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New to the board and CPAP
#1
New to the board and CPAP
Hello from Australia! I was diagnosed about ten days ago and have been using CPAP for about a week now. I've been lurking around these boards and have already learned a great deal. I am very glad I found you as my follow up from my resp physician has been zero since I chose to rent a machine through another provider.

I am slowly adjusting to sleep with the mask, and getting my head around the sleep stats and Sleepyhead (which is brilliant!), but I'm hoping the collective wisdom of the group an educate me a bit further.

My prescription is 6 and 16. I'm using a rented Resmed Autoset 10 and a Fisher and Paykel Simplus mask. Before treatment, I had an AHI of 31. Last night, and the night before, my AHI was 9. Obviously better but not low enough for my liking. Mask seal is good, no major leaks, pressure under 15.82 for 95% of the time. So, to my question: if I were to adjust my pressure settings to, say 8 and 16 or 8 and 18 would I expect to see my AHI get lower? Do some people just never achieve a 'normal' AHI on CPAP (ie is there a limit to how many events CPAP can prevent in some individuals?).

Many thanks. Smile
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#2
RE: New to the board and CPAP
I would put the minimum just below the median number and the max 2cm above your 95% number
see how it goes and post some sleepyhead charts,
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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#3
RE: New to the board and CPAP
G'day Quirkysleeper. Welcome to Apnea Board.

We'd just be guessing if we were to suggest a pressure change at this early stage. It does take a while to get used to breathing through a hose (with a plastic alien strapped to your face Shock ) though there's probably no reason you can't do better than an AHI of 9.

Can I suggest you upload a screenshot from Sleepyhead so we can work out what's going on. It could be that your pressure is too low, but it could also be that you are experiencing sleep-induced central apneas. These are not uncommon when people first go onto CPAP, but they are an indication that pressure should not be increased without a more thorough analysis.
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#4
RE: New to the board and CPAP
I'm in agreement with the others. If you can show us a screenshot of your data, it would give us a better chance than trying to take a stab in the dark.
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#5
RE: New to the board and CPAP
That isn't what I have read, the median and 95% pressure is suggested as a general pressure setting guides for APAPs, fine tuning from there could be desireable. not every apap works with sleepyhead and has full data displays. To discount it out of hand wouldn't be best practice to my mind
http://www.multidoctorshop.com/image/dat...nual-2.pdf
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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#6
RE: New to the board and CPAP
Thanks for the quick replies. This is why I didn't want to start playing with settings etc so I'm glad you guys are here.

Having some difficulty with getting a good screenshot of the charts etc, but here's a screenshot of stats from last night. I'm aware that its too early to start making judgements about the effectiveness of the settings - I'm just curious to know what factors might contribute to a reduction in AHI.


.tiff   stats 11 june.tiff (Size: 58.88 KB / Downloads: 55)
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#7
RE: New to the board and CPAP
   
...and what i can get of the charts.
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#8
RE: New to the board and CPAP
Quote:That isn't what I have read, the median and 95% pressure is suggested as a general pressure setting guides for APAPs, fine tuning from there could be desireable. not every apap works with sleepyhead and has full data displays. To discount it out of hand wouldn't be best practice to my mind
http://www.multidoctorshop.com/image/dat...nual-2.pdf

Yes, fair enough, but just setting pressures without seeing what's going on is certainly not best practice. The OP has a Resmed Airsense 10 Autoset, which does give full data and is compatible with SleepyHead. Therefore we should make use of that data to guide any decisions about pressure settings. We should also use that data to confirm there are no central apneas happening, for which pressure increases are contraindicated.

Not sure of the significance of the Resmart manual?
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#9
RE: New to the board and CPAP
To read a bit more about Sleepyhead and how to organise your screenshots, go here: http://www.apneaboard.com/wiki/index.php...SleepyHead

OK, looking at your chart I see there is a small component of central apnea, but not enough to cause any concern. You can see the pressure is butting up against the maximum limit for about an hour (00:20 to 01:20), so you should increase your maximum to around 18. At the lower end you should increase the minimum a bit so the machine can get up to pressure more quickly if it detects an event or precursor. Around 10 would be my recommendation.

As you can see, Ajack was spot-on with his suggestion! I tend to be a little bit cautious and like to see the data first - comes from being an engineer for over 40 years.
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#10
RE: New to the board and CPAP
I'm just listening to the clever chinese, it wasn't my idea Smile
I also saw he has the resmed a10, that is why I also suggested he posted his charts, which some people need to wait till the g'kids to visit

If it were me I think the med number will rise, as he closes on on his ideal pressures, and I'm guessing will be over 12. for now I would set 11 as a min and leave the max on 16. I would even be tempted to reduce max to 14 or 15 if it is uncomfortable, till I got use to the pressure.

also the OA and CA flags have been turned off in the main graph, at the top of the page.
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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