.


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#2
RE: New guy needing advice
Hi Lason;

You need to let your body get used to the pressure change. Run for a while at 9.5 /10 pr, (a week or so ) then raise the pr. 0.5 cm. at a time and when you get confortable with the set pr. give it another 0.5 cm. till you get to your goal. Going slowly gives you a chance to verify your charts and then see if you improve or regress on your therapy.

Better informed members will probably give you more info. on your settings ,meanwhile welcome to apnea board!

                                                
                                               Bag-head     snorybob.
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#3
RE: New guy needing advice
Your results are very good and by all means, the medical community is going to do handsprings to see results under 2.0 AHI. The chart from 8/14 tells an interesting story.  Early in the night you experience some snore, flow limits and RERA (not at an unreasonable rate), until 01:00 when pressure reaches about 13 cm. Coincidentally your median pressure.  At this point we see a much improved respiratory flow rate and a break in events until your machine starts dropping pressure at 1:30.  Shortly after that the FL and RERA is back and you even begin to have some OA...until your machine finally gets back to 13 cm again, and over-shoots to about 16 cm.  

This chart is telling you that 12.0 to 15.0 is probably pretty ideal for you.  The chart from 8/13 is a bit better, but we see a similar pattern as the machine loiters around 10-11 cm during events from 01:15 to 02:15, and again until later in the night when pressure rises again. The notable period here is from 06:00 where there are no events until pressure drops back and events pick up again at 07:20 near a pressure of 10.  

These graphs are snapshots, but the tell us what is working, and how your sleep changes through the night.  The thing you have to keep in mind is the Philips machines are slower to respond and faster to drop pressure, compared to Resmed, so the remedy is increased minimum pressure.  Overall, looks very good, but room for improvement.  


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#4
RE: New guy needing advice
Thank you both for your input. Good info about my Phillips unit. I know it wont react to every event but I did notice it seemed to have little rhyme or reason when it raised and lowered pressure but now that makes sense.
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#5
RE: New guy needing advice
Hi Lasson,
WELCOME! to the forum!
Good luck with CPAP therapy.
trish6hundred
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#6
RE: New guy needing advice
Hi Lason,
Welcome to the forum.
The Philips machines are slightly slower to respond and may have a tendency to overshoot, maybe as they are slightly slower to respond. There is not a huge difference but when I tried both machines, I did prefer the ResMed machine over the Philips. There was a couple of reasons, ResMed was slightly quieter (maybe it was just the machine I tried) but I found the humidifier are the rear of the machine was awkward for me.
The closer your lower and high pressures are the better, but the closer you are to your usual high pressure you set the machine the better. Just keep an eye on centrals creeping up, they may do at the start and then settle down as you get used to the machine, but keep an eye open for that.

As for do not adjust the pressure you might die! I should have been dead a long time ago then!!!
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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